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Private Practice


Simply . . . Like Jobs. Steve Jobs . . . and Redesigning Apple

Apple logo: Wikipedia

Apple logo: Wikipedia

Simplification . . . Yes, KISS** is still good advice!

In his book, Boundaries for Leaders, Dr. Henry Cloud tells the story of Steve Jobs, who—having returned to Apple as CEO, brought clarity to the struggling organization—eventually driving success by eliminating 70% of their models and products. How did he do this? By having a clear vision of what Apple was and was not. Jobs, while sitting in a product strategy session, shouted, “Stop! This is Crazy!” and going to the whiteboard, drew a four-cell chart. “Here’s what we need,” he said—then he wrote “Consumer” and “Pro” across the top of the two columns and followed this by labeling the rows “Desktop” and “Portable.” “Their job,” he said, “was to make four great products, one for each quadrant.

Simple. Elegant. Apple. Great at what it does. Different.

Often times in business we over-think ourselves. We move, naturally, toward more complexity—believing that “more is better,” that complexity or more choices creates more value, right? But experts remind us that focus, clarity, and quality are often driven by parsimony . . . simplicity if you will . . . and may be more important than complexity. (Think of your T.V. remote. Do you really want more options?)

How about your business? Have you driven your strategic planning to parsimony? Have you achieved Job’s level of clarity? If you quizzed your board, employees, vendors, customers, would they all describe what you do in the same terms? Are you clear what and whom you are and what you are not?

One Example

At HSC, we have focused on developing this clarity and created four core products—one for each market segment and product level. This clarification of our vision has driven us to focus on continual development of these products and prevented being “distracted” by pouring energy into new ancillary products that take the focus off what we do best.

For example, a recent conversation with a business owner lead to the discussion of an “opportunity” to develop a product to help private pilots deal with the anxiety of flying—particularly the additive stresses of landing. An interesting, and tempting, thought given our background in mental health, mindfulness, and training. Should we do it? Should we invest energy in developing expertise in this “problem” and create a training to meet this need? Well, focusing on our core model helps get to an answer . . . does it focus on our customers? Not clearly. Is it a service we offer? No. So, unless we change our strategic plan, this is not an opportunity that we would pursue.

Maybe it will help you to do the same.

Like Steve Job’s example, we divided our table into two segments: our market segments and our product lines. Here’s a representation of our model for comparison:

Keynote slide on our four core products.

Keynote slide on our four core products.

Notice that we have two primary markets: Organizations (including family business) and Professionals. We also have two distinct product lines: Services and Training. Our four core products then are located in the yellow cells. cross-referenced by these four variables.

What issues are each of our core products focused on improving"?


Human Systems Consulting: There are many ways to implement a successful business plan. In almost all cases, the plans depend on people to carry them out. Our core consulting service is designed to help resolve issues related to the human element. Challenges with culture, motivation, conflict, performance . . . all the human variables that interfere with high functioning.

Team Player Skill Development: People behave as they have been conditioned to behave. Reach out your hand toward someone raised in the USA and they, involuntarily and instinctively, extend their hand toward yours. But that rationale “act” of shaking hands is not universal—it is a conditioned response. villagers in asian countries may not respond in the same way. Employees need training that does not simply “tell them” how to do something different they need to practice. Our training is to start the process of practicing new, functional behaviors that create good team functioning.


Leading Edge* Coaching: Professionals want new ways to practice and pay their bills. But most are “locked into” a health care model dependent on insurance reimbursement. We help professionals develop private practice contracts and to develop a consulting practice through personalized coaching sessions. our coaching process is designed to help identify opportunities, understand how to apply their skills and knowledge to contracting, create marketing plans, develop their fee structure and generally support professionals developing private practice contracts and consulting work.

IMPACT Model*: For professionals ready to jump into contracting and consulting, provide and introduction to the contracting/consultation process we have developed over 20 plus years, to give them a road map on how to work with organizations. We have trained professionals on our marketing/consulting model in national conferences, on-line trainings, and in person workshops.

Well, that’s it. Our four products, one in each quadrant to serve organizations and professionals.

Special note: Interested parties can check our availability for training/services by contacting us. Please note that due to demand, we typically schedule trainings a year in advance. Other services are on a first come, first served basis, and subject to the availability of a consultant at that time.

**KISS acronym for “Keep It Simple, Stupid!”



A Peek into Our . . . not Google's (sorry!) . . . Consulting Algorithm

I think a map would definitely help in this case! Photo by  Victor Garcia  on  Unsplash

I think a map would definitely help in this case! Photo by Victor Garcia on Unsplash

Just finished a post for our email subscribers about the critical need for professionals, turned consultants, to have an “algorithm,” or decision-making process, process or path, to guide them as they engage with human systems. This engagement may be in developing their private practice through contracting or by going “beyond the couch” and becoming a consultant. In plain terms, this algorithm can be boiled down to a series of questions and decision points that creates a path to follow, such as . .

HSC CONSULTING ALGORITHM: (Sample questions to ask yourself.)
1. Do I have contact with a decision maker? YES .....
NO ......

1A. If, YES, go to #2 . . .
1B If, NO, then ask to make contact or move on . . . .

2. Does the decision maker recognize a need? YES ....
NO ....

2A. If, YES, go to #3.
2B. If, NO, go to 1B.

3. Does the recognized need, require a deep understanding of the human system? YES . . .
NO . . .
3A. If, YES, go to #4.
3B. If, NO, Is the need solely training/coaching for the decision maker? YES . . .
NO . . .

3C. If 3B is YES, then seek conceptual agreement to propose training/coaching.
3D. If 3B is NO, explore the issues and how they relate to the system, then seek
further exploratory meetings or a conceptual agreement to propose

The Power of an Algorithm

The power of an algorithm like this is comes in . . . confidence. Confidence in knowing where you are in the process, what has been done already, what needs to be done next, and a process that is replicable—and can be used again and again with decision makers. This algorithm, for HSC, has developed through more than two decades of consulting work, reading the consulting literature, teaching graduate students and professionals how to do consulting, and our own publishing.

Developing this process at HSC has evolved to the point that we created our IMPACT Model of consulting and forms the core of our Competitive Edge Coaching process . . . helping mental health professionals who want to develop consulting contracts. We even created a “cheat sheet” of our process in our IMPACT Model Quick Start Guide.

Moving from Healthcare to Contracting/Consulting

For those starting, or wanting to start, this process . . . here is a place to start:

  • Recognize that this process—creating an algorithm—is helpful for getting private practice contracts that provide “health care” . . . as well as consulting with organizations. At HSC we have done both—private Employee Assistance Programs, for example, and business consulting/coaching. We use the same process for both.

  • Read everything you can get your hands on about consulting. Especially, resources coming from those who transitioned from health care to consulting since they will speak the same language and can highlight the similarities and differences.

  • Consider getting training as a coach or consultant. Training programs will decrease the time and effort to make the transition and start getting contracts. Organizations such as the International Coaching Foundation, or others, can help you get moving.

  • Adopt an “algorithm” process or plan that has worked for other consultants until you develop your own—if you ever need to. Don’t “reinvent the wheel” start by finding a template to follow then you will tweak that, or create your own, as you gain experience.

  • Be patient, but aggressive. Remember, it will take time to transition into a new product or service and to transform yourself into a new skill-set. Be realistic about your progress and not overly self-critical. Get support, find mentors, and just keep working . . . and it will be likely to happen.

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Nine Signs You are a Normal Therapist . . . and encouragement to break the mold.



In the BBC hit series, Sherlock, the protagonist, Mr. Sherlock Holmes, characteristically known by his unusual double-billed hat called a “deerstalker,” given to him by his faithful Dr. Watson, describes himself as a “consulting detective.” Further, he also describes his nemesis, James Moriarty, in similar fashion, as a “consulting criminal.” This description, of an external expert as consultant, is something we need. In the profession of mental health, we need more “consulting experts” and fewer “normal therapists.” Consulting experts . . . ready to use their knowledge and skills to assist in all kinds of venues. Medical, legal, business, government, education. Here’s why.

I’ve been a professional therapist for over 35 years. I don’t consider my journey within the profession to be that remarkable or different from the “average” or “normal” therapist. Where it has been different, has been in the things I have done outside the “normal” parameters. In working with manufacturing companies, with family-businesses, non-profit organizations, and others.

Being a “normal therapist” myself, I’ve also supervised, administered, trained, and taught hundreds of other normal therapists over the years, and . . .

Let me be blunt . . . there are a lot of things about being “normal” that, over time, will drastically increase the risk—the risk of practicing in a manner that will undermine the therapist’s life and career. Over time, doing significant damage if not understood, addressed, and overcome.

What do I mean? Well, let me tell you. I mean that I have cringed as I have heard too many therapists, often nearing the end of their careers, that don’t have good retirement savings, do not take off quality time from their practices (some skip vacations and have not had a quality vacations for years), are not in a position to financially help their children or families and who are burned out, tired, and, sometimes, defeated by the very career they chose to support and sustain them and their families.

From a business/career stand point, the normal therapist is often their own worst problem. Let me lay it out for you . . .

Nine signs of the normal therapist:

  • Believes that working for an organization is safer than working for themselves. Ah the benefits! Salary, insurance, paid time off, training budget . . . there are several aspects of working for an organization that appear to make it the safe choice. But is it? It feels like it until the the layoffs, down-sizing, closings happen. Most businesses, even Fortune 500 firms, don’t last more than about a couple generations. It’s just not as safe as you think.

  • Thinks that the most reliable way to get paid is to be dependent upon insurance reimbursements. I hear many talking about wanting to get away from insurance but most, even the experienced, see insurance as a reliable source of revenue. Okay, sure, it is. But, organizations—who provide coverage for your clients— change insurance providers. Reimbursement rates are dropped. Getting paneled becomes more limited. You either spend time chasing the payments or pay someone to chase them for you. Is this really the most reliable form of income? For me, the answer is, “No!” Contracts, several that have laster more tan 12 years in my case are far more reliable. Negotiated rates with organizations that appreciate the value you offer is far different than the insurance panels trying to minimize costs.

  • Worries that peers, or others, may think they are driven by a desire for money. Occasionally I wonder if the worst thing you could say to a “helping professional” is that they seem to be “interested in being financially successful.” Most deny this by quickly pointing to other priorities for their work. But, just because it is not their primary goal, does it mean that they don’t want to be financially successful. In most cases, “No.” However, they are uncomfortable acknowledging this. They constantly make sure that peers know, and will not judge them, by downplaying and insisting their focus is not on money.

  • Are willing to trade time for vague benefits. They are wooed by vague benefits to their own career and live based on hopes reaping “marketing benefits,” unplanned “giving back” to the community or profession, and “just a good experience. They accepting being on call, providing free phone support, writing letters, and other tasks without much, if any, benefit to their business. I’m not suggesting that none of these things should happen—circumstance dependent, any and all of these may be appropriate or necessary; my point is, that the normal therapist simply does this, and accepts doing it, because it has been the standard practice historically.

  • Makes excuses about the unsavory elements of their career rather than working to change them. Long term complaints about hating paperwork, insurance, no shows, without taking assertive steps to remove those things from their business life. Most will simply accept these things as part of the profession rather than re-examining their utility in today’s environment or seek other forms of practice that minimize or eliminate some of these elements.

  • Constantly seeks to reassure themselves that they are competent. I hate to say it, but a majority of normal therapists have a lot of self-doubt. Just like the college student taking Psych 101 and wondering if the symptoms described in class men that they have a certain diagnosis, therapists, perhaps due to the personal intensity of their studies or primal interest, often give marquee attention to their weaknesses or deficits rather than their strengths. Few feel confident that they “know enough” or are an “expert” beyond a narrow and specifically trained knowledge base and skill-set. Yet, in truth, their life-experiences, knowledge, and training make their utility much more broad then they imagine.

  • Doesn’t take risks, even small ones, that could provide significant improvements in their career. You’ve probably heard the old joke, “How many therapists does it take to change a light bulb?*” How about the correlary, “How many therapists . . . will change.” Therapists tend to play it safe. Leaps of faith for the sake of their career are rare. This includes wisely spending money to increase the likelihood of progressing in their careers. So, they go to mediocre trainings, don’t pay for supervision to gain expertise, do not spend money to learn new processes or products that could make their practice stand out and separate them from other providers.

  • Follows the rules. While their are pioneers in our field, out there breaking new ground, as a group, therapists are prone to follow the “tried and true” of that the profession has dictated health care “is.” There are few “disrupters” or “contrarians” as a rule in the group and thus not much innovation. Tendencies run more toward “am I doing it right?” and against, “could it be done better?”

  • Feels victimized by outside sources. Let’s face it colleagues. We often “play the victim.” Whether it is society, insurance companies, culture, history, etc. there is often a stain of helplessness norms in our thinking. These professionals, among the highest educated and trained people in the world, feel trapped and powerless by forces outside their control. We may seek to liberate others from the forces that we fear may be in fact constricting our own trajectory.

Professionals that stay trapped in this normative mindset may have an adequate, or even good, careers. Many do. They will, however, be subject to operating within the confines of the health care system and their own perceived limitation of their profession. The tragedy of this is that their are no “consulting therapists” in daycare centers, oncology offices, pediatrician practices, legal firms, or on family business boards—among many other places where they could provide significant benefits. More sadly, most professionals have never even asked themselves the question, “Could they benefit from my consulting?” Thus, the inquiry is never made. No discussions take place. No services are defined or contracts completed . . . and no help is available.

Do you see these signs in our profession? How does it affect the careers of your colleagues? How many of the nine traits influence your thinking?

As a profession, we need to focus on becoming more entreprenurial, taking a broad view of our capabilities, and turning those into non-traditional areas that could use our help. IN as sense, we need to see our selves as “consulting professionals” and not just therapists. Are you ready? If so, grab your “deerstalker” and let’s go. The game is afoot, dear Watson.

Ready to be abnormal? Share our post, make a comment, or more than one, and include in your comments how you shared the post, and you will be entered in a drawing for a digital copy of our book Beyond the Couch: Turning your behavioral health degree into cash without losing your soul and other prizes. To encourage comments, we will give away one copy of the book for every 10 comments. So, even if you already have it, or are not interested in the book for yourself, you can tell us who you’d like to give to or we will give it away for you!

*So, how many therapists does it take to change a light build? “Only one, but the light bulb has to want to change.”



If you practice like no one else, your practice can be like no one else!

Pic 2.jpg

Some of our giveaways I got to share with my colleague at coffee. (Graphic Design by Andrew Miller ( and

If you practice like everyone else, your practice will be like everyone else!

Throughout my almost 30 years working in the health care field I have had great colleagues. These experts provide critical services for individuals, couples, and families. They are specialists—true experts—in their scope of practice and I happily refer to, collaborate with, and respect them for their work.

However . . .

Considering the “State of the Art”

Colleagues in our field as a group, perhaps like most industries, generally talk, month in and month out, about the same repetitive topics . . . referrals, going “fee only” (or dumping insurance), recruiting new professionals, insurance contracts, and procedures or techniques they are learning or implementing. Go to coffee with many in the behavioral health industry and you are sure to wind up talking about these issues.

There’s nothing, at all, wrong with that of course.. These are the daily concerns of the typical practice and the variables that owners/providers need to focus on to be successful. Many are happy to confine their “work life” to these issues but some of us are not.

For the “others” these topics, while necessary to deal with, are often redundant, task-focused, conversations that—like chores—need to be done but rarely result in a “bounce in the step” after the conversation. After almost three decades in the industry, while these continue to be necessary discussions, engaged in regularly, I find myself more interested in conversations about the national melodrama of politics, the latest cool product (currently Darn Tough socks), new technologies, or woodworking projects. Maybe you can relate?

A different practice

I was reflecting on this after a recent coffee meeting with a colleague. No, not because the conversation was a better version of the typical topics, quite the opposite, because it wasn’t—at least not the vast majority of the meeting. A meeting that I left feeling energized, excited, and ready to push my business forward. Why? What was different? What was different is we weren’t just talking about the same-ole-same-ole topics.

My colleage isn’t just practicing like everyone else. He is more entrepreneurial that the average clinician.

Through serendipity and the encouragement of others less risk-aversive, I have learned, despite my natural tendencies toward the opposite, to do the same. So our conversation wasn’t about insurance, referrals, recruitment and all the old repetitive topics. Instead, the conversation was about an upcoming training we are doing out of state, demonstrating for him a game we newly licensed to use in our training, possible opportunities with a local manufacturing enterprise, and discussions about developing our own new software games for training. All factors of my practice not being defined by the typical “private practice” label.

Sustained changes

This week, under this broader umbrella of Human Systems Consulting, we will be billing an engineering firm for coaching. Signing a training contract with a government agency to use games to train leaders on teamwork skills. Continuing our monthly trainings of other professionals on becoming consultants. Talking to a non-profit about the status of a 13 year old contract to determine if it will continue as is, change, or be terminated. Continue discussions about developing a communications/teamwork game with a software developer. None of this directly related to my full time private practice as a mental health professional.

If it sounds like work, it is. Is it But its work, I find, that invigorates. It’s not boring. It’s new. It’s mine. No one else, outside my team is doing what we are doing. It continually challenges me to grow and expand my learning, my skills, and, assumably, my value to systems who need some help. It also protects from some of the inherent risks in healthcare. All factors that makes the private practice less anxious, more sustainable, flexible, and versatile.

Normative vs. transformative

Now, if you tend toward the stable, comfortable, personality that enjoys routing, likes tweaking and improving know systems, and are perfectly happy with continued discussions listed in the first scenario—then good for you! You likely are not looking for something different or more. However, those who crave learning new things, challenging themselves to do more, want new vistas or horizons to explore . . . even if you are good at putting up with the first scenario . . . then this latter scenario is much more invigorating. In my experience, it is an antidote to burnout and makes you more enthused about both.

What would you like your practice to look like if you could choose to do whatever you wanted?

What services or products would you be excited to provide?

What’s stopping you?



Broken shovels and new handles.

The poor old shovel . . . yellow fiber-glass handle finally gave out!

The poor old shovel . . . yellow fiber-glass handle finally gave out!

Sometimes you just gotta do it. I was replacing my mailbox post when it happened. The old shovel handle broke. I've been expecting it. This old, yellow, fiberglass handle was never the best. It quickly began to weaken; the digging becoming a maddening-test-of-stubborn-resistance as the handle flexed, twisted, and alternatively held it''s rigidity as a project progressed.

Now it was caput. Finished. Should I "pitch it" in joy of the cessation of the frustration and hold a wake to it's demise? No. I would replace the handle with a good, solid, wooden one. I grew up in that era. Don't through away things that still have value. Even if the time, the replacement parts, and ultimate finished product are less than ideal.

Changing that handle (see the finished product below) reminded me of the process of helping professionals with "old" skills upgrade to "new" ones. Learning to add contracting or consulting to their professional practice. The tools essentially remain unchanged but the experience is transformative.

Check out our no-coast, no obligation, webinar on Private Practice through Contracting!

Almost makes me look forward to digging.

Almost makes me look forward to digging.



Professional Burnout

Photo by  Yaoqi LAI  on  Unsplash

Photo by Yaoqi LAI on Unsplash

My private practice, it seems, has recently become an oasis for professionals experiencing burnout in their careers and personal lives. I’m not talking about professionals who just can’t cope or who have personality traits that make them doomed to burnout; I’m talking about successful helping professionals–experts who have been practicing and thriving for 15 to 35 years who suddenly cannot stand the work they once chose and loved.

While I’ve written about ways to prevent burnout in the past I am still learning things as I help these experienced professionals–who are often very insightful and creative in their own right–reinvent their professional and private lives to make their work-life balance manageable and sustainable forms.

I wrote this almost two years ago, and I followed it with some reasons I think successful professionals suffer burnout. (My original follow up post was entitled "Regaining the Joy of Your Career!"

Reasons successful professionals experience burnout:

  • There is an emotionally overwhelming triggering event.

  • They have an exaggerated personal accountability for their work.

  • There is denial of the effect of exposure to traumatic emotional events.

  • Self-care is seen as optional (and sometimes selfish!).

  • Accountability is universal (I have to do everything well!) and not subject to rank ordering.

  • Unrealistic comparisons to others lead to a lack of balance.

  • The isolation of the profession diminishes their perspective of life.

  • Emotional avoidance of guilt, fear, shame, rejection often underlies unhealthy behaviors. (just like our clients . . .)

  • The “supporting cast” of family and/or friends reinforce unhealthy functioning.

  • Band-aids are applied when surgery is needed.

At the time since I wrote this list, conditions in the profession seem to be exacerbating the problems. (Faithful readers may remember when I challenged myself to state what our field needs in just 4 words.) Today, some insurance companies are requiring professionals to pay application fees and annual fees just to be on their boards (the customers don't pay the overhead now the service providers do?), cutbacks in public funding is threatening services, demands for "validated" therapies threaten to make healthcare the paper-pushing cousin to education, and professionals in other fields are developing services that challenge the mental health industry.

More and more professionals I talk with are seeking a way to mediate these negative forces, or leave the healthcare industry through adopting private pay or concierge practices, marketing life coaching, contracting directly with organizations, retooling into another industry, or retiring.  (Not all experts are the same Organizations need people-experts to advise them.) Often professionals, unprepared for a shifting healthcare context, burnout under the vicarious trauma of a long career. Seeing more clients that is sustainable in a healthy manner. Today, more than ever professionals often need a backup plan and exit strategy.

What can you do, in the short-term, to prevent burnout? Here's a few ideas:

  1. Don't expose yourself to additional trauma through your entertainment choices.
  2. Limit your clinical work by mixing in other business ventures.
  3. Find and maintain restorative hobbies, activities and friends.
  4. Listen to music and turn off the news.
  5. Take a break--a long one--from social media.
  6. Create a long-term business/career/life plan that includes diminishing the heavy clinical load.
  7. Broaden, or narrow, your niche to include activities that are not saturated in traumatic material.
  8. Develop a network of social contacts that are not from the healthcare industry.

Good luck!

Read: The greatest leadership lesson I ever learned.



Interested in decreasing your dependence on insurance? Check out Private Practice through Contracting. It will help you "think outside the box," encourage you to seek work you love, guide you into paths that are sustainable . . . and it's free.




Fee-for-Service through . . . Contracts

Introductory letter from an old contract

Introductory letter from an old contract


Fee-For-Service or Private Pay

Many mental health professionals would like to transition their private practices solely to fee-for-service, also called private pay, clients. Why? Less paperwork, higher fees, lower overhead costs, personal preference . . . there are probably many reasons.  "It's easy. Here's how to do it." to stories of "Tried to do it. It was hard or impossible." My sense is that it may vary depending upon the population and financial demographics of where you work, your years of experience, your reputation, and your entrepreneurial marketing ability . . . and other factors.

The typical "help" on-line takes those who through articles and blog posts that advise the reader on how to transition from third-party payment to private-pay practices. This certainly is helpful and may in fact be the path many will pursue. One element that, for me, is almost always missing however is . . .  private contracts. They never seem to be mentioned. Why? I know of therapists who have contracts with pediatricians, chiropractors, non-profits, schools, churches, federal programs . . . and more! Contracts provide stable, non-insurance dependent, revenue. Most of these are for "therapy services" but at times they are for leadership training, coaching, or consulting.


Here's why this bugs me . . . For over twelve years, 40% of my business income has come from two customers. Two. I have also spend more than a decade training students how to get these contracts. I mention this now because I can--both of these contracts have been replaced with other consulting work and there is no threat to revealing the amount of business it provided. (Incidentally, I terminated both contracts when it became clear that leaving them behind was best for my business. One contract lasted 12 years and the other 15 years.


Private Contracts versus Private Pay

For those of you who have the entrepreneurial spirit,  contracts can become "the business" independent of a private mental health practice entirely.  (I had a friend in college whose sole business was repairing seats for Pizza Hut . . . he travelled all over the country and made a good living! How's that for specialization?) For the less-entreprenureal, it can be a great supplemental to their clinical practice.   I have primarily done the latter, choosing to operate a limited private practice--where I saw a mix of insurance and private pay clients--and having fee-for-service contracts in addition. It's worked well for over 18 years. 

Although the private practice has been the "main gig" in the last decade,  it was the contracts that provided the most stable source of income, the lowest paperwork to dollar ratio, and that provided a cushion when changes in the insurance world (the implementation of the Affordable Care Act) which dried up all payments for several months.  

While a full discussion of the advantages and risks is beyond the scope of this blog post, here are some comparisons that have made contracting very attractive to me personally. My hope is that this comparison, as crude as it is, will get you to consider your options and make your own choices about what you want your career to be.

 Comparing the Two Models

For comparison purposes, the Fee-for-service model will assume an average of 20 sessions per client with the professional seeing 25 clients on average per week and working 48 weeks in private practice.  Contracts can vary widely depending if they are "one time meetings or workshops" or "on-going services" or somewhere in between thus the number indicated is a minimum  and the upper end of the range is undetermined.

Item                                Fee-for-service                               Contract

Clients (annually)                      60 (25 a week for 48 weeks)                    1*

Statements                                 0-720                                                          12*

Referrals (annually)                   up to 60                                                      0*

Fees                                             "health care" schedule                              "health care" or "consultant"

Environs                                      Clinical office                                               Clinical office or "off site"

Marketing                                   Sustain 60 clients                                       Sustain 0 clients*

* Or more depending upon the type of contract and work to be completed.

Now, for the Skeptics . . . 

Okay, some of you, skeptics like myself, will say, "Yes, but there is a downside to trying to get fee-for-service contracts and some inherent risks!"  True.  Again, just a reminder, a full discussion is beyond our purpose here and we will not attempt to cover all the points needed to make this decision, but here are a few of the challenges/risks just to get you thinking . . .

  • If you have only two clients then losing one is a big part of your revenue. Where losing one client out of 60 is less traumatic. I've never had this happen but it is true that this kind of “event” has the potential of being very threatening.

  • I may have to master new processes (depending upon the nature of the contract) to work in a new business environment.  You will.  For me, after more than 26 years as a counselor, this is exciting and part of why I do consulting.

  • I will have to establish my own fee structure and negotiate with customers. Yes, since you may not be able to just "call other practices" and charge what they are charging there is a need to establish your fee structure.

  • Establishing a fee-for-service private practice may be the traditional way to move away from third-party payment systems but it is not the only way and, I would argue, it may not even be the best way!

So what is it that you would really like to do?  What connections do you have that might lend themselves to developing a contract for your expertise? What needs can you meet and can you get someone to agree to pay you to help them meet that need?  It is possible!

My dream contract is to get paid to use my Taylor 614ce guitar and use it to teach life-lessons to younger people. It would be fun.  But, sadly, no one is offering. It may be a lack of talent thing. Until then, I will keep practicing and hope I miraculously get blessed with some higher-level talent, or at least skill,  before it's too late!  On second thought, maybe a more realistic goal for me would be to focus on impressing the grandchildren--but one can always hope!!





Regaining the joy of your career

Photo by  Devin Avery  on  Unsplash

Photo by Devin Avery on Unsplash

In an earlier post (on professional burnout) I told about some of the lessons I am learning about why experienced and successful professionals get burned out. Today, I’m going to share with you some of the solutions. 

Regaining the joy of your career:

  • Only do what no one else can do. (Many professionals can teach basic parenting skills but few can talk from their own experience what it is like to stay married for 35 years.)

  • Rank order your responsibilities. (Your family's needs before additional networking contacts.)

  • Consider a leave of absence . . . with a plan. (Sometimes a break will reinvigorate and help you redirect your energy in the right places.)

  • Avoid unnecessary exposure to traumatic material. (You get enough of that in your work as a professional . . . it should not be your hobby as well!)

  • Set your own goals and stubbornly maintain them. (After all, if you don't who will?)

  • Formalize and prioritize your self-care. ("All work and no play makes Jack a dull boy" they used to say. It's true.)

  • Consider what it really means to you to be "at work."

  • Use an advisory team to find new ways of providing your services. (Too many professionals go it on their own. They don't value or utilize a professional coach or mentor. This can be a path to burnout.)

  • Do “a little . . . well” or “a lot . . . well enough.” (Don’t be perfect. Don’t be the best . . . right now. Unless you limit your focus to one thing. Some can do this and be very successful. Some can't and some shouldn't . . . know who you are and what works for you.)

  • Ease back into your career one step at a time. (If you are "toasty" and can't stand what you are doing . . . try to get a break. But once it is over don't just jump back in! Prioritize and transform what and how you are as a professional.)

  • Consider changing careers. (In the final analysis or some it is just time to make a permanent change. Better that than decades of dread, inefficiency, boardroom, and failure.)

All the best!


P.S.  One way I have avoided burnout is through contracting and consulting.  If you haven't already downloaded our free eBook, Private Practice through Contracting, feel free to check it out.