In the beginning, every clinical hour feels like a necessary hour. 7 a.m.? Sure! 9 p.m.? Why not! The anxiety of building your practice and accommodating everyone drives you to disregard the clock, using your rental office at odd hours and paying no attention to the carefully thought out schedule you were planning to follow. Good boundaries are imperative for smart hours vs. any hours.
Consider Marcie. As a 4th-year clinician with a great niche and a budding practice, she was raring to go. She was young and energetic, and had hours to fill and an office that would accommodate early mornings and late nights. In addition, she would slide her fees to fill up any spots left open for more than a day. I noticed this when Marcie had to cancel consultation (twice) to see an emergency client. Then, I ran into her as she was rushing out of a CEU to get to the office at 7 p.m. Finally, I took a call from her one evening to see if I knew anyone on the northside of town to “lend” her an office for the following morning. Whew!
She was everyone to everybody except herself. When I finally caught up with her, she explained her logic. “I won’t be able to fill my practice unless I make myself available. And I don’t mind working odd hours or sliding my fees until I fill up.” I get it! I really do. But when you “fill up” with the hours you don’t envision and with the clients that may not be able to meet your financial goals, there’s a problem. You have not given yourself the room or space to develop the practice you want. Instead, you are reactive and helping in a way that doesn’t promote your own business goals.
Resist the Marcie model. Why?
Remember: You are the boss of you. If you start out by tailoring your schedule to everyone else, you immediately set yourself up for resentment. When you decided to take the plunge, part of your reasoning may have been the desire to make your own schedule. So do it!
Be a responsible clinician. At an agency, a big ethical dilemma is the over-scheduling of clinical hours. Proper intake, complete notes, reflective time and a break are all part of an ethical, long-lasting, clinical practice. Eight in a row is not, and it shows.
Model what you teach. That includes taking care of yourself at work by planning your day in an effective, self preserving way. Build in emergency appointment times, lunch, phone time, and research moments. Write your notes at work when your client’s issues are fresh and present. Practice time management and clear boundaries around when the work day begins and ends.
Guard against burnout. Staying breathless and unorganized each day while you accommodate clients is a clear path to being avoidant and feeling frustrated. Be clear about what a client emergency is and what it is not. Recognize your limitations for an at-risk client and know when to send to a hospital or other treatment.
Be mindful and balance your time. Set out your business plan, follow to a tee, and adjust it as necessary when all of your options are explored. Continue to market and seek supervision or consultation. Decide if a day of sliding-scale clients starting early and finishing late is better than targeted networking, developing your website, or visiting a possible referral source. Seek out the clients you desire.
Finally, calm the fear. If you are mindful, balanced, a good model, and truly listening to yourself as the benevolent leader of your practice, you can and will create a practice that is sustainable, successful, and most importantly, fulfilling.