by Sarah Griesemer
If you are busy preparing for 2018, and getting your ducks in a row, now is the perfect time to schedule your vacation days for 2018. Last week my husband and I got a sitter and went to a coffeeshop for two hours to sit down and plan our year. Let me walk you through some of the things I've found important to do:
One of the reasons that you need to look at this, is because you should be building time off into your fee structure and expenses. Don't have a budget and haven't thought of "fee structure" as anything more than charging what your bff charges? It's time, dear.
If this is scary, I get it. Taking time off when you are scrounging for clients or self-employed is scary! It is so important though. Consider trying out our upcoming retreat this February to help you get inspired!
by Sarah Griesemer, Ph.D.
Originally posted on Session Notes
When I first started a private practice and decided on my fee I looked around at what other people were doing, picked a number, and wrote it on my consent forms.
Little did I know that this was exactly the WRONG thing to do when setting my fee, and it was seriously setting me up for failure. Luckily, I had a fantastic business mentor at the time who helped me figure out how to set my fee for success. Now, I get to pass along that wisdom to you. Here’s how to set yourself up for success in three steps!
1. SET YOUR FEE BASED ON HOW MUCH YOU NEED IN YOUR POCKET.Most therapists set their fee and try to get a bunch of clients in the door. Then, if they aren’t making enough money, they try to get MORE clients in the door.
This ringing any bells?
The problem with this approach is that it assumes that the fee you set is high enough that you CAN see enough clients to make your take-home without going crazy.
Let me float you an example of how this can go south: You set your fee at $75/client and set a goal of seeing 15 clients a week. At $4500 of income you find that after the first few months you are taking home around $1500 each month. Soon after, you realize this isn’t enough. Your daughter is getting braces and you need to bring home $3,000/month.
One problem is that we forget that the fee we set doesn’t cover the hour of work we do with the client. It covers ALL the work we do for our BUSINESS.
At 15 clients, when you’re done making calls and doing other tasks, you’re already working around 34 hours/week and don’t have a lot more time to add more. (I estimate for every client hour you do 1.25 hours outside of session.) Suddenly, you realize that to make the money you need, you’ll have to start working on a Saturday and miss some of your son’s t-ball games.
Unfortunately, since several weeks have already passed with you not making enough, the burden is only greater, and the panic increasing. By postponing looking at your expenses and income, you’ve only delayed the panic and made the whole situation worse…Which leads me to #2…
2. MAKE A BUDGET
It’s boring, I know. I hated doing it, too. But you know what else I hate doing? Dishes and laundry. But I do those. All. The. Time. Why? Because if I don’t I’ll end up with piles of mess everywhere.
I hate to break it to you but if you don’t budget, your practice's finances are gonna be messier than a pile of dirty dishes in the sink. It might lead to debt, financial problems, or the closing of your private practice. The best thing you can do for your practice to see it thriving is to create a budget. It will enable you to figure out your fee based on what you must make instead of what seems like a good idea.
3. FACTOR IN PTO AND SICK DAYS
If you were working for someone else, you’d have vacation days and sick days available for you. Even though you are working for yourself, you still need PTO and sick days. You’ll also need to be out of the office here and there for trainings.
Unfortunately, most people don’t factor these into their fee. Instead, when they take vacation days and their income dips, they hit panic mode and feel worried about money and anxious about taking time off. If you factor time off into your fee, you know that you’ve been able to set aside money for just this occasion! It makes the ebb and flow of private practice feel more manageable, and vacations feel more stress free!
Let me break down the above fee example for you in the real life lens…the above formula doesn’t cover days off, sick days, days your kid is sick, days your client is sick and cancels, or the normal ebb and flow of private practice. Which means, you probably need to aim for more than 20 clients to cover those things. Add in paperwork, phone calls, marketing tasks, and insurance filing (I estimate you spend 1.25 hrs on business tasks for every client) and all of the sudden you are working 50 hours a week.
But if we do the math backwards, you get a recipe for sanity. For example:
My take-home (profit) must be: $3000
My expenses are: $3000
So I need my income to be: $6000
I’ll factor in PTO, vacation days, sick days, cancellations, and general ebb and flow of clients: I’ll estimate 2 full working days a month.
I have the bandwidth to work 40 hours/week which means about 18 client hours (if we assume my admin time from above).
In other words: 18 clients/week x fee – 2 days of income/month = $6000.
This gives us the suggested fee of $150 which is a HUGE departure from what we had guessed.
What a difference knowing your expenses makes!
This doesn’t mean you have to charge $150/client. But, it does mean that something will have to give if you want to charge less. Maybe you will have to work longer hours. Maybe you will have to make less money. Or maybe you will have to find a cheaper office space.
WIth this knowledge you can make planful choices about your practice so that you can enjoy the work you do and help your clients without feeling panic about money.
In the end, that’s usually what we want most of all.
You can find sample budgets online, or you can check out our Fee Setting Video Series HERE complete with sample therapist budget, a fee setting worksheet and three videos to get you going.
by Sara Paules
Alexis Edwards, LCSW & Certified BEST Doula, is the owner and founder of Birth360 as well as the witty blogger of Mrs. Mombie where she writes the truth about motherhood. She also is the director of the doula training program through pphatx.org. This girl is all about empowering other women through the entire pregnancy from conception through postpartum and we’re so excited to have her at Launch Wellness as a member!
Read more about Alexis in our recent interview together:
How did you get into blogging?
Honestly, I just started blogging after my daughter was born. At the time, I was sleep deprived and felt like a zombie. [Thus her blog title: Mom Zombie/Mombie!] Writing was a great tool at the time to help me get out a lot of what I was feeling inside and really helped. I started blogging more professionally afterwards but I didn't initially start out with that in mind.
Tell me about Birth360.
I opened Birth360 last January 2017. I wanted to work with women surrounding birth, hence the name, Birth360. My passion is serving the link between new parenthood and our mental health. As a doula I can establish relationships with parents during the prenatal period which allows us to develop trust and makes it easier for parents to reach out should they need additional therapeutic support postpartum
What do you enjoy most about your job?
Being able to normalize and validate that the early parts of parenthood aren’t very supported in our culture and that it’s totally normal to struggle. Even at it’s best, new parenthood can be hard.
What’s something you talk to your clients about often?
Signs of postpartum depression to look out for and how to know if it’s baby blues versus a mood disorder. I also encourage both partners to go to birthing and breastfeeding classes because it helps the partner understand what the mom is going through and they can help support them a little better. Breastfeeding can feel overwhelming for a lot of women so it’s nice to be able to have someone who isn’t as overwhelmed to help them like a partner.
It really is true that it takes a village to have a baby and raise a family. Back in the day, there were other women around who would both educate and support the new mom through taking care of things like household chores so she could be more present with her child. Our modern culture these days is very individualistic and puts so much pressure on moms to do it all on their own. So I also start planting the seed early on that we need to think ahead of time and prepare for our postpartum period too.
How would you define what a doula does?
They really serve as a support person that provides relational, emotional, physical and informational support for the whole family and are there to help you feel more empowered in your choices.
I am also very passionate about trauma-informed care and encourage all birth and postpartum professionals to approach their work through a trauma-informed lens when working with our clients. The birthing process can be triggering for trauma survivors and many providers and support professionals don’t ask if their clients have a trauma history. I am passionate about educating other professionals on the unique journey trauma survivors might face during the prenatal and postpartum periods
What is the difference between a birth and postpartum doula?
A birth doula relationally, is another person that you can trust. Informationally, they help you with your birth plan and in normal language vs scary medical terms. They help you understand what all your choices are so you can make an informed decision. Physically, they help with different labor positions and techniques that help with pain management. They show your partner how to support you the whole time and encourage the partner to go take care of self during the birthing process (like go to bathroom, eat something, etc.).
A postpartum doula, emotionally helps with processing birth, breastfeeding, and being a mom. Informationally, with breastfeeding, postpartum healing and physically, by offering and encouraging mom to take some space for self-care in addition to helping her come up with a routine, with sleep, setting up breastfeeding station in house, help with cooking, and pretty much anything to help with the transition afterwards. This role also helps with giving her the tools and knowledge she needs so that she feels like she doesn’t need a doula anymore. Basically, I’m always trying to work myself out of a job.
What is a resource out there related to what you do in your career that other people should know more about?
“The Business of Being Born” documentary. It’s actually what really got me initially interested in becoming a doula. I also recommend the book, “When Survivors Give Birth” for birth and postpartum professionals.
What are you currently reading?
Honestly, I never have enough time to read and I have a stack of books I need to get around to looking at. If I do have the time to read, it’s usually fun versus professional books. Right now I’m reading “The Unmumsy Mum” by Sarah Taylor and “I’m judging you” by Luvvie Ajayi.
What’s a food you’ve been craving lately?
Definitely a peanut butter cup milkshake from Hat Creek.
You can learn more about Alexis on her website at: https://www.birth360.net/ Find her on Instagram at ww.instagram.com/birth360atx.
One of the reasons I hear to not start a private practice is "I don't want to hussle."
I don't know about you, but I seem to always think of a 20s flapper when I hear that word.
Detour. Sorry. Watching too much Kimmy Schmidt.
The truth is, a private practice is a business and involves more than seeing clients. That said, marketing your business does not mean a) "hussling," b) selling yourself, c) being schmarmy, d) using social media (though, it can), or e) acting extroverted when you don't feel like it.
There are very natural and authentic ways to market a private practice. An authentic marketing strategy requires only two steps.
Seriously, two steps.
1) Know who you are.
2) Know who you want to serve.
(I didn't say they were simple steps.)
Okay, here's your action plan for these steps.
1 Know Who You Are
Steps to choose from to help with this:
- attend therapy (if you are a therapist not doing your own work, then you aren't doing the most important training that you can do, IMHO)
- talk to your friends about your strengths and weaknesses
- be honest about what you enjoy spending time doing
- dress for yourself, not to please someone else or wearing to work what you "should wear"
2 Know Who You Want To Serve
This is not agency work any longer, and unless you are working as a contractor in a group practice or are on many insurance panels, having a "I'll take anyone" approach is very hard to accomplish successfully. When you get clear about who you like to serve and want to serve then your practice will grow. I have seen this to be true time and time again.
- think about who your favorite clients have been. what about working with them brought you joy?
- side question: do you believe you deserve to enjoy your work? do you believe you should get to choose your clients?
- work on your niche with someone who has already done it -- a coach, a friend, or watch an online video.
These are just some of the topics we discuss in our Launch Together mastermind group for private practice. By the end of the group our members are clear on what they want and need to have a thriving private practice. Join us!!!