How do you build a practice so that you can make a living?

Paul JerryRegistered Psychologist

Associate ProfessorAthabasca University

Basic Building Blocks 1

• Registration in your jurisdiction• Declared area(s) of competence

• Business plan• Business resources (accountant, lawyer)

• Vision• Passion

Basic Building Blocks 2Who are you going to serve? What are you going to do for them? How will

you get paid?

• Referral network• Collegial network

• Client base (who, what/why, where, how)• Services menu (translate clinical to business)

• Workflow & systems

I’m set up... Where are my clients?

• Marketing• Contracts• Pay-as-they-go clients

• Reputation – professional psychology is a service industry. You are your service.

What if there aren’t any clients?

• Population pyramids (answers “who are you going to see?”)

• Base rates (answers “what are you going to do for them?”)

• Combined... They may answer “how am I going to get paid?”

• Collegial distribution (answers “who else is seeing your clients”)

Start with the really big picture

Then look at your location

http://www12.statcan.gc.ca/census-recensement/2006/dp-pd/prof/92-591/details/page_Figure.cfm?Lang=E&Geo1=CSD&Code1=4801006&Geo2=PR&Code2=48&Data=Count&SearchText=Medicine%20Hat&SearchType=Begins&SearchPR=01&B1=All&Custom=&Profile=2000&Sex=Total

2006 Community Profile: Medicine Hat, Alberta: pop. 56,997

(A brief comparison)2006 Community Profile: Brooks, Alberta: pop. 12,498

http://www12.statcan.gc.ca/census-recensement/2006/dp-pd/prof/92-591/details/page_Figure.cfm?Lang=E&Geo1=CSD&Code1=4802034&Geo2=PR&Code2=48&Data=Count&SearchText=brooks&SearchType=Begins&SearchPR=01&B1=All&Custom=&Profile=2000&Sex=Total

How about here...

http://www12.statcan.gc.ca/census-recensement/2006/dp-pd/prof/92-591/details/page_Figure.cfm?Lang=E&Geo1=CSD&Code1=4611040&Geo2=PR&Code2=46&Data=Count&SearchText=winnipeg&SearchType=Begins&SearchPR=01&B1=All&Custom=&Profile=2000&Sex=Total

2006 Community Profile: Winnipeg, Manitoba: pop. 633.451

Base rate example: Depression

• Canada: 8% lifetime http://www.phac-aspc.gc.ca/publicat/miic-mmac/chap_2-eng.php

• Normal onset adolescence• Average age of diagnosis early 20s to 30s• Female:male – 2:1

Base Rates Depression Winnipeg

• Choose age band (25-44)• Generate an estimate (population in 25-44:

176 965)• Calculate estimate for depression prevalence:

(8% x 176 965 = 14 157)

Winnipeg: Male Population Winnipeg: Female Population

(Note: examine axes carefully on these tables)

Competition demographics

• Professional Literature• Regulator/Collegial surveys• Labour Market surveys• Stats on other professions

Are we in decline?NOC Title(s) Non-student

Employment (000s)1987

Non-student Employment

(000s)2005

Non-student Employment

(000s)2015

Past Growth 1988-2005

Future Growth 2006-2015

415Psychologists, social workers, counsellors, clergy and probation officers

60.1 121.0 141.3 4.0% 1.6%

(Yes)

http://www.rhdcc-hrsdc.gc.ca/eng/publications_resources/research/categories/labour_market_e/sp_615_10_06/page08.shtml

Psychologists: What do we know nationally?

Canada has 19,570 psychologists, 18,010 of whom report that they have a place of work in Canada (92.0%). A very high proportion of them work in Quebec (39.2%), although the Quebec population

represents only 23.8% of the population of Canada... The national average ratio of psychologists per 100,000 people is 58.

It is relatively common for psychologists to work in a sector other than health care or social assistance institutions, such as schools.

Accordingly, slightly more than 1 in 4 psychologists work outside health care institutions (26.8%).

http://www.statcan.gc.ca/pub/91-550-x/2008001/part-partie1-eng.htm

Psychologists’ practice setting: What do we know provincially (Alberta example)?

“Private practice is the most common primary practice setting, with 35% of respondents selecting it. This was followed by schools (14%) and hospitals (12%). ‘Other’ was selected by 4% of respondents.”

Other included a wide variety of activities (many of which could overlap with the above categories):

Blue Cross, child welfare, outpatient clinic/not hospital based, rehab, community health/mental health for government, develop and publish tests, EAFP/EAP, First Nations/Metis settlements, giving workshops, in home consulting, international aid organization, law enforcement psychology, management, media, military, organizational consulting, physician offices, private health clinic, Pro Bono clients, regulatory work, research and writing, school division head office, social services, treatment centre, Worker’s Compensation, writing books.

Report on the Continuing Competency Survey of Alberta Psychologists For the College of Alberta Psychologists, Woodhead Lyons Consulting Inc. 4 June 2007, p.1 .

Psychologists’ primary practice area: What do we know provincially (Alberta example)?

clinical/counselling 45%education/school 20%health 11% rehab 10% forensic 7%neuropsychology 4%industrial/organizational 3%

Some psychologists had more than one ‘other’ practice type. education 22%, clinical/counselling 20%, and health 20%

Report on the Continuing Competency Survey of Alberta Psychologists For the College of Alberta Psychologists, Woodhead Lyons Consulting Inc. 4 June 2007, p. 6-7 .

So...

• Who are you going to serve?

• What are you going to do for them?

• How will you get paid?

Resources

• Stats Can: http://www12.statcan.gc.ca/census-recensement/2006/dp-pd/prof/92-591/index.cfm?Lang=E

• DSM-IV-TR and literature reviews• Canadian Medical Association Journal:

http://www.cmaj.ca/home/review.dtl• Journal of the American Medical Association:

http://jama.ama-assn.org/collections/