One of the biggest confusions in private practice, is the difference between being a Subcontractor and an Employee.
So much so, that clinicians more and more want the best of both worlds when working at a group private practice, leading to practice owners feeling like no matter what they do, it is never good enough in the eyes of the clinician.
Many clinicians want to be Employed in order to get all the bells and whistles of annual leave, sick leave, paid training, etc but they want the flexibility of being a Subcontractor.
Others want the high earning capacity of being a Subcontractor, but expect the practice owner to pay for their training, their business cards, their admin time, the list goes on. They forget that they are in actual fact a business themselves and hence need to look after their own professional development, equipment and non-billable hours.
And then there’s those unrealistic expectations that they both share, like….
Expecting the Practice Owner to be solely responsible for ensuring they have a consistently fully booked diary.
Yes, the Practice Owner has a responsibility to market the business as a whole, but YOU – whether you are Employed or a Subcontractor still has responsibilities around your diary.
- To actively build rapport and engage all clients booked into your diary. If you’re a Psychologist, that means having a Drop Out Rate of less than 27%. If you aren’t good at this, expect to see many open appointments in your diary.
- To actively case manage your clients, by confidently advising clients of session frequency required to provide a best practice service, allowing clients to achieve the results they are paying you to achieve.
- To support the practice’s marketing efforts in any way, shape and form, as more clients mean that you NEED TO BE THERE.
Just last week I spoke to two allied health providers, whom are now starting their own solo private practice, as the group practices where they were employed previously (one in Queensland and one in South Australia) had to close down.
Yes, it happens – allied health practices are no different to any other business!
No clients = No Income = No Bills Get Paid = Close the Practice Doors = Everybody loses
Clinicians (whether you are a Subcontractor or an Employee) with high Drop Out Rates = Insufficient Income = Bills Don’t get Paid = Close the Practice Doors = Everybody loses
I know what you might be thinking……
Well, if the business fails then surely it is the Practice Owner’s responsibility.
I agree, to some extent.
Problem is, with the current attitude that a lot of clinicians are brining into private practice, the poor Practice Owner is raging a losing battle.
When clinicians come into a group private practice…..
- expecting to hear the word ‘yes’ to their every request
- threatening to leave if they don’t get their way
- setting limitations on how they will ‘show-up’ as a practice team member
- kicking against and resisting every possible (whether consciously or unconsciously) change the practice owner wants to facilitate in the practice, even though the practice owner believes it is in the best interest of the business
Then more and more group private practices will be folding – and that is not good for the mental health communities that we serve!
And to be frank, this attitude just leads to a shitty work environment for both clinician and Practice Owner.
A big part of this, is the confusion between the Employee and Subcontractor MINDSET – as already alluded to above.
More generally, I find that Subcontractors in particular (especially if they were previously in an employed job) struggle to achieve the mindset shift needed to be a happy and successful Subcontractor.
Similarly, I find that new grads whose first role is that of Subcontractor, don’t realise the difference between Subcontractor and Employee and hence often expect to be treated like and Employee as that is the only role they have been exposed to.
So my advice to those clinicians new to Subcontracting is this…..
When you approach a Practice Owner, or you apply for a role at a group private practice as a SUBCONTRACTOR, look at it in the same way you would as a Business Tendering for Work.
A business, let’s called it ‘The We Can Help Private Practice’ puts the word (Tender) out there that they need this specific task/project done.
You as the business (as yes, as a Subcontractor, you ARE a business) decides, awesome, I would love to do that. ‘The We Can Help Private Practice’ tells you all about the ‘tender conditions’ – in this case your subcontracting conditions – which you are expected to ADHERE to. You sign on the dotted line as START DOING WHAT YOU AGREED TO.
Instead, 2 months in you decide that you no longer have to adhere to your contract conditions.
Instead, you decide that you will only do what you FEEL like doing.
Instead, you decide that you will do things on YOUR schedule – to heck with what the contract states.
[ THIS HAPPENS PEOPLE – LIKE EVERY DAY ]
Geez, if you were delivering on an actual Tender your contract would be terminated faster than you can say the word ‘tender’.
But because Practice Owners are patient, emphatic and don’t want to cause upheaval to the vulnerable clients being seen by these clinicians, they tolerate this unprofessional behaviour. Behaviour that finally leads to the Practice Owner him/herself burning out or just closing up shop as it just becomes all too hard.
So the just of my message is this……
- If you are a Clinician looking to join a group private practice, ensure that you FULLY understand and embrace the mindset of the role type that you are accepting.
- If you are a Subcontractor, remind yourself that:
– you ARE a business
– the PRACTICE OWNER IS YOUR CLIENT, so instead of asking what the practice can do for you, ask: What can I do for the practice?
- If you are a Practice Owner, stop being so damn patient. If a Clinician is making your life a living hell – after of course having taken the time to provide education on the role expectations – then release them and move on.
We really need to start working together.
Know your role.
Know your obligations.
And then go and over-deliver like the amazing clinician you are.
Yours in Private Practice Success,
PS: I’m often asked whether I do 1:1 Individualised Mentoring & Coaching and for a long time I have shied away from it, as I wasn’t 100% aligned with the ‘how’ of it all to ensure optimal value, given there is only one of me I’m pleased to say that I have found the perfectly aligned program. So if you want me as your personal Mentor & Coach in this Private Practice adventure then email me directly at email@example.com with the Subject Line ‘Mentoring’ and I can send you all the details.