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29 tips to Turn Pro and improve your private practice – Part 1

1 June 2015 By David Kinnane Leave a Comment

To succeed in private practice, we know that we need to be professional. But what does this actually mean?

Ethical? Of course. But being ethical isn’t enough to keep you in business for long.

Steven Pressfield has published a small book that packs a big punch: “Turning Pro”. He says that turning pro is a decision: “We finally listen to that still, silly voice in our heads…We find the courage to identify the secret dream or love or bliss that we’ve know all along was our passion, our calling, our destiny”.

That all sounds good in theory – who doesn’t want to live their passion? But how do we do it in practice?

Of the 29 professional habits I learned from reading Pressfield’s book, here are the first 11, with examples of how I’ve implemented or applied them in my speech pathology clinic:

1. The professional shows up every day.

First thing every morning, with all my sessions planned and ready to go for the day, I spend 5 minutes per client filling in his or her home exercises sheet, reflecting on goals, and thinking about what I can do to improve each session. It reminds me why I’m at work and that speech pathology is about helping people with specific needs, not “processing clients”.

2. The professional stays on the job all day.

I’ve always done the work. But sometimes it seems to take me forever. But over the last few weeks I’ve instituted a new practice. From 8am to 5pm, net surfing, newspaper reading, social media scrolling, chit chat and – especially – complaining, are all banned. I’m amazed how much more focused I’ve been and and how much more I’ve achieved within standard business hours. This has allowed me to finish on time more often and spend more time with my family.

3. The professional is committed over the long haul.

When I started my clinic, I introduced myself to local teachers and doctors. But I didn’t waste time and energy on an expensive or pushy marketing campaign. Instead, I built my business up slowly through word of mouth, recognising that speech pathology was my career – not a short term gig or hobby – and that my reputation is bound up in my practice.

4. For the professional, the stakes are high and real.

Early on, I was tempted to take on contracting and consulting jobs related to my former legal career to subsidise my clinic earnings. But I resisted. Having no safety net (especially with kids and a mortgage) is a terrific motivator to do great work for clients and establish your practice.

5. The professional is patient.

Patience is not my virtue! I’m a bit of a control freak and get frustrated when I have to rely on others or wait. I’m getting better (slowly). For example, my start up checklist helped me keep an eye on the big picture, and not sweat the small stuff, like waiting for registrations to come through.

6. The professional seeks order.

Sometimes it’s fun to ride by the seat of your pants. But it’s exhausting wasting energy putting out fires or reinventing wheels. Speechies in Business is all about systems, routines and processes to automate as much mindless stuff as possible so we can focus on front line care for our clients.

7. The professional demystifies.

I can’t stand it when professionals of any kind hide behind jargon or hoard their “secret information” behind pay-walls. I’m a big fan of transparency and Plain English. On my clinic blog, I publish a free article once a week – rain, hail or shine – about speech, language, voice, fluency and other communication issues relevant to clients, prospective clients and the general public. Here’s an example about how to help children learn new words and another about Auditory Processing Disorder.

8. The professional acts in the face of fear.

We all get scared. Professionals feel the fear and do it anyway. One of my mantras is to welcome new opportunities – especially the scary ones. When I opened my doors, saw my first client solo, gave my first community talk, lectured at a local University, and expanded my scope of practice, I was worried: my reputation was on the line. But I wouldn’t be where I was today without having done them.

9. The professional accepts no excuses.

Sometimes, we all have off sessions, forget to return messages or miss deadlines. When I make mistakes, I own up to them and apologise in person. Quality client care means being accountable and asking for continuous client feedback. My Complaints Policy encourages honest feedback and has helped a lot, generating loads of useful suggestions I’ve been able to incorporate into my practice to reduce errors.

10. The professional plays it as it lays.

I get sick. Equipment fails. Without warning, clients sometimes don’t show up. Over the years, I’ve learned to be more accepting of bumps in the road. I’ve recognised that private practice has its peaks and troughs; swings and roundabouts. Getting angry or frustrated with things beyond your control doesn’t change reality – but a good attitude can. Recently, I’ve been reading the Stoics, which has really helped. (More on that to come.)

11. The professional is prepared.

I have a simple rule of practice: I don’t go home unless my sessions for the next day are all planned, with materials ready to go. Recently, this rule served me well when my clinic had a 5 hour blackout on a busy day. It sometimes means late nights. But it’s a big motivator to ensure I don’t let myself get overbooked or behind in session-planning. I love going home to my family after a solid day’s work.

So, there you have it. 11 professional habits, with practical tips to acquire them. We hope one or more of them helps improve your practice.

Join us again for Part 2 and Part 3. And feel free to leave comments below!

Main source: Steven Pressfield (2012). Turning Pro: Tap into your Inner Power and Create Your Life’s Work. Black Irish Books, NY, NY. Well worth a read. You can get it here.

Image: https://bit.ly/1HGvKNr

22 lessons I’ve learned from a private practice pioneer in allied heath

19 May 2015 By David Kinnane Leave a Comment

In my quest to keep up-to-date with information about launching and running a successful private practice speech pathology clinic, I stumbled, courtesy of @wespeechies, via Twitter, upon an interesting article by Robert Payne. Mr Payne is, to this day, a clinical director of a hearing and audiology practice that has been in business since 1939.

1939!

So what can we learn from a practice launched during World War II? What changes can we make to our practices based on lessons learned by three generations of audiologists in private practice over the last 75 years?

Here are my favourite 22 tips, some paraphrased and reworded to make them relevant to speech pathology:

On private practice: what to expect and what matters most

1. Expect some negative reactions: When you first go into private practice, expect a degree of disapproval from some colleagues and/or professional organisations. There are plenty of private practice sceptics and some clinicians in public practice who think that the term “Professional Private Practice” is a contradiction in terms. Prove them wrong by providing first-rate client care ethically. (Editor’s note: Professional organisations, such as ASHA and the SPA, are much more supportive of private practice these days than they were in the early days of private practice Mr Payne is referring to.)

2. Do it for the right reasons: Your objective should be to deliver quality health care to your clients. Your initial role is to educate clients about reasonable expectations, and to guide them through the assessment and treatment process so they can make intelligent choices about their health care options.

3. Beware of commercialising your services: Strategies that identify a practice with a product commercialise the service and are inconsistent with a philosophy of educating and guiding clients toward the best possible results.

4. Focus on client relationships: De-emphasise the service/product and emphasise the client’s confidence in, and comfort with, your practice. Foster good relationships with clients, rather than engaging in promotions and other product-oriented marketing techniques (see more below).

On finding the right model

5. Develop your own practice model, but first learn from others in private practice: Private practice in many allied health fields has no “traditional” model and we only have each other on which to model our practices. There are several models in which private practices structure fee schedules, personnel and staffing, office/clinic location, image, service delivery techniques and marketing strategies. For example, geography may play a large part in determining appropriate fees.

On staff

6. Employ versatile staff: Hire people who can perform a range of clinical services, rather than hyper-specialists, who will be less flexible if your practice or client mix changes. Staff should be expected to be able to perform all types of assessments and treatments offered by the clinic. Staff should be well-educated, technically well-trained and motivated. They also need to show good judgment so you can trust them.

7. Key professional staff: If you use a corporate structure, you will need corporate officers, such as directors. If you run a multi-site practice, you should employ: (a) a clinical director who reviews each report, trains new staff, and introduces new testing procedures and therapy techniques; and (b) an office manager who works with professional staff and is responsible for payroll, accounts payable and receivable, mass mail-outs, book-keeping, marketing mail-outs and financial/management reports.

8. Key support team members: You should retain an accounting firm and legal counsel to review all contracts and company policies.

9. Favour salaries over commissions: Incentives should operate to foster a sense of team, rather than individual competition, especially if staff are frequently scheduling for each other.

10. Look for alternatives when you can’t afford to raise salaries and wages (assuming minimum conditions are met/exceeded): Consider increasing holiday time and flex-time in scheduling. Rotate staff between practice areas and (if relevant) practice sites to keep staff from feeling they are stuck in a rut.

11. Share information and invest in Professional Development: one of the saddest scenarios of a sole practice is isolation from daily clinical exchange. Encourage the constant interchange of ideas and accessibility to others’ knowledge on a daily basis. Encourage staff to join and participate in professional organisations and to attend local, state and national meetings to augment the practice’s collective knowledge. Reimburse staff for such meetings on the proviso that they must share what they learn with the team on return.

12. Meetings: Attempt to meet up as often as possible – recognising that this is a difficult thing to do consistently.

On marketing and advertising

13. Marketing to new clients: Focus on gaining, then maintaining, a marketing advantage for your services by defining a strong image of your practice in the public mind. “We have decided to neither discount our services nor position ourself in an “exclusive” price category.” Marketing activities that work include a newsletter, a re-evaluation notice sent to clients, education of referral sources (such as doctors), as well as copies of assessment reports to referring physicians, which place you in the position of co-providers of healthcare services which reinforces physicians’ referral decisions.

14. Marketing to existing clients: Marketing to an existing client base is extremely important. Develop mailings as well as follow-up telephone contacts to do this. Send newsletters or relevant articles, but treat it as a way of staying in touch rather than as a “selling” tool. Help clients keep in frequent touch with you. Stress results and include related services needed to produce them including instruction, counselling and reading material (for clients and their families).

15. Market to your strengths: For example, Payne markets his practice as a long-standing organisation known for dedication to clients, fair pricing policies, and proximity to all major compass-points of the city. They write articles for senior citizen and other special interest magazines, and accept all invitations to speak about health-related topics. Management is active in community and service organisations.

16. Stay independent: Resist product or service-specific advertising of all kinds and do not identify your practice with any one manufacturer or publisher. Offer nothing other than the best care for each client – regardless of who supplies the equipment needed to offer it. Maintain good relationships with suppliers, but do not enter industry-related promotional programs or other incentive programs in favour of the best treatment for clients.

17. Do not over-sell: If you oversell a product or service you undersell yourself.

On location and ambiance

18. Position, position, position: Choose an office close to major hospitals and referral points.

19. Health over business: Emphasise health care in a clinical setting, rather than a business setting.

On fees and finance

20. Fees: Client service should be the basis of your fee structure. Each professional should be responsible for discussing the costs of your services and methods of payment with clients. Wherever possible, get paid upfront, although allow more flexible arrangements like instalments when warranted – judiciously. (Editor’s note: also be careful not to discriminate in the way you price services for different clients.)

21. Benchmarks: There are no/few published industry/statistical norms from which to measure private practice key performance indicators or success in some areas of allied health. Beginning practitioners might pattern their initial efforts from industries in which such data exist, e.g. optometric practices. (Editor’s note: more on this shortly.)

On quality systems

22. All staff should perform duties and functions similarly in testing procedures, reporting and therapy: Work hard with your team to reach a consensus on how to approach the job you do, and to encourage discussion of ways to shape your practice to better meet the needs of your clients.

What a treasure trove of information and tips! We hope you found our summary useful.

Key source: Payne, R. H. (1992). Aspects of a Private Practice. AJA, March, 27-32.

On accounting for wisdom

11 May 2015 By David Kinnane Leave a Comment

As they say, there are 3 types of accountant – those that can count and those that can’t.

A confession.

I come from a family of accountants. My dad’s an accountant. So are both my sisters. I even did an accounting degree in the 1990s before becoming….a corporate lawyer. What a rebel!

One of the many advantages of being surrounded by accountants at family gatherings is free advice – sometimes solicited. Usually, it’s about the drudgery of small business management, e g. collecting late payments, using accounting software properly, or improving systems.

But, sometimes, the advice I get is more profound. Wise, even.

With decades of experience as an accountant and senior executive, I asked my dad to distill some business lessons he’d learned (often the hard way). Then I chose the 7 tips most relevant to speech pathologists in private practice:

1. When setting prices for your services, make sure you include a full salary and the amount of your investment (including training) in working out your break even point.

2. Do not be afraid to charge for the value you are providing to others. If you are going broke, do it lying on the beach rather than working until midnight.

3. If you find an error, look for two others. This saves embarrassment.

4. Enjoy what you do. The most boring tasks can be made interesting – even if the thing you enjoy the most most is crossing them off your to-do list.

5. Do not waste time complaining. No one is interested and you will always perform better when you are positive.

6. Advice is often worth what you pay for it. (Except, of course, this advice!)

7. Don’t let yourself be exploited by friendship, a desire to please, or good intentions. Assess projects and opportunities objectively as a professional, even if you are not planning to charge market rates for the work involved.

Writing to persuade people – 21 tips from a professional argument-winner

19 April 2015 By David Kinnane Leave a Comment

Lawyers get paid to win arguments. To win arguments, they need to convince judges and juries. A key way they do this is by writing compelling legal briefs.

Bryan A. Garner is an expert in legal-writing. As the author of several books on legal writing, he knows a lot about winning arguments through clear, persuasive writing. Garner’s “The Winning Brief” contains 100 practical tips for writing persuasive arguments. Most of them apply to all kinds of persuasive writing, including sales, pitches and other presentations. Here are 21 of my favourites:

1. Be organised:

Plan every project. Break it up into small sections; then write each section.
First state the purpose of what you are doing and identify the main issues you will cover. Don’t write to discover your purpose.
Organise the issues from most to least important.
Write the first draft before you edit it. Let it sit awhile before you edit it.

2. Help the reader understand the big picture:

Straight after outlining the purpose and main issues, sum up your argument and your theme in a brief statement.
Weave specific facts into your issues to make them concrete and easy to understand. Don’t just talk about ideas and issues.
Make your points as simply as possible, but no simpler.

3. Write good paragraphs:

Begin each paragraph with a strong topic sentence – tell the reader exactly what the paragraph is about.
Break up long, complex sentences. Aim for an average sentence length of 20 words or fewer.
Bridge from one paragraph to another, but don’t overdo connectors like “further”, “moreover”, “in addition”. Instead, use pronouns (e.g. he, she, it), “pointing words” (like, this, that, these and those) and “echo links” (words that repeat an idea in summary language, e.g. “this rule” to refer to a rule your have just written about at length).

4. Edit for brisk, uncluttered sentences:

Eliminate jargon.
Avoid too much detail in the main body of your work. But don’t put arguments in footnotes.
Put people in your sentences – use real names, not titles or labels.
Search and destroy weak “be” verbs (is, am, are, be, were) and replace them with strong forceful verbs – preferably ones you can picture in your head.
Write in the active voice wherever possible (e.g. “The man slammed the door”, rather than “The door was slammed by the man”).
End your sentences with punch – preferably a strong noun or verb.
Get red of “throat-clearing” filler phrases like (“In my opinion”, “May I respectively submit that”, “It should not be forgotten”, “It is important to remember that”).

5. Choose the best words:

When you edit, don’t just cut words, but also replace boring words with snappy ones that spark interest.
Use interesting nouns and verbs. Minimise adjectives and and verbs.
Use one syllable words when possible. If no one-syllable word exists for what you want to say, aim for two-syllable words.
Simplify wordy prepositions (e.g. replace “with respect to” with “to”, “in order to” with “to”).

Source: Garner, B.A. 1999. “The Winning Brief.” Oxford University Press, NY, NY.

6 professional communication tips to improve your client care

9 April 2015 By David Kinnane Leave a Comment

People often ask me how I balance working as a speech pathologist and a lawyer. Keeping up-to-date with developments in two professions can be a challenge. The history and cultures of each profession differs markedly. But speech pathology and law have one important thing in common. Something that applies to all professionals:

Client care.

A key aspect of client care is communication. Poor communication can result in complaints and even disputes.

It’s your professional duty to communicate effectively with clients.

Professionals of all stripes must provide clear and timely advice to assist their clients to understand the issues and make informed choices about action to be taken. For many professionals, this basic duty is enshrined in their code of ethics, e.g. Speech Pathology Australia Code of Ethics or rules, e.g. NSW Professional Conduct and Practice Rules 2013.

So how do you do this? A recent article in a legal journal by Clare Chaffey contains some great tips for communicating with clients. Although directed at lawyers, several apply to all professions (and professionals):

1. Plan how you are going to communicate with different clients. Use checklists, props, flow charts to aid communication of complex ideas.

2. Create a safe environment for clients to give honest responses. Spend time with new clients (especially clients who have never been to see a member of your profession before) to explain the process, your services and how you work. Demystify the process and what you do.

3. Encourage questions, making it clear that clients are free to ask you anything – even if it might be embarrassing or difficult for them. There are no “stupid” questions.

4. Use language your client understands. Wherever possible, don’t use jargon. If you must use jargon or a technical term, explain what it means in Plain English.

5. Stop talking and listen to your clients. Ask your client to tell you what it is they understand you can do for them in their own words.

6. Take great care with difficult conversations and advice. It’s human nature to filter or even block out things you don’t want to hear. Use file notes and memos to record important advice and your clients’ understanding of your advice. If necessary, ask your client to sign them. Record the steps you took to ensure your client understood your advice – follow up on written reports and letters to make sure your clients understood them.

7. Communication skills can be learned and improved with training. Good communication skills are worth the investment.

Source: Claire Chaffey. (2014). Lost in Translation. Law Society Journal of New South Wales, December, 30-32.