Attorney Articles | Building a Private Practice Part 4

Articles by Legal Department Staff

The Legal Department articles are not intended to serve as legal advice and are offered for educational purposes only. The information provided should not be used as a substitute for independent legal advice and it is not intended to address every situation that could potentially arise. Please be aware that laws, regulations and technical standards change over time. As a result, it is important to verify and update any reference or information that is provided in the article.

Building a Private Practice Part 4

For all but a very select few, marketing is a necessary component of any business, and of course, your practice is a business. Learn more about how you can market your practice by creating a successful marketing strategy that includes a wide range of activities.

by Mary Riemersma, Former Executive Director
The Therapist
March/April 2004

Some professionals consider advertising their services to be unprofessional. Meanwhile, they are faced with the threat of losing patients/clients to other professionals who do advertise. How should you react when you feel the need to retain your professional posture in the face of growing competition?1

The key is "marketing," which may or may not include advertising. Put simply, marketing for a professional means determining in advance what your patients/clients want and/or need, structuring your practice to fulfill those wants and needs, and engaging in the "right" communications to achieve your desired practice.

While the term "marketing" has distinct commercial connotations, viewed broadly, every professional is marketing his/her services. The difference among professionals is not whether they engage in marketing but rather, how well or poorly they do it. A successful marketing strategy includes a wide range of activities, which again may or may not include advertising. Here are the main elements:

  1. Analyze your market. When a new professional selects a location for his/her practice or a professional seeks to relocate or expand, marketing decisions should be made. Find out how many professionals per 1,000 population are already in the area. Is it already saturated? What is the average income of the area? Can the population afford the kind of service you want to offer? Income averages are available through the U.S. Census Bureau. The local Chamber of Commerce, public library, or an Internet search may also reveal this information. Average age and family size of those in the area are also important. The level of education in the area can also influence the success of your practice.

    Analyzing your market means not just looking up economic and demographic statistics, however, it is also meeting and talking with people who are potential patients/clients. Needs and wants will vary depending upon competition from colleagues, ethnic background-yours and your potential patients/clients, values and goals-again, yours and your clients/patients. It is important to realize that even if you are not establishing a new practice, you may uncover previously missed opportunities.

  2. Gear up to deliver the services your market wants and needs. Think not just about the apparent needs of your market, but the subliminal desires. Learn to look beyond the obvious, and present your cases and recommendations accordingly. It is best to try to not be all things to all people. Once you've determined the wants and needs, if patient/client volume allows it, select only those patients/clients who desire the kinds of services you most want to provide. Then make sure your practice is equipped to deliver the requested services.
  3. Get the word out! Advertising in the newspaper or telephone book are only a couple of tools professionals might use to attract patients/clients. And, these tools may or may not be effective depending upon a multitude of circumstances. Once you have determined the wants and needs in your area, and have prepared yourself and your practice to deliver them, consider the ways you can let prospective patients/clients know you are available. Later in this article is a listing of marketing methods that have proven effective for some therapists when deployed in the right manner. Keep in mind that you have selected the right advertising medium, but the ad itself may be wrong. The copy may lack punch and go unnoticed. Conversely, you may have a great promotional piece but it is put into a resource that is not hitting the right population.
  4. Make it convenient. Once you are actively letting prospective patients/ clients know about you, make it convenient for them to get to you and to accept the services you recommend. Increasingly, location is a primary consideration. If you are in an area where little parking and no public transportation is available, you may be in trouble.

Much has been said about offering credit. However, in today's society, it is a must. Credit cards and in-office budget plans help the patient/client pay for his/her needs. While it is important to give the patient/client every opportunity to pay immediately, the professional who insists on cash at the time of service may be restricting the growth of his/her practice.

Offer therapy hours at times that are convenient for the patient, which may include evenings and weekends. Or, consider offering reduced fees for those times that may be more difficult to fill.
Marketing is about making others understand that you are valuable and that you offer a service that they need or that they can benefit from. Obviously, for others to understand what you have to offer, you must first understand and be able to articulate what you have to offer.

Finding the right "Niche"
Many claim that the single best way to develop a private practice is to be able to offer something unique, something where you have skills beyond those of your competitors. Developing such an area of expertise is known as building a niche. To build the niche you should attempt to learn everything you can about your chosen area of emphasis. That means reading all of the resources you can get your hands on, participating in trainings, workshops, seminars, and courses in your chosen area, and possibly getting consultation from those more expert than you.

To become proficient, you will also need a great amount of direct experience in working in your chosen area or with your chosen population. In your mind, you should become an "expert" or "specialist" in your selected niche, even though we would not advise that you refer to yourself as such, because you would be held to that standard. Click here for niche opportunities that you may want to consider developing for yourself. This is, by no means, an exhaustive list, but it may help to spark your imagination to create a niche that is unique and well-suited to you.

When you have selected and ultimately developed the competence necessary to be more proficient than your peers in working in your selected niche area, you will want to consider how you will market yourself, and accentuate your niche in that marketing.

The Marketing Plan
At this point, you should consider developing a marketing plan. While you can certainly contract with a marketing expert to create this plan for you, it is likely not in your budget to pay for these services as a budding private practitioner. It is possible for you to develop your own marketing plan. The typical marketing plan has the following components:


Format for Marketing Plan
1. Situation Analysis-define where you are now
  A. Evaluate the opportunities and threats within your external environment-see #1 above
    i. Competition
    ii. Economy
    iii. Political/legislative/legal/regulatory
    iv. Suppliers
    v. Technological
    vi. Professional
  B. Evaluate the opportunities and threats within your internal environment
    i. Financial
    ii. Personnel
    iii. Managerial
    iv. Professional
    v. Informational
2. Marketing Opportunity Analysis
  A. Existing or new markets you are able to or can serve
    i. Demographic/psychographic profile
    ii. Opportunities and threats
    iii. Informational
3. Mission Statement-where do you want to go and what do you want to do or be
4. Performance Objectives
5. Strategic Marketing and Administrative Plan-including timelines. How Do You Want to Get There and What Will It Take to Achieve Objectives
  A. Financial
  B. Management/Personnel
  C. Marketing and Promotion
  D. Pricing

Legal and Ethical Issues Related to Advertising
One cannot take a look at marketing without referring to the legal and ethical issues surrounding marketing and advertising. Every profession has Ethical Standards or Codes of Ethics that may address issues of advertising. Each professional should look to his or her profession's ethical standards to see if and what limitations may exist for the profession. Generally speaking, all professionals are expected to engage in advertising that is not "false, misleading or deceptive." For example, the relevant ethical standards for marriage and family therapists in California are indicated in the sidebar  Click Here for sidebar information.

Policy on Advertising "Psychotherapy"/"Psychotherapists"
In addition, in California, CAMFT has a policy on Advertising "Psychotherapy"/ "Psychotherapists." This same policy was once adopted by the licensing board for the profession and is equally applicable to clinical social workers and marriage and family therapists.

This policy provides:
"This policy is adopted by the California Association of Marriage and Family Therapists because of its firm belief that arbitrary limits or restrictions on the use of the specific words in advertising do not serve the interests of consumers of mental health services, but tend to promote unhealthy "turf" battles between competing professions. CAMFT's commitment is to the provision of factual information, which will assist the consumer in making informed decisions with respect to the utilization of professional services.

This policy should not be construed, nor is it intended, to encourage any specific manner or form of advertising or the usage of any words. It is not intended to serve as a substitute for independent legal advice on the issue of permissible, i.e., lawful advertising. Its purpose is simply and solely to clarify the position of the California Association of Marriage and Family Therapists with respect to the use of the words "psychotherapist" or "psychotherapy" in advertisements by its members who hold the Marriage and Family Therapist license.

Use of the words "psychotherapy" or "psychotherapist" in advertising by a licensed marriage and family therapist is not, in itself*, a violation of law or regulation, nor is it, in itself, false or misleading advertising, provided that all of the following conditions are met:

1. the advertisement indicates the full name of the licensee and the complete title of the license (licensed marriage and family therapist or marriage and family therapist-in those words).

2. the person advertising is competent, by reason of his/her education, training, and/or experience, to perform the professional services advertised or to act in a manner or professional capacity advertised.

*The words "in itself" are of significance. Whether or not a particular advertisement is found to be false or misleading or in violation of any law or regulation depends upon an analysis of all of the facts and circumstances relating to the advertisement in question. Certainly, the usage of any and all words will be amongst the factors considered.

Marketing Opportunities
Following are a listing of marketing opportunities that have worked well for others. You may or may not have a similar experience. Keep in mind, once again, that this list is not exhaustive, but hopefully it will help to spark your imagination to create the marketing techniques that will be effective for you. Further, keep in mind that any marketing technique will be only as effective as the individual is positive. Should you take the attitude that it will not work, it probably won't. What's more, no technique will likely be effective, because it will be thwarted by attitude. So, put a smile on your face, and look at all of the possibilities that could potentially work for you.

  • Make sure your TherapistFinder listing is as comprehensive as it can be, or if it does not exist, create it
  • If you do monthly statements, enclose educational flyers
  • Do one or more local radio shows
  • Speak before local service groups and clubs
  • Write an educational column for a local newspaper, local tabloid or other local publication
  • Submit news releases to local media about your professional activities
  • Speak at local bar or other attorney association meetings
  • Develop relationships with the courts
  • Network with attorneys
  • Create an attorney-therapist network in your local professional association
  • Offer support groups targeted at issues in your area(s) of emphasis
  • Do workshops at adult community service programs
  • Teach a college class
  • Offer telephone or Internet therapy
  • Fill in for therapists on vacation or taking leaves of absences
  • Develop a professional relationship with a physician and work in his or her office
  • Offer parenting classes
  • Take out small, classified ads in local newspapers and periodicals for any special offerings
  • Publish community resource materials, e.g., manual for eldercare concerns, and provide it to other healthcare professionals, libraries, etc.
  • Offer executive or personal coaching
  • Offer a support group for therapists
  • Offer 60-minute brown bag lunches for women or men
  • Offer a late night counseling service and/or hours on Sunday
  • Create a website
  • Get your name into no-cost or low-cost directories
  • Send thank you notes to all who refer to you-you don't need to identify the patient's name
  • Develop a relationship with other professionals in the area who may be overloaded or wish to reduce work hours
  • Hire an intern who is great at marketing
  • Send birthday, anniversary or graduation cards to patients
  • Follow-up with patients in writing after therapy has terminated-keep your name on their minds so that they can refer others or return for a tune-up when needed
  • Get your name onto referral service listings-those that do not require an exorbitant fee that is

Create and distribute patient/client newsletters- the newsletter can be online or mailed. Remember-the more you keep your name in front of people who may need your services or who may be able to refer to you will reap rewards. However, know your limitations, if you are not a good writer, do not write a newsletter unless you have a competent editor. You want your marketing to create a positive impression-poor writing skills will create an unfavorable impression.

Write personalized letters to referral sources and potential clients-however, if you are going to ask for something, be prepared to offer something. Offer to take other professionals to lunch so that you can get better acquainted so that you may be able to crossrefer. Be prepared to learn more about the other professional, what they specialize in and the populations they treat, so that you are able to refer to them. Offer to provide them with a resource that you have prepared that they may share with patients in your or their area of specialty. While time consuming, such letters should be individually prepared for each recipient.

Meanwhile, think about those in your community who may be your referral sources. They may include, but are by no means limited to, physicians, chiropractors, attorneys, accountants, financial advisors, rehabilitation therapists, pharmacists, ministers, human resource directors, employee assistance professionals and programs, employers in your community, schools, churches, nurses- especially school nurses, front desk personnel for health care professionals, community programs, nursing/retirement homes, hospices, clubs for retired persons, community- based, adult education, professional association chapter members, and other psychotherapists. But, don't stop with "thinking about" these folks and entities, make contacts, follow-up and develop relationships.

As an aside, our surveys indicate that 22 percent of referrals come from patients, 16 percent from colleagues, 8 percent from family friends and neighbors, 8 percent from managed care entities, 7 percent from physicians, 6 percent from EAPS, and 5 percent from advertising.

Don't forget to ask your patients on intake how they heard about you-this question will help to identify what marketing efforts work best for you.

Join the local Chamber of Commerce, service clubs, or even Toastmasters, to develop relationships with those who may refer to you because you have developed a relationship with them. Besides, if you join Toastmasters, you may even perfect your public speaking skills, which will also aid in your marketing efforts.

Write, Produce and Distribute a Practice
Brochure-a first-rate brochure is one of the most versatile and least expensive marketing marketing tools available to the professional in private practice. This brochure can be used to create other advertising, as well as a website. Consider how such a brochure can be useful in your practice:

  1. Give to new patients/clients to create a powerful first impression.
  2. Give it to existing/prior clients to reinforce ties.
  3. Use it to boost morale by creating a sense of identity for yourself and for your staff, if you have staff.
  4. Mail it with a personal letter to prospective patients/clients.
  5. Provide it to those with whom you are attempting to develop referral relationships.
  6. Give it to existing patients/clients to share with friends, family and other acquaintances.

Writing Copy that Sparkles
First, prepare an outline. If you don't know where you are going, any road will take you there. That is why the first step in writing crisp, clean copy is to prepare a roadmap, or outline of what you want to cover. Jot down any and all ideas that come to mind-you can always cull out the unnecessary information.

As you get started, here are the topics most commonly covered in practice brochures:

  • Short, friendly welcome message.
  • Your name, address and possibly directions, telephone number, license title, and website.
  • Parking and public transportation information.
  • Your office hours and availability.
  • Your credentials, areas of emphasis or specializations (briefly).
  • Appointment procedures.
  • General information on fees, acceptance of credit cards, insurance accepted.
  • Brief history of practice or experience.
  • Possibly a picture.

When your outline is complete, and you have eliminated what is unnecessary from your individual brainstorming session, draft the copy for the brochure. Remember that a brochure is only an introduction to your practice-do not try to answer every conceivable question. When you are down to your final list of topics, arrange them so that they make sense. If you are having trouble arranging the content of the brochure, do what many writers do-write each topic on a separate index card and shuffle the cards until they are in the "right" order.

Writing the text: The best brochures are often those with the least copy, usually one to three paragraphs on each topic. Think about it in terms of what is the least amount of copy I can write to adequately convey the message. If necessary, write it, then cut out what is unnecessary.

Then, set it aside, and later edit it. Do the setting aside and editing at least a couple of times. Then, get another editor to look over your work, correcting things overlooked, catching typographical errors, and identifying items that are unclear or confusing. Then finalize the content. Remember, it should read as friendly, with simple basic English (if written in English), be written in the first person, and be pleasing to the eye. To be pleasing to the eye, there should be a lot of "white space" (copy should not be too wordy or too tight in the brochure), only one type face should be used and that should be a "serif" type (serif type is easier on the eye and thus easier to read), should have a jagged right margin, and should avoid using all upper case type. The color and graphics should be pleasing and allow for good readability. Then have the brochure professionally printed. And, by all means, do not photo-copy bad copies.

For all but a very select few, marketing is a necessary component of any business, and of course, your practice is a business. Set aside time each week to market your practice, and then use that time for the purpose intended-marketing. Marketing is not a "dirty" word, it is a necessary component for you to be able to do what you want to do-therapy with your clients. Marketing may be the "work" needed to get the reward-the opportunity to treat new and different clients. Remember, that in any field, marketing becomes a numbers game. You will not win with every attempt, but you will win some of the time. Thus, the more you do, the greater the rewards you will reap. Don't look upon marketing as drudgery, it is the means to the end goal. And, like anything else in life, the more you do it, the easier it will become.
1We do not believe that advertising is necessarily unprofessional or unethical. Of course, it may be, but the test is in the nature of the advertising.

This article appeared in the March/April 2004 issue of The Therapist, the publication of the California Association of Marriage and Family Therapists, headquartered in San Diego, California. This article is intended to provide guidelines for addressing difficult legal dilemmas. It is not intended to address every situation that could potentially arise, nor is it intended to be a substitute for independent legal advice or consultation. When using such information as a guide, be aware that laws, regulations and technical standards change over time, and thus one should verify and update any references or information contained herein.