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Practice, Heart and - Money - Can They Really Go Together? Introduction First of all I wish to thank the 36 people who took the time to give us their information and feedback that made this survey worthwhile. It was particularly helpful that there were those contributors who took still more time to write out additional comments which proved to be both informative and enlightening in answering the questions. There were a divergence of opinions which are thought provoking and point out once again that there are a number of values involved in running a practice some of which values can conflict with each other. This is the true dilemma, when there is a conflict between values rather than a conflict between right and wrong. There is a challenge to run a practice that can both be a means of providing a solid livelihood and a practice that is of service to others. This was one of the interests I had in putting this survey together. My hope was in the end to have a sense of how our local practices are being managed and to share this information in a way that will be of help to each of us. Considerations and Questions If there had been sufficient time, it would have been valuable to have run a test survey to work out some of the bugs: Also, after the survey was published, further questions came to mind as well as those suggested by the contributors: Were this survey ever run again, these revisions would be important and helpful. The Survey To download the original survey, click here! The Results (written responses for questions 9, 13, 22, 26, 28 will follow after question 28) Abbreviations: R = range Av = average 1. What is your normal fee? R: $110 to $55 Av: $88 2. Do you offer a sliding scale? Yes: 32 No: 4 3. If so, what is the range for your fees? * Min: $20 - 80 Av: 52; Max: $70 - 110 Av: 88 4. Do you limit the number of low-fee clients? Yes: 23 No: 13 5. Do you accept insurance/managed care? Yes: 28 No: 8 6. Do you charge for late cancellations? Yes: 33 No: 3 7. If yes, what do you charge? Full fee: 31 Other: 2 charge ½ fee 8. Again if yes, do you charge: always: 8 sometimes: 25 9. If sometimes, please explain: (see below) 10. Do you need to earn an income? Yes: 32 No: 4 11. What is your comfort level in charging your full fee?
(On 10 point
scale, 10=easy, 0=hard) 12. What is your comfort level in charging for late cancellations or no
shows? 13. If you use a sliding scale, how do you determine what to charge? 14. What is your last year’s (2004) gross salary for your practice? 15. In your practice, do you work: Part-time: 22 Full time: 12 16. Do you have more that 1 office location? Yes: 9 No: 26 17. If you work part-time, do you wish to work full time? Yes: 5 No: 19 18. Approximately how many hours per week do you work in your practice? 19. How many hours per week would you like to be working in your practice? 20. Do you have non-practice income/work? Yes: 20 No: 16 21. If so, do you wish to continue both kinds of work? Yes: 14 No: 3 22. If so, would you explain why? (e.g. stable income, etc.) (see below) 23. How long have you been licensed? R: 2 - 30 Av: 14.0 24. How long have you had a practice? R: .5 - 32 Av: 13.3 25. Are you a member of your local Chamber of Commerce? Yes: 1 No: 34 26. Honestly, on a gut level, does it feel like charging fees and providing therapy seem like a conflict of values? Yes: 8 No: 25 Both: 3 27. How comfortable are you "marketing" yourself and your practice? (10 to 0
scale) 28. Do you have any questions or thoughts along these lines that you would like to have brought up at May’s meeting for discussion? * MediCal base rate = $33.64 / Child Protective Services base rate = $30 Written Responses (questions 9, 13, 22, 26, 28) 9. If you do sometimes charge for late cancellations, please explain: Responses: Don’t charge for: Comments: 13. If you use a sliding scale, how do you determine what to charge? Responses: Client determines based on ability to pay; what person says they can afford Negotiate with client Full fee for non-insurance clients Comments: 22. If you have non-practice income/work and wish to continue both kinds of work would you explain why? (e.g. stable income, etc.) Responses: It was with question 26 that I had hoped to explore the potential conflicts and dilemmas of managing a practice. The responses that follow give a wonderful perspective of the values involved! 26. Honestly, on a gut level, does it feel like charging fees and providing therapy seem like a conflict of values? Responses: Comments:
And finally the last question: 28. Do you have any questions or thoughts along these lines that you would like to have brought up at May’s meeting for discussion? Fees Coaching Survey results Other issues that would like to be addressed:
Summary: Most of the respondents use a sliding scale and charge for late cancellations so sharing their comments can be helpful to us all in having a sense about what others are doing and use to guide us in our own practices. One recommendation I would make from this is that we each consider having a written policy that clearly states what our expectations are for our clients and ourselves. So hopefully by comparing our fees to those charged by others and making use of ideas that may prove helpful to us we may be able to expand our practices as we are wanting so that we can have that balance between truly providing for a living for ourselves as well as serving our clients. My hope is that this survey will be helpful toward this end. F. Michael Montgomery, LCSW, MFT |
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F. Michael Montgomery, LCSW, MFT |