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Reviewed By Ronald H. Rozensky, Ph.D.,ABPP, Professor and Chair,
Department of Clinical andHealth Psychology, University of FloridaGainesville, Florida
Re-Printed from: The National Psychologist, July/August 2001.
Saying Good-bye to Managed Care:Building Your Independent Psychotherapy Practice by Sandra Haber, Elaine Rodino, and Iris Lipner, all well experienced independent practitioners, will serve as an extremely useful transitional object for all psychotherapists who are entering independent practice for the first time, thinking of going from part-time to full-timepractice, or those already in practice who wish to expand their practice opportunities.
This book offers the reader specific ideas and direct methods to build the clinical and business sides of practice and successfully market yourself as a healthcare provider. Throughout the text, the authors utilize shortvignettes, their own stories and those of others, detailing practice development issues, problems, and solutions. They identify by name those practitioners telling their stories, their individual practice circumstances,and successful solutions to problems based upon real situations. This narrative style makes the book effortless to digest and brings the messages right into the reader's own consulting room with stories that are familiar and easy to identify with.
There is a frank discussion of "money" including how to discuss cost justification for psychotherapy and the oft uncomfortable topic, especially for novice practitioners, of fee setting and how to ask for payment. The authors also offer a specific list of cost control ideas for those who are understandably anxious as they embark on starting or expanding their independent practice.
There are chapters specifically designed to help the reader identify their personal niche[s] in which to practice and how to move into new areas of practice in order to expand professional independence and income opportunities. Practitioners are encouraged to explore many expansion opportunities. The authors define what they title a "gold standard" for practice skills needed to establish the expertise required to successfully move into and then market new arenas of practice. They state that in order to be successful one should "take a good look at what you know and what you will need to know to become an expert. Be sure to consider your education, supervision,and experience" (p 176). They then go on to suggest continuing education training and workshops to build new areas of expertise before embarking uponpractice expansion. They offer a meaningful formula for practice successcomprised of those gold standard clinical skills plus a long term marketingstrategy.
On the marketing side, and most useful to readers,are specific ideas for practice expansion. These range from infertility counseling to parenting skills, from premarital psychotherapy to divorce counseling, and from psychotherapy with those with illness or disabilities toeldercare issues and funeral consultation, just to name a few. Some marketing targets like clergy, funeral homes, various medical specialists, and websites are discussed. Some of these suggested areas of practice expansion will be "old hat" to many but willstimulate additional opportunities for those whose practices are confined tothe usual office-based scenario and are looking to break out of the constraintsof their present situation.
The authors present very practical, hands on, examples of marketing techniques ranging from the traditional "how to layout a business card" to the more contemporary "how to build a webpage". Actual copies of newsletters, fact sheets, and brochures are presented and these will be very helpful to both the novice and experienced practitioner considering how to better market themselves to the professional and lay public in order to enhance referrals. Practical suggestions on how to organize workshops and lectures inthe community as marketing tools will serve the readers as useful catalysts for practice enhancement. Various dates throughout the year (for example, National Depression Screening Day, Family Health Month, Breast Cancer Awareness Month, etc) are listed as marketing foci along with ideas on how to use the media, radio, television, newspapers, and publishing your own work to "get the wordout" about you and your practice.
I have held comment on the "Saying good-bye to managed care" sections of the book until last although they are actually the first chapters of the text. The authors do a good job describing the day-to-day "troublesome issues that question the quality of care" (p 19) for those practitioners who choose to or must practice within the managed care controlled practice environment. The authors also recognize that some practitioners might continue in the managed care market due to their own financial needs or in understanding that, for many patients, managed care is their only financial means to psychotherapeutic treatment. But, make no mistake about it, the authors make it clear that they are highly motivated themselves, and are highly motivating to the practitioner-reader to strongly consider the advantages to him- or herself and his or her patients of "saying good-bye to managed care."
They detail well with and speak strongly about the usual problems of confidentiality, poor payment, loss of independence, and ethical issues in treatment that managed care stimulates. Appropriately so, the authors spend less time on those problems, well known to most practitioners and students these days, and the bulk of the text focuses on solutions to building an independent practice to benefit the practitioner andpatients alike.
Finally, the authors suggest that not enough is done or taught in graduate training for those choosing to go into practice. This educational problem has been changing dramatically in recent years with more and more courses in professional issues now including practice management concepts and healthcare economics for graduate students in psychology. For those interested in independent practice careers, more knowledge is certainly better, and this book will be a useful and practical tool that both will encourage and help the reader succeed in practice development and marketing. References are listed including various healthcare websites and names and addresses for those practitioners who offered their own practice vignettes.
Saying Good-bye to Managed Care: Building Your Independent Psychotherapy Practice is published by Springer Publishing Company, is 228 pages in hardcover, and lists for $46.95.
Saying Goodbye to Managed Care
By Sandra Haber, PhD, Elaine Rodino, PhD, and Iris Lipner, CSW
Springer Publishing Company, New York, 2001.
Reviewed by
Stanley Molawsky, PhD
In this time of struggle with managed care and the resultant drop in mental health services by 54% over the past ten years, this book is very welcome and heartwarming. It takes you on a journey from despair to joy as you learn how to build your independent practice free of managed care. It teaches you how to market yourself. It presumes you are well trained but aren't comfortable marketing yourself. Read this book and you will find the skill! The examples in the book by well known psychologists who have done it are inspiring and help you develop the wherewithal to free yourself and thrive as a practitioner. This is a "how-to" book, taking you through steps such as developing a web site, advertising, basic tools, intermediate tools and advanced tools of the trade. It helps you ask for money for your services and not be embarrassed about it. It reminds you that you are a professional but that you are also an entrepreneur, that is, a business person.
This book is well written and free of psychological jargon. You feel you are being mentored by experienced people and that they are enjoying being with you. No criticism is being extended as they help you on this journey. Some folks have to hang on to some managed care cases as much as they hate it and the authors respect your situation but show you ways to move in the direction of a truly independent practice.
This book is recommended for students who are contemplating entering private practice as well as those who are already there. It is packed with helpful hints and should be on the desk of all psychologists. I loved it.
Books in Brief - NYSPA Notebook (New York State Psychological Association),
June 2001.
Patricia Pitta, Ph.D., ABPP
Haber, Sandra, Rodino, Elaine, & Lipner, Iris (2000). Saying Goodbye to Managed Care: Building an Independent Psychotherapy Practice. Springer Publishing.
Do you want to build or rebuild an independent psychotherapy practice? Do you want to maintain control over your professional life? One way to do this is to create a practice free from managed care. Unfortunately, traditional psychotherapy practice, with more than enough referrals, is a phenomenon of the past for many psychologists.
Managed care has created a reality in which therapists are working longer hours with less compensation. Managed care has cheated both practitioners and patients. Patients have lost the ability to succeed in their therapeutic goals without being managed by a third party. At the same time, they frequently lose their rights to confidentiality. Therapists have been denied the decision making power to determine the needs and treatment of their patients and the right to earn a well-deserved fee for their services.
"Saying Goodbye to Managed Care" is meant for those who want to develop an independent practice free from the demeaning, destructive, and demoralizing system of managed care. It is also meant for practitioners who do not work within the managed care network but who are looking for ways to revitalize their practice. In short, "Saying Goodbye . . . " can help practitioners bring a new perspective to creating a successful private practice.
The authors (the first of whom is a NYSPA member) offer practitioners a step-by-step approach to enable them to visualize and create a plan to enhance their practices so that they will be fulfilled professionally, economically, and personally. Their topics include:
- Money: how to ask for it and how to get it
- How to carve out your niche and market your services
- Basic tools of the trade, including stationary, business cards, flyers, and newsletters.
- Intermediate tools of the trade, including speeches, workshops, web listings, and a basic web page
- Advanced tools of the trade, including press releases, pitch letters, writing books, interviewing for the mass media, advanced web sites, virtual groups, on-line counseling, e-zines, and electronic publishing and advertising.
I especially liked the personal stories by the authors describing the ways in which they created their own successful and gratifying practices. Of particular interest are the descriptions of ways to create "value added services" (other professions needing our services) as a means of building a successful independent practice. A step-by-step process of creating consultation and niche market practices is described with samples of marketing techniques. Visual samples of marketing products are illustrated and explained. All of these efforts are directed at helping practitioners bring integrity, control, quality, and success to their practices.
Reviewed by: Sharon Shrensel, Psy.D. & Charles I. Zadikow, Psy.D.
Co-Presidents of the American Mental Health Alliance - USA, Inc.
For AMHA Website
Saying Good-Bye to Managed Care: Building Your Independent Psychotherapy Practice
Sandra Haber, Ph.D., Elaine Rodino, Ph.D., and Iris Lipner, CSW
Springer Publishing Company, 2001, New York, NY
The introduction to this informative book is written by Karen Shore, Ph.D. who speaks of our need, as professionals, to become independent of managed care. She also speaks as an inspiring advocate for patient rights, that it is our responsibility, as professionals, to help preserve quality psychotherapy for future generations of con-sumers as well as professionals.
This book asks us to be courageous, to follow the instincts that brought us into this field originally. It takes courage to stay out of managed care but these authors have taken those necessary steps and tell us how to follow them. They offer an over-view of beginning a private practice, deal with such difficult issues as money and fees, and explore attitudes and fears about becoming an autonomous business per-son. These seasoned therapists guide the reader through marketing strategies, that respect and support independent direct-fee private practice. They deal with the con-flicting ethical subject of dealing with managed care and demonstrate how this can have a negative effect on the client, the therapy and how it can serve to demoralize the therapist.
Further, the writers, all experienced in building private practices in a managed care age, proceed to remind us that psychotherapy is cost-effective, that people CAN afford to pay for quality therapy, that private pay buys confidentiality, and importantly, how the therapist can deal with his/her own anxieties about money in order to over-come them.
The authors offer helpful hints on such topics as broadening our scope of practice and discuss niche specialists versus generalists. They offer a great deal of useful information on marketing tools. One very important tip is that we must market, market, and market. They go on to highlight future developments such as the in-creasing use of and potential value of web sites for psychotherapists. At the end of the book is a long and useful practice building resource list.
In the final analysis, the authors urge us to value our own work and worth and not to submit to the devaluation and depersonalization inherent in a for-profit man-aged care system. We highly recommend this volume to all therapists needing to establish and/or revitalize their practices. We praise these authors for their principled positions and practical solutions. They will help you to build a thriving private practice.
Reviewer: Ed Lundeen, Ph.D., Allentown, PA, Member of Interdivisional Task Force on Healthcare Reform - Saying Good-bye to Managed Care - A Book Review.
It is said "that every cloud has a silver lining". Sometimes a silver lining itself can even have a silver lining. Allow me to illustrate. Via the good graces of 2 truly respected colleagues, I was asked to review their new book, "Saying Good-bye to Managed Care, co-authored by Sandra Haber, Ph.D., Elaine Rodino, Ph.D. (both noted psychologists), and Iris Lipner, CSW (Social Worker). The honor was mine at the asking, though it meant reading another book and the height of my pile had already exceeded local zoning codes (you know, you've seen shorter signs for McDonalds). But in my consent came the second lode of silver, as Haber, Rodino and Lipner have put together a compendium worthy of anyone practicing psychotherapy in this, our winter of discontent.
Though the book is titled Saying Good-Bye to Managed Care (with a foreword by stalwart managed care slayer Karen Shore; I suppose they had to slag the industry somehow), it could easily go by its subtitle "Building Your Independent Psychotherapy Practice". For while it is founded on the premise that you can burn your managed care contracts once you have mastered this volume, you need not be a zealot to profit. For Haber, Rodino and Lipkin have offered to teach us how to build a practice that lets us choose where our business comes, teaching us to be marketers and business people while retaining our ultimate craft as healers. Many who read this volume may begin the path to freedom from the burden of even one more treatment plan or case manager conversation, but many others will simply use these ideas to augment their existing practices, with no change in their affiliation with managed care.
This is a book chock full of practice ideas but first Haber, Rodino and Lipkin do something rarely (if ever for most of us) done. They ask us to define our practice and our beliefs in therapy, and then, in the ultimate taboo, they ask us to think about money. And they don't ask this in some existential, analytic or ethereal way. They offer concrete information on how to think about money and its meaning in our business. The authors know that even healers must make a living to do what they do and that without understanding how to deal with money matters, we do both ourselves and our patients (clients, customers?) a disservice. This chapter alone makes the book worth a read as I have yet to find another such printed conversation on this most important subject (and don't worry, they don't violate any anti-trust laws in the process).
Having "freed our minds" the authors then come at us with chapter after chapter of thoughts on how to successfully market your business, and build a niche (or niches). In these chapters, there is something for everyone, a veritable cornucopia of ideas for practice expansion. And the ideas are not just pie in the sky. Each is tried and true as every idea is backed with the real life example of fellow colleagues with their own success stories. Haber and Rodino also have extensive work contact with marketing professionals, whose ideas (so different from ours, yet so useful) are what successful businesses use. And when you get really excited and want to know more about a particular idea, the authors have given us a Resource List (with contact information!) of the professionals quoted in the book as well as other noted professionals, who have blazed the trail of successful independent practice (and I know by experience that many of these people will even contact you back).
This book will energize you. It will give you ideas you didn't think of and encourage you to explore others you have had. Students should read this book before they try to hang out their own shingle - it will teach them what they simply didn't have time to learn in Grad School, e.g. how to make a successful and reduced-frustration living at the occupation we spend most of our lives training for. Existing and even seasoned practitioners will find in this book the confidence boost they have wanted to wrestle free from the chains of the health care system so as to start enjoying practice more. Read this book and then take action, because you will want to when you have turned the last page. Then, pass it on to a friend, because it deserves to be read by many (and knowing Haber and Rodino, I can imagine they would abhor collectors dust on their books).
"Saying Good-Bye to Managed Care" by Sandra Haber, Elaine Rodino, and
Iris Lipner is available via Springer Publishing Company, 536 Broadway,
New York, New York 10012-3955, Tel. 212 431-4370. ISBN: 0-8261-1463-6,
Published 2001.
Saying Good-Bye to Managed Care: Building Your Independent Psychotherapy Practice
By Sandra Haber, PhD, Elaine Rodino, PhD and Iris Lipner, CSW
New York: Springer Publishing Co., 2001, $46.95; 205 pages: hardcover
Reviewed by Jana N. Martin, PhD
Say hello to realistic, clear-cut strategies for building and thriving in your independent practice. By reading the recent book by Sandra Haber, Elaine Rodino, and Iris Lipner, you will be introduced to clinicians who have faced some of the same dilemmas you may be facing about how to maintain a viable practice in a time when managed care and other impediments seem to be working against you. The authors do more than introduce you to these clinicians, however. They also describe and provide numerous examples of the tactics used by successful independent practitioners and, most importantly, translate how these and other strategies can be used by you in your own practice. This approach elevates the book from being an informative resource which summarizes what has worked for others, to the ultimate "how to" book which comes as close to one-on-one consultation as a book can. Additionally, the book manages to be as useful to the seasoned clinician as well as to the new professional and provides some guidance even for graduate students.
The format of Saying Good-Bye to Managed Care: Building Your Independent Psychotherapy Practice contributes to the user-friendly nature of the book. Once the philosophical background of the book in the first few chapters is grasped, the reader can then refer to specific chapters of interest and get the most from them without having to re-read preceding chapters. The format also carries the content well using bullets, headings, figures, and insets to make reading and finding topics easier, to enhance absorption of the information, and to allow for generalization and individual application by the reader. Each chapter is focused on a particular aspect of marketing that can be used by any independent practitioner. The authors delineate the "tools of the trade" as basic (e.g., business cards, fact sheets), intermediate (e.g., workshops, web listings), and advanced (e.g., interviews, press releases, E-zines), again, so readers can determine which approach is best suited to their level of training, comfort, and need. The authors bring readers full circle and conclude their book with a sample marketing plan complete with a timeline, a "to do" list, and a rich appendix of resources.
Throughout the book, Haber, Rodino, and Lipner emphasize an ethical and responsible approach to educating the public and promoting the profession. They frankly address issues such as resigning from managed care panels, making a profit, marketing services, and being in the public eye, which cause tension for many independent practitioners. Their discussion is effective and may provide just the right shift to motivate and ease previously cautious clinicians into action.
Saying Good-Bye to Managed Care: Building Your Independent Psychotherapy Practice can be an integral tool for the success and enjoyment of your practice. It can fill the gaps between your practice and the public you want to serve. Say hello, and let the introductions begin.
Jana N. Martin, PhD is in private practice in Long Beach, California. Dr. Martin is CPA President-elect, and serves as Chair of the CPA Marketing Committee. She is also Southern California Public Education Campaign Coordinator for the American Psychological Association
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