I have built three successful practices having lived in Tampa, the Seattle area, and now Atlanta. My father-in-law once said to me, “Steve you are really good at getting customers.” At first I was taken aback thinking “customers”? No, I have clients. After all I’m a health care professional.

            My father-in-law was right. Our clients (whether they are the person sitting across from us in our offices or the gatekeepers that help to fill our practices) are our customers. Thinking they are clients is likely a remnant of having provided services in agencies or organizations where we were trained or obtained our first jobs. In these roles we did not have to think about the business of practice. Somebody else paid the rent, provided the telephone and computer system, and hired the support staff to make the clinic run. They even provided the paper and forms that we wrote notes on, and the ink to write the notes.

            In our Twenty Principles of Private Practice Success (for a copy of the list write to me at stevewalfishphd@thepracticeinstitute.com and I will forward a complimentary copy) the first principle that Jeff Barnett and I write about states:

            “You Need To Resolve the Conflict between Altruism and Being a Business Owner”

If you don’t get this one you are going to have a difficult time being a small business owner. Indeed, you may also place your practice at risk for clinical and ethical lapses. There are many reasons for this being such a challenge including lack of training in the business of practice, transference reactions from clients regarding the therapeutic relationship and having to pay for their treatment, and countertransference reactions from the clinician regarding money and being paid (sometimes at a high level) for provide care to someone in need.

            We are in a service business. Customers seek our skill sets (or products) that we label psychotherapy, assessment, and consultation. If this conflict is present for you, resolve it as quickly as you can. Resolution will help you practice effectively and ethically, and will allow your business to thrive.


Steven Walfish, Ph.D. is a Licensed Psychologist in Atlanta and a Partner at The Practice Institute (TPI). His book, Financial Success in Mental Health Practice: Essential Tools and Strategies is available thru APA Books or Amazon.com For more information on TPI go to www.thepracticeinstitute.com. Join our mailing list to learn more about activities and products to enhance both the clinical and business health of your practice.