I celebrated FOUR years in private practice this month🍾🍾!! It feels like I have been doing it forever but also seems wild to me I have a successful business and it has changed my life in so many ways. When I first opened my practice it was mostly out of survival, I was at a practice where I did not feel aligned with the practice and my patient's were noting this and I decided if I wanted to be able to do things a certain way I was going to have to just do it myself. I did not feel ready, I felt scared but I also felt like it was my only option at the time. When I first started I was working a lot transitioning patients from one practice to another entering them into my EHR, getting their insurance information, setting up my EHR, insurance contracts, learning how to bill insurance etc. On top of still seeing a full caseload. I spent a lot of friday nights and saturdays on the computer doing the most mundane tasks but I knew it needed to get done.

Once I "opened" and was seeing patients I had this mindset and feeling like I was always working. My husband and I went away on vacation and there was a PA that came through and it had to be printed, filled out and faxed it could done be done on covermymeds or electronically and I was frustrated. Luckily, I have some NP friends and one was able to print fill it out and fax as covering for me. This made me feel like I couldn't be "off". It took a good year to 18 months for me to shift this mindset. I knew I did not want to go back to being an employee but I also didn't want to feel like I was working all the time. I learned alot along the way to make sure things like this didn't happen on vacation and I worked on my thoughts about never being off. I know look at it as I spend 5-10 minutes a day on vacation to be able to have unlimited time off which is a good trade off. I also don't come home to an over stuffed inbox like I did as an employee. When I go back to the office I have some left over things that didn't need to be done while I was away but I know my inbox is basically clear. This trade off may not be for everyone just as owning a practice may not be for everyone, but I turly feel it's a mental shift we make in order to feel the freedom of private practice.

Vitamin D

What't the antidote to burn out as a psych NP in private practice?

I think it's learning the limits of your clinical practice, emotional capacity and your bullshit (administrative) capacity. They all carry different weight, they all effect each of us differently and I think this can change during certain seasons of life. I have been embracing the seasonality of my practice. There is a general flow- for me as a pediatric provider- OCT/ NOV and April are poppin', I also like to work over breaks- Christmas break tends to be appointment heavy but amdinstratively less busy which is actually really nice. I typically also work the random school holidays.

Second cup ☕

I am curious your thoughts about insurance vs cash pay practice? This feels like such a hot button topic and very all or nothing. It's something I think about from time to time as an insurance based practice- would my admin burden be less? Well of course, but I also imagine I would have to advertise and network a lot more to have the caseload I have. I do feel as though I weight the idea of dropping some of the lower reimbursing insurances but then I look and there are two in particular I am in network with that are quite lower than the others but then I see I have a total of 5 (long term) patients between these two panels and I am not sure it's worth it. Curious your thoughts about this?!

What insights about private practice, burn out, Psych NP do you want to see? Shoot me a DM or reply to this email!

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Thanks for being here- See you next month!

-The Psych NP Nextdoor Natalie