Why you can’t Afford To Practice Without An Office Assistant


By: Larry Waldman, Ph.D., ABPP

For the past twenty years when I present to mental health providers on how to develop, manage, and market a private practice I always ask members of the audience to raise their hand if they practice without an assistant. Depending on the group and location, typically half or even more of the providers acknowledge practicing solo.

When I question why this is the case, the most common reason expressed is cost. My response is always the same: “You cannot afford to practice without an assistant.”

On my three busiest days I see eight to ten patients. If I had to pull charts, re-file them, answer the phone, collect, reschedule clients, schedule new clients, return “shopping calls,” make new files, type letters, etc. I could see only half that many patients. Thus, I cannot afford to be without an assistant.

Aside from the cost issue there are several other reasons why working with an assistant is necessary:

1. If you are running a one-person shop, I believe you are sending a message you are “small potatoes,” as my Dad used to say. To me it suggests a lack of professionalism. I would think twice before using any service professional—attorney, financial consultant, CPA, etc. who worked alone.

2. When that prospective new client decides to call your office that morning, did they decide to call just that day or had they been thinking about calling for some time? Obviously, the latter. When that prospective new client calls, what do they want? They want to speak with a knowledgeable person and schedule their first appointment as soon as possible. What they don’t want is to get a recorded voice telling them to leave a message.

When that prospective client finally makes that initial call and gets a recording what are they likely to do? Many will leave a message but many of them also will make another call—to the next therapist on their list. Once again, one cannot afford to be without an assistant. When new patient calls my office they get a live person who can answer all their questions and schedule them immediately.

The first question I ask every new client is, “How did you find me?” (Every mental health provider should ask this question.) I cannot tell you how many times the answer to my question is, “Your office was the first to answer my call.” (Strangely, over the years many new clients have reported they never receive a return call from other therapists. I guess those other therapists are too busy filing and making charts.)

3. When the solo provider finds the time to call back the prospective new client, assuming the client has not made an appointment with another provider, the conversation is likely not to be brief. Once the client realizes they are speaking directly with the therapist they will be tempted to “tell their story.” This presents a difficult situation, as the therapist is reluctant to cut off the conversation. Thus, the solo therapist is spending more time without compensation, not to mention teaching the client they are willing to work for free. Moreover, if during the “free scheduling phone session,” the client implies they might be suicidal, the therapist is now also faced with the duty to protect a client they have never seen.

4. If the provider is seeing only a few clients per day they might get by working solo. However, with this practice they are likely to remain small because they will have insufficient time to market their practice to make it a larger thriving one.

Larry F. Waldman, Ph.D., ABPP is a licensed psychologist who has practiced in the Paradise Valley area of Phoenix for 35 years. He works with children, adolescents, parents, adults, and couples. He also provides forensic consultations in the areas of family law, personal injury, and estate planning. He speaks professionally to laypersons, educators, corporations, and fellow mental health professionals. He teaches graduate courses for the Educational Psychology Department for Northern Arizona University. He is the author of “Who’s Raising Whom? A Parent’s Guide to Effective Child Discipline,” “Coping with Your Adolescent,” “How Come I Love Him But Can’t Live With Him? Making Your Marriage Work Better,” “The Graduate Course You Never Had: How to Develop, Manage, Market a Flourishing Private Practice—With and Without Managed Care,” and “Too Busy Earning a Living to Make Your Fortune? Discover the Psychology of Achieving Your Life Goals.” His contact information is: 602-996-8619; 11020 N. Tatum Blvd., Bldg. E, Suite 100, Phoenix, AZ 85028;LarryWaldmanPhD@cox.net; TopPhoenixPsychologist.com.