The Private Practice Success Podcast

6: Know your Place in the System

• Gerda Muller • Episode 6

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Join Gerda as she shares her insights on the unique role of private practice in the mental health system. Learn how to navigate the challenges of systemic gaps while maintaining your focus and profitability. Reflect on your place in the system and empower your practice to thrive in its distinct role.


In this Episode, you'll learn (amongst others):

  • The distinct roles of the public, NGO, and private sectors in allied health.
  • How to navigate the pressures of filling systemic gaps without overextending yourself.
  • The importance of maintaining clear boundaries to prevent burnout.
  • Why charging fair prices and operating profitably are responsibilities, not options.
  • How to impact system accountability and improvement for the benefit of the industry and the community it serves.


Who This Episode Is For:

  • Private practice owners feeling overwhelmed by systemic gaps.
  • Allied health professionals navigating their role in the broader system.
  • Business owners seeking to balance innovation with sustainability.
  • Healthcare entrepreneurs aiming to build and scale profitable businesses.

Listen now to enjoy this thought-provoking episode, where Gerda explores the critical role of private practice within the broader allied and mental health system. This episode emphasises the importance of knowing the role and responsibilities of private practice business in the fight to prevent the burnout of clinical team whilst ensuring long-term sustainability in service provision.

Connect with Private Practice Success & Gerda here:

Hello there, spectacular private practice owner. My name is Gerda Muller and you are listening to episode number six of the Private Practice Success Podcast. 

And today I want to talk to you about a really interesting topic. Now you would have noted that the title for today's podcast episode is: Know Your Place in the system. I wonder what that is all about. I'll tell you. Knowing your place in the system, specifically means knowing where does the world of private practice fit within the world of allied health, and more specifically the world of mental health. Now I specifically focus on mental health because I'm a clinical psychologist myself, and my two group private practices are predominantly psychology practices, so that's the discipline that I live and breathe every day. But these principles obviously apply across all the allied health disciplines. 

The Three Main Players in Allied Health

So, if we look at the Australian context - because that is where I'm located - when we look at the system tasked with looking after the mental health, as well as the allied health needs of our community, there are three main players. 

The first player is public. The public system, or the public mental health system in the case of me as a psychologist. So I often have to work together or alongside the public mental health system. 

The second player is the NGO space. That is the non-government organisations, also known as the non for profits that play a role in supporting the mental health as well as the allied health needs of our community.

And then of course, the third player is the private practice part of the industry. So private practice is my world. I am a private practice owner, and you are most probably a private practice owner. 

And together, these three main players are tasked with looking after, supporting and advocating for the mental health needs and all allied health needs of the community that we all live and work in. And each of those three players have its own unique role to play. And this is where the title comes in. And that is to know your place in the system, and to know what your job is within that system.

Understanding Your Role in the Allied Health System

Now, I will be the first to say that I am always talking about innovating. I am always talking about stepping outside the box, breaking the chains of how we would normally do things and of how things have always been done

And I'm still 100 percent for it. But I'm also a realist, and I know that if we as a private practice business, tries to also operate within the public health space as well as the non for profit or the NGO space, there's not going to be a lot of time, money and energy left for the private practice space.

So we really want to ask ourselves and consistently remind ourselves, like in which of these three spaces am I meant to be operating in? What is my business here for first and foremost? Because I often see practice owners who are so very passionate about supporting their clients that they start to act like public health, because they know how hard it is for their clients to be taken into the public health system because of the long wait lists. People need to be in such a severe state in order to actually be accepted, that it's almost too late for them to get the help that they need.

And therefore, there's this huge bunch of people falling through the cracks. Same thing with NGOs. So NGOs generally get government funding and or grants, but they still have that budget within which they need to work, which means that again, they can only do so much. And I often find that it is the practice owners that try and pick up the pieces for where public mental health is failing our clients and our community. And where also at times, the NGO sector is failing our clients in our community.  

The Consequences of Acting like Something you are not

And the result for private practice is significant when they try and do that. It is first and foremost that mental and emotional load of knowing that you've got clients that need these other services, but for some reason they can't access it. Whilst private practice might not be suitable for them. And clients for which it might not be suitable are people that might need two to three sessions a week, okay, because that becomes really expensive for somebody to pay for in the private system. But if public mental health isn't taking them on, and they can't get in with an NGO, what is there for them? And this is just one example, right? 

And then the practice owner might go, okay, I will, just bulk bill you for all those sessions. But then there's only 10 of those that you can bulk bill a year. And then we have another problem because now we've gone through all these bulk bill sessions and what do I do now? Do I work for free? Do I start doing pro bono work? And I don't have an issue with practices doing pro bono work, right? But for how many clients can you do it? 

And that is where the problem comes in, when it is too many clients needing that type of support. And then what starts to happen is that clinicians start to take on clients - extra clients, - pro bono, maybe even bulk billed. And because they still need to earn an income, they now book additional clients in their day and in their week. And what starts to happen is they burn out. 

And guess what happens when clinicians burn out? They very often leave the industry, whether that is for the short term or even the long term. When I was a student studying to become a psychologist, I could never imagine ever leaving the industry once I got registered. But you know what? I hear of people leaving, like every couple of weeks. I learned of somebody that's just decided - No, I can't do this anymore. Okay, I can't do this anymore. It's too much. 

And knowing your place in the system is going to help you to prevent burnout -  whether that is you yourself as a solo practitioner, or whether it's you as a practice owner, because very often you might be the one taking on those pro bono clients while still needing to support your team, support other clients even, and manage and lead this business of yours called a private practice - and then you might burn out. Or if you ask your clinical team to do it, they might burn out.  

So my reminder for you today is to first and foremost acknowledge - that yes, you feel for your clients. It is extremely frustrating knowing that our clients need a particular service and that they can't access it.

As a practice owner myself, I know how that feels. I've been in the business of private practice now for 17 years. I've also been a business coach to allied health professionals that own group private practices now for 10 years. So I know it is not just me. I know that there are a lot of people that feel this way, and we really try to look after our clients in the best way possible. And sometimes it's just not possible to do, and the consequences dire, as I've said before.

So I want you to remind yourself - that your practice, if you've got a company or you are a sole trader with an ABN - that you are a private business, and that trying to act like the public system is not going to work out well for you. Trying to act like an NGO, is not going to work out well for you. Trying to be what you are not, is setting yourself up for failure. And if the other systems aren't performing as they should, don't step in and pretend to be them. Instead, what we need to do is keep them accountable. 

For us, as particularly as mental health professionals, our go to mode is to become the rescuer, to want to help, to want to serve. But that's not going to change the system. It's just going to burn us all out. And then what's going to happen to private practice? There's a chance of losing our industry altogether, and we do not want that. And I also don't want big corporates taking over our industry. There's something very unique and very special that the small to medium sized private practice has to offer our clients and our community, and I want you to be here for the long term. 

Supporting Your Team and Community

That all being said, being in private practice comes with its own set of responsibilities. For example, it means that you're going to have to be okay with charging a fair price for the service that you provide. That fair price allows you to have caseloads that’s not going to burn out your clinicians. That fair price allows you to pay your bills, to pay your operating expenses, to pay your amazing admin team, that is the gel that keeps the practice together. You have a responsibility to operate at a profit. 

Do you know that it's actually legal in Australia to not operate profitably? As a company in Australia, you've got a responsibility to make a profit. Profit is not a dirty word. Profit is great. It means that you are running your private practice as a business. And it's only when you start to make a profit, that you can actually afford to be abundantly generous and offer pro bono work. If you are profitable, you can get to a place where you can, without taking the risk of burning out your clinicians, do more for your community.

But you can only do that if first and foremost, what your place is in the system, what your role is in that system, and what your responsibilities are within that system. 

Now, I'm very mindful as I'm sitting here. I'm thinking - oh, is this a bit harsh, Gerda. And if it is a bit harsh, I hope you're taking it in the way that it is intended to come across, because I'm very passionate about what we do within the mental health and allied health field. But I'm also very passionate about looking after the people that's doing the work. And it starts with you as the business owner. I need to look after you as a business coach and mentor, because if I can look after you and help you run an amazing business, you will be empowered to look after your clinical team and after your admin team. And when you can look after them, guess what, then they can look after the clients.

So there's a cascading impact that happens here. And knowing your place in the system is a mindset that you need to start off with. You need to accept that this is who I am. If I've chosen to have a private practice and I've registered it as a business or a company, that this is now my job, my role, and my responsibilities, and I'm going to execute it accordingly. And if you do that, you will be able to have a long-term sustainable business that can help the clients that you are meant to help there. 

If there are clients falling through the cracks, yes some of those we are capable of picking up, especially If we've managed to build a profitable business, so we have that extra buffer to put towards some pro bono work - but we can't do that for everyone, and that's where we must, we absolutely must keep the other systems accountable for also knowing their place in the system, and doing their work within the system, and being responsible for what they need to do in the system. 

And this is something that I've had as my personal motto for a very long time. And I had to remind myself of this right from the start, because I have always been driven with this motto of – I want to help as many people as possible, and I want to help people in better and more effective ways at all times.

Surprising Moments in Private Practice

And it was back in 2015, that I reached a very significant milestone in my career as a clinical psychologist, but also as a private practice business owner. And that was when my practice:  The Psych Professionals won the Queensland Mental Health Award. And that was in the category of ‘small employer’. And what made this really significant was that this was the very first time ever that a private business won those awards.  Generally, those awards would be won by NGOs, by schools or by other government departments. 

So I was super chuffed. Of course, I did not expect to win. I actually went in, I booked in for the lunch, it was like a daytime lunch in Brisbane there in the city hall. I took my operations manager with me and I went, because I just thought - what an amazing opportunity. I knew we were finalists, obviously. And I just thought, there's no way, no chance in hell that we're winning this, but I'm going to go have an amazing lunch. Going to rub some shoulders with other people who are also passionate about mental health, meet new people, do some networking and just have an enjoyable day.

So I did not prepare a speech. Needless to say, I was super shocked when they called the practice's name and I had to get up, walk onto the stage in front of this humongous room full of people. And I don't know, like even 99 percent of these people, right? Like I said, I knew my ops manager. And I had to stand up in front of people I do not know, but people that I also respected because these were people in the trenches of mental health. These were my peers, these were my colleagues. And I got up and got onto stage - obviously blushing was so freaking annoying - and the only thing that popped into my head probably came straight from the heart. And I literally said something to this extent, that I so wish somebody recorded it because we were not prepared for it. So the speech was not recorded, but I said something to the effect of - 

“Within this room, there are people that play a role across all aspects of mental health. We've got public health here, we've got NGOs here, and we've got private practice. And each of us has an equally important role to play, and it's up to each of us to make sure that we play that role to the best of our abilities, and I'm extremely grateful for the privilege to do the work that we do within the private practice system.”

And I clearly remember. Talking about that because it is so important, and I felt like I had to name that because finally they were also acknowledging the importance of private practice within the industry, and subsequently other private businesses have also won the Queensland Mental Health Awards, which is just absolutely amazing. 

Conclusion

So that is just a quick reminder for today. I would encourage you to spend some time reflecting on your view on all of this. And maybe how trying to be what you are not, has been tapping unnecessary energy, and resources from doing the actual work that you are here to do.

So I would always encourage you to go, okay, I am a private practice and within my role I want to be stepping outside of the box. I want to be innovative. I want to be doing things differently. But also knowing that I am a private practice, which means I'm a private business - with the emphasis on business - which means that I do need to do things differently than public and government sectors and as NGOs.

Alrighty, I would also love to hear your thoughts and opinions on this topic. You are very welcome to email me directly. My email address is: gerdam@private-practice-success.com. I personally check and respond to all the emails that go to that specific email address. So I'd love to hear from you. 

And if you found this episode of help, I want to encourage you to share it with other group practice owners, because it's only together that we can uplift our profession and our industry and our discipline, and therefore also in turn the mental health and the allied health needs of our community.

Thank you so much for tuning in. And as always, remember that I am here to help you build a practice you can't stop smiling about. 😊



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Gerda Muller

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