Mind-Body practice : Practical tips

[rhollander]

I wonder if anyone has tips on how to start/run a private Mind-Body practice. I know Howard does a virtual practice as a health coach so he can practice from anywhere in the world and does not have to deal with billing patient health insurance or malpractice insurance. I’m looking into renting coworking space so I can see people in person when possible and have a separate business address from my home. Anyone have experience with those? any tips on website creation, billing, networking/referrals? what problems have people run into and what tips do you have to make it simple and cost effective? Thanks, Rachel Hollander

[aolden]

Hi Rachel I would be happy to talk with you about my experience. I started my practice about five years ago and it has been liberating ! Feel free to email me at aaron@mindfulmed.com and we can set up a time.

[Lilia Graue, MD]

Hi Rachel.

I offer fully virtual mind body medicine & psychotherapy services in Mexico, and coaching for people elsewhere. When the pandemic started I closed my physical office, and for the time being I work only remotely from home (commutes in Mexico City are awful, so even patients I have here prefer meeting online).

In terms of insurance, I can’t offer any insights or tips – in Mexico, anything deemed to be complementary & alternative medicine / mental health is excluded from health insurance, and my non-clinical services are not covered by insurance.

For website creation, I’ve had a really good experience with Squarespace. They have great templates, the platform is really user friendly and the cost is very affordable – I use the Business option at $23 per month and built my own site (you can take a look here: https://liliagraue.com/). My navigation menu is less friendly than I would like because I have a bilingual site using a single domain, but it saves me a ton of money, and it works for now. And if your website is English only this is not an issue. You can also add an email address with your domain through Google Suite ($72/year). I use Acuity as an online scheduler (it’s actually been bought by Squarespace so the integration is pretty seamless) – it allows for integration with Stripe and Zoom, so people pay directly through my scheduler and Acuity generates the Zoom link and emails it in the confirmation email (which saves a lot of time). Acuity starts at $16 per month.

The only downside of Squarespace is that it’s less efficient with SEO than WordPress, but for another site I have hosted through WordPress I did have to hire a web designer to get it going and deal with all of the APIs – I can now edit it as I like but couldn’t have done it without a web designer.

Some friends of mine have used Wix and like it as well.

Links:
Squarespace https://www.squarespace.com/
Acuity https://acuityscheduling.com/
Wix https://www.wix.com/

For billing, my Mexican patients pay by wire transfer, and overseas clients pay me through Stripe. It’s fantastic service, decent fees, and people don’t need an account like they do with PayPal. It allows for saving credit card info, recurrent or one time payments, creation of payment links, and all the functionality you need. At least in Mexico, Stripe is linked to my tax information, and getting my commissions invoice is super easy (for monthly deductions).

To sum up, in terms of tech/platform, I use Zoom, Squarespace, Acuity, and Stripe. I’ve used MailChimp in the past and might do so again.

For networking and referrals, I lean on building relationships with colleagues so we can do cross-referrals. I meet colleagues through trainings like these, as well as consultation groups. Other great sources of referrals are directory listings (eg PRT and upcoming OvidDx), as well as podcasts. I have a mostly hate-hate relationship with social media, so that’s not a resource I use. I used to have a mailing list (I used MailChimp and was super happy with it) and a blog, though I’m not currently doing that either because of time constraints. My experience has been that for 1:1 work, networking with colleagues, word of mouth from patients/clients and podcasts bring in a consistent flow of patients/clients, but in order to fill groups (if you do group work) you absolutely need a strong mailing list, a good number of followers with good engagement on social media, and/or a source of numerous referrals (like a clinic treating a specific condition or type of pain). My group offerings have filled up mostly through my mailing list.

My main tip for making it simple is to focus on your strengths and what you enjoy. Eg: I love and am skilled at building relationships with colleagues, doing speaking gigs and writing blogs/emails – all great sources of referrals. I hate social media, working at it is soul crushing, and for many years I invested a lot of time, energy, and even money on paid ads, without much success. In terms of marketing, it’s more efficient to invest on creating content for your blog, mailing list and YouTube channel, and podcast interviews (they’re all searchable by SEO and have a long internet life) than on social media (unless you’re super social media savvy or can hire a wonderful community manager) where posts have a really short life. Facebook groups are favored by some as a platform for self-promotion and marketing, but in my experience they’re a lot of hassle (especially the larger they become) and require serious admin labor, particularly if you want to make sure community guidelines are upheld and people aren’t harmed.

For cost-effectiveness, I never had a lot of money to invest, so I built/grew slow and steady, organically, and I’ve always been a one-woman show, so I don’t have a VA or community manager. If you do have a ton of money to invest to begin with, hiring someone to create an amazing website with lots of valuable content and great SEO is a good strategy, and a VA could be a good idea too.

I hope this is useful and I wish you success with your practice.

[bstreufert]

I’m interested in tips as well, as I’m just starting into my private practice. I’m a psychologist, virtual practice, self-pay.

Here are my questions:
1. What ICD diagnoses are people using? I’m not sure if as a psychologist I should be listing the symptom/condition as the diagnosis (eg IBS, tinnitus, headache, chronic pain) or using something like “pain related to psychological factors” or Functional Neurologic Disorder (but would something like IBS count as a neurologic disorder?)
2. I asked in an earlier post for some guidance on marketing materials I can share with local medical providers, therapists, and clients, as Alicia said they’d work on some 🙂 So when these materials are finished I want to take them around to local primary care and pain clinics and send them around the state to colleagues. If anyone else has some they’d be willing to share (with credit of course!), I’d be forever grateful!
3. I’m not sure how physicians licensing work, but I’m wondering if there are physicians doing this work with whom I can collaborate when needed? I’m licensed in Nebraska and Tennessee so can only see patients from those states, and TN is tricky for the moment because I’m trying to figure out how to register as a foreign LLC without having a physical address in TN. Can other medical providers see people from out of state for a collaborative relationship?
4. I was just thinking of another question yesterday and considering putting it here on the forum but wouldn’t you know it I’ve forgotten (so expect it to come later).

Here are my tips so far:
1. I’m using SimplePractice (simplepractice.com) for my EHR. It allows for completely paperless intake. I was able to custom build Howard’s intake form (with my own professional-specific tweaks), my informed consent docs, etc. and I can send out the Body Map as a PDF for clients to print, complete, and upload via scan or from their phones into the app. It’s got telehealth capabilities built right in, sends invoices, takes electronic payments, provides a professional website space with super easy build process (I did mine in like 10 minutes), the whole shebang from what I can see so far. It also provides marketing through Monarch, which is customizable as well. It seems pretty user friendly and has a ton of demonstration videos and provides an onboarding video chat. If you want to check out my website (for anyone who wants to provide feedback) you can see it here: https://thegoodlife.clientsecure.me
2. I’m planning to get myself on the PRT directory (I’m certified through the Pain Psychology Center), Psychology Today, Psychologist Connect/The National Register, and (eventually?) the PPD Association when it gets revamped.
3. I looked into health coaching so I could see people from other states but my professional liability insurance said if I’m licensed as a psychologist and any “coaching” I do even reeks of psychotherapy and I get a board complaint from a coaching client, it won’t matter if I call it coaching, it’ll be treated like psychotherapy, and I can get in trouble, so I opted to avoid coaching and just stick with psychotherapy.
4. My state university law school has an entrepreneurship clinic for law students in their last semester to provide free legal services to small business start ups. I was accepted to the program and they did the research for my LLC registration and practice policies to make sure they were legal, so you can check with your area law schools to see if they offer something similar? If not, we were recommended to use BizFilings.com for all of the legal assistance.
5. I used looka.com to create my business logo for free then purchased the rights when I got it the way I wanted it
6. I used VistaPrint for my business cards and got a 20% off discount with the code QUICKSPROUT20 (from this review article: https://www.quicksprout.com/best-business-card-printing/)

[bstreufert]

I’m interested in tips as well, as I’m just starting into my private practice. I’m a psychologist, virtual practice, self-pay.

Here are my questions:
1. What ICD diagnoses are people using? I’m not sure if as a psychologist I should be listing the symptom/condition as the diagnosis (eg IBS, tinnitus, headache, chronic pain) or using something like “pain related to psychological factors” or Functional Neurologic Disorder (but would something like IBS count as a neurologic disorder?)
2. I asked in an earlier post for some guidance on marketing materials I can share with local medical providers, therapists, and clients, as Alicia said they’d work on some 🙂 So when these materials are finished I want to take them around to local primary care and pain clinics and send them around the state to colleagues.
3. I’m not sure how physicians licensing work, but I’m wondering if there are physicians doing this work with whom I can collaborate when needed? I’m licensed in Nebraska and Tennessee so can only see patients from those states, and TN is tricky for the moment because I’m trying to figure out how to register as a foreign LLC without having a physical address in TN. Can other medical providers see people from out of state for a collaborative relationship?
4. I was just thinking of another question yesterday and considering putting it here on the forum but wouldn’t you know it I’ve forgotten (so expect it to come later).

Here are my tips so far:
1. I’m using SimplePractice (simplepractice.com) for my EHR. It allows for completely paperless intake. I was able to custom build Howard’s intake form (with my own professional-specific tweaks), my informed consent docs, etc. and I can send out the Body Map as a PDF for clients to print, complete, and upload via scan or from their phones into the app. It’s got telehealth capabilities built right in, sends invoices, takes electronic payments, provides a professional website space with super easy build process (I did mine in like 10 minutes), the whole shebang (except e-prescribing) from what I can see so far (so not sure if it’ll be helpful in your professoin. It also provides marketing through Monarch, which is customizable as well. It seems pretty user friendly and has a ton of demonstration videos and provides an onboarding video chat with support specialists. If you want to check out my website (for anyone who wants to provide feedback) you can see it here: https://thegoodlife.clientsecure.me
2. I’m planning to get myself on the PRT directory (I’m certified through the Pain Psychology Center), Psychology Today, Psychologist Connect/The National Register, and (eventually?) the PPD Association when it gets revamped.
3. I looked into health coaching so I could see people from other states but my professional liability insurance said if you’re licensed as a psychologist and any “coaching” you do even reeks of psychotherapy and I get a board complaint from a coaching client, it won’t matter if I call it coaching, it’ll be treated like psychotherapy, and I can get in trouble, so I opted to avoid coaching and just stick with psychotherapy.
4. My state university law school has an entrepreneurship clinic for law students in their last semester to provide free legal services to small business start ups. I was accepted to the program and they did the research for my LLC registration and practice policies to make sure they were legal, so you can check with your area law schools to see if they offer something similar? If not, we were recommended to use BizFilings.com for all of the legal assistance.
5. I used looka.com to create my business logo for free then purchased the rights when I got it the way I wanted it
6. I used VistaPrint for my business cards and got a 20% off discount with the code QUICKSPROUT20 (from this review article: https://www.quicksprout.com/best-business-card-printing/)

[bkennedy]

I am also opening my own mind body medicine practice in Portland OR in October.
I appreciate the information about Simple Practice for the EHR. I was looking at Elation which has more features for physicians.
Howard, I am wondering how often you prescribe medicines or order tests. Would I be remiss in not having the feature available at all in the EHR?

I would say if you see long COVID patients and the word gets out in any capacity you can, you will get patients coming to see you. I have had great success with many long COVID patients with this model. They almost all say “I wish I had learned about this sooner” (as I’m sure all patients say).

Becca

[aolden]

I agree with Becca about long COVID – lots of demand out there for this and it seems to respond well to the mind-body approach. RE: medical records, I use Jane (jane.app) which is built for acupuncturists but is affordable and adaptable for what we do. It takes care of scheduling, appointment reminders, confidential communication, documentation, but not eRX. I find that it is perfect for my needs.

[bstreufert]

Here’s my referral link from SimplePractice in case anyone wants to sign up and save us both $150 https://www.simplepractice.com/referral?p=61ab5cc827 (they offer a 30 day free trial to try it out, during which all features are free.)

I forgot to say I use DialPad as a HIPAA compliant VoIP service that allows me to send/receive calls and texts, record and transcribe calls, all in HIPAA compliant form, and easy to access their BAA.

Proton for business also offers a BAA for their HIPAA compliant Google Suite type of services/products (email, calendar, VPN, drive, password manager/generator).

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