Back in 2003, my otherwise healthy father had a serious myocardial infarction. For days I traveled back and forth from my home to the hospital in Massachusetts, visiting, keeping track of his progress, and advocating on his behalf.
Had I been in private practice, or working for a hospital or agency, that would have been devastating to my work schedule and livelihood because I was out for weeks.
You see, those working models are based on an hours-for-dollars payment model. For decades, we as practitioners have been primarily bound to this model, charging clients either by the amount of time we spend with them or by the procedures we perform, and in both cases, it’s all about the time we’re required to put in.
There are a lot of problems inherent in this, but one of the most frustrating is that the only way to increase our income is to see more clients . . . and that means working longer hours.
Besides the obvious limitation of there only being 24 hours in a day, there’s the equally important consideration of stamina and effectiveness – the harder you work, the more burned out you get.
I think of this whenever I hear practitioners worried about building a bigger practice, because it still requires them to trade hours for dollars.
And that’s true even if you use Skype in your practice. You might not be tied to your location, but nevertheless, you still have to be present at a certain time in order to use your expertise to earn a living.
But there are other ways you can reach more people and increase your impact on the world.
Not only can certain tools help you to reach out to more people, they can provide you with significantly more income and provide that reassuring buffer should someone in your family need your attention.
You won’t need to sacrifice your livelihood at a time when you need it most to support yourself and the ones you love.
With some simple strategies, not only could you make an impact on people around the world, but you would be a lot less tied to your weekly schedule – seeing patient after patient, and even trying to add more to an already full roster.
Wouldn’t it be nice – a relief, really – to have some free time to learn more ways to help others, or have time for yourself and your loved ones?
Sure, there would be an initial investment of time and effort, but in the end, the payoff could be well worth the commitment. And it definitely could be a lot more than the old regimen of hours-for-dollars.
Would you like to imagine some other possibilities?
Please share your thoughts on the hours-for-dollars model most practitioners currently follow. What’s your
fallback position should you suddenly be called away for a family emergency?
Please leave your comment below.
If only I would have had this advantage before I had my first bout with cancer and had a kidney removed in 2009 and subsequently it reocurred in my bladder this year. I am now cancer free and regaining my health and strength but have lost my practice and my income which would have enabled me to purchase this program. I am in despair over this but there is nothing I can do at this point without the funds to even pay for the split up payments. It is unfortunate, but there are a few of us here even in my area that are suffering to this extent due to poor health or other financial reverses. I am praying about this because I still feel I have something to offer.
Dear Ruth and team,
I have followed and enjoyed many of your webinars in the last few years! I have appreciated hearing well known speakers/authors share wisdom and have been able to maintain the CPD which I believe is so important.
The neuroscientific discoveries of recent years informed EMDR many years ago and have recently led me into LIFESPAN INTEGRATION (Peggy Pace) which has further developed the use of our brain/body co-ordination and integration to produce amazing healing for clients. I am a UK Lifespan Integration Consultant.
I also use “HEALING TIMELINE” which Cathy Thorpe developed (with Peggy Pace’s permission) to include a spiritual prayer dimension
Finance/income is now reduced due to my husband’s retirement, and 8 young grandchildren have arrived so we relocated from rural to urban home to be closer for 2-way support. This has also affected my client base access, but I remain on the fence regarding the possible extension of methods suggested “to increase income”
Ironically it seems that you have provided a taster but that this time there is no opportunity to listen at a weekly prescribed time….. if therapists were willing ti stay up late/get up early …..but did get chance to listen once??? I hope I’ve just missed the words that permit opportunity to listen when the financial cost is beyond our current means?
I would really appreciate clarification a s a p
Thank you again for all you have provided which I have enjoyed and used I hope to my clients’ benefit!
Sheelagh Montgomery (N Ireland UK)
Much of alternative medicine and psychotherapy or -analysis is not covered by insurance policies today, but is supposed to be under the Affordable Care Act. However, this doesn’t mean you can’t use the insurance model to help pay for your services. E.g. you can band together with chiropractors, naturopaths, midwives, physical therapists and other rehab services, occupational therapists, palliative care practitioners, dentists, trainers and exercise gyms in a type of “health mall” where your clientele can purchase “insurance” which gives them discounts for therapy they seek from each of you. As a group, you decide how to divide up the insurance income you would get. More than likely, the patient coming to you for therapy will get better but will need one or more of the other practitioners at some point in their lifetimes, making it more likely they will purchase this “insurance”. As insurance companies, you are eligible to get payments under Obamacare, too. You have to start with low insurance costs, sharing adjusters in one business, until you get a dedicated population who buys your insurance. Most chiropractors and naturopaths can serve as primary care physicians, as well, making it more than likely you will get a dedicated clientele. Publishing articles about this new model in local newspapers, magazines and appearing on TV shows like “The Doctors” on CBS speaking about your new model would clearly help. Becoming associated with the new “retirement communities” where people over 50 share a house together (e.g. Trilogy House in LA, the Baba Yagas House in France) would be another way to take part in the new medicine that is blossoming now all over the country.
Thanks Ruth, for the inspiring topics and your honesty about the possible conflicts of mental health professionals. If you refer to psychotherapists, balance in life is always a key issue. One does need a support network so when family issues or illness of self comes up, there is a back up colleague who can provide care for your clients/patients. It is not only ethical, but mandatory for medical doctors to do so.
I compare psychotherapy to parental role, they are not the same, but there are common elements. Your person is a major curative factors, and the special attachment that you can form with people you help. However much technology changes, humans do not so much. It is the least expensive way to care for mentally ill people, to have continuing care by a special person.
It can not be done in bulk or by lectures or notes, but by the presence of the therapist who has to take care of his/her own needs to remain competent and empathic as well as enjoy the work .
I never booked more then 6 patients a day, earned a lot less then most of my colleagues. Shared practice so we covered for each other when on holidays or any other reason we were away from work. Having a healthy life can only add to our ability to do good work.
A really good answer, full of raniytalito!
I actually like the dollar for hours model. It’s worked for me through the death of both parents,
my own serious illness etc. I always found a way to see clients and manage the rest of my life. I
occasionally saw clients at home or moved their appointments but it all got done.
I have sold packages of sessions which produces more income, but I found it more difficult to “sell”.
All you have to do is stay with it for a very long time and eventually your patients just whither away or become so healthy they do not need you any more. This is probably one of the few fields where success can be measured by how quickly you lose your clientele! (To better health, of course) I also taught in the field, and ran seminars, other ways to reach more people. Writing articles and having them published is both helpful and satisfying. When I had to have a “fallback” position, I called on colleagues, who called on me for the same reason. Now, as i am in old age, I have just a few clients, enough to continue to feel useful, but with time to do all those things I never had time for before, and to spend time with grandchildren, one of life’s greater gifts!
Thank you Ruth, and yes you are so right: I have have been profoundly concerned by the emerging predicament of humanity in the face of overpopulation, religious strife, technological pollution, resource shortages, and much else besides ever since I worked on “The Limits to Growth” scenarios in the 1970s. Nevertheless for a decade now I’ve been successfully experimenting with “the great enabler” – the emerging digitisation paradigm – to reach audiences that are hungry to learn new ways of health, growth and longevity – rather more effectively than just one client at a time … it’s simple, but not so easy.
Nohting I could say would give you undue credit for this story.
While models like this are the most prevalent, there is still hope that the unfamiliar ones will make an appearance. For awhile… I worked in a community.. where everyone worked/shared their knowledge to make the community exist, largely depended on donations for the basic overhead.
Hi Ruth. So nice to know someone that was intuitive enough to put family before patients. I feel your warm heart from here. How fortunate your father is to have your attention.
I meet with a support group once a week to knock around ideas of how to reach out to others. We support each other through life circumstances and encourage each other to stay in the now and practice mindfull meditation. For one hour on Wednesdays we trade time for time… Our objective is to listen and let our subconscious do the work…
Usually I have an answer to the dilemma by the next day….it just pops out of my head when I don’t think!!! Surrender control and relax into the now… Just let it be and you will see that life is easy, effortless, and guess what… It’s free!
Our resources are right in front of us…all in plain sight.
Let down the shield … And you will see you’ll lose that fright before tonight!
Blessings to you.
Namaste
Now in my late sixties I would like to not have to work full-time although I do anticipate working the rest of my life. I have a wealth of experience to share in a more time effective way and I have repositioned myself on the leading edge of integrative medicine as an Integrative Health Coach Professional and Mindfulness Professional. Those are the services I am moving my Boomer career into. Looking forward to what NICABM has to share. This sounds like it can be part of my not-Retirement Planning 🙂
My experience as well Ruth. And so not having more than 24 hours in a day, we get stretched thinner and thinner. And when a parent is ill and then passes, we are then left with the guilt and sorrow of not having been available to them and not spending enough time with them in the end.
Looking forward to your next post.
I found your blog some weeks before my 60th batihdry, not too long ago! I had already felt the stirrings of rebellion brewing in my psyche because of that SIXTY staring me in the face and yet today all the stereotypes it entails, and then I happened across your blog and the wonderful ladies and gentlemen featured in it. Now, instead of saying to myself “I could never wear that” I am saying “hmmmm, let’s try that on and check it out”; and instead of saying “I could never do that” I am saying instead “what’s the worst that could happen if you do this – or that?” Well, I could end up broke and fighting the cats for alley food in my 80’s – but on the other hand… Asking myself these questions had pretty much left my radar; now, I’m blipping all the time 🙂
Warm greetings Ruth
In opening I hope this note from Scotland finds you well?
I read your latest email and then read it again .
As this was the story of my odyssey the only difference was location I trade pounds for hours. So I had to do some nimble financial foot work to keep afloat
It certainly was a long eventful journey.
I so look forward to reading your next email I have been riveted to what you have Had to say
Sent in enveloped in much gratitude
Kathy S