If you're in solo practice with a full schedule and a steady stream of referrals, you might be thinking about adding an associate. This would bring extra income into your practice and enable you to take more time off.
But before you start your search for an associate, answer these questions:
1. How much control do I want over an associate's work activities?
The answer to this question has implications for your taxes as well as your preferred working arrangement.
If you want to manage all the major decisions about clients, referrals, payments and working hours, then your associate would be considered an employee. You would be responsible for paying employee taxes and issuing a W2 form (T4 form in Canada).
If you are simply looking to provide office space to a colleague who sets his/her own hours and fees, you could either sublet and collect rent, and/or enter into an "independent contractor" arrangement. You probably won't need to pay employment taxes, but do carefully review the IRS rules of what constitutes an independent contractor. To be certain, get a professional opinion from an accountant or tax attorney.
2. How flexible can I be in sharing my office space with another professional?
Even if you are the boss and make decisions about office policies and procedures, you and your associate will need to co-exist with mutual respect as office mates. It is highly unlikely that you will share interests and priorities 100%. And there's a good chance that each of you will have at least one habit that annoys the other. Are you open to discussion and negotiation about the little things as well as the big things? Are you prepared for the extra time and effort that this might require?
3. Am I willing to take on additional administrative responsibilities?
Prior to bringing an associate into your practice, you'll need to prepare a contract outlining compensation, who owns the clinical records, what happens if the associate leaves, and other details. (We highly recommend legal and professional consultation at this point.) After the associate joins you, you'll have extra paperwork related to tax accounting and reporting.
If you tend to procrastinate on record keeping and other administrative tasks in your solo practice, you'll need to be more diligent when you have an associate who depends on you to keep current records, to be paid in a timely manner, and to provide office amenities according to your agreement.
If your solo practice is overflowing and wearing you down, but you'd prefer not to take on additional financial and administrative responsibilities of bringing in a new associate, consider reshaping your solo practice. For example:
Specialize. Focus on specific types of problems or specific groups of people that you like to work with. Refer those who don't meet your criteria to other mental health professionals. Working with clients that you feel most effective with will more likely energize than drain you. Here are some examples of mental health practitioners who developed niches and specialties.
Consult with organizations or businesses. Your expertise extends beyond your office. You probably have skills that can readily translate into improving people's lives on a larger scale.
Re-evaluate your contracts with managed care companies. Stay with those who refer clients you enjoy working with and who pay a reasonable fee with minimal hassle. Drop out of the other plans. You can still opt to see people who cannot afford your full fee, but this will be on your own terms, with no interference by managed care.
FOR A MORE COMPREHENSIVE OVERVIEW: Get Dr. Jeff Zimmerman's audio recording, Adding a Clinician to Your Practice: What you need to know.