If you own a car, you know that routine maintenance is essential to its efficiency, safety and longevity. Without preventive maintenance, repairs can be very expensive. And sometimes a poorly maintained car can break down suddenly, causing accidents or deaths.

Your mental health practice also needs maintenance. Like a car, there are a lot of parts that need your regular attention. Here are a few to consider:


1. Change the oil

Oil is the lubricant that prevents friction among the moving parts of an engine. But over time it breaks down from heat and from accumulation of dirt. If you don't change the oil on a regular basis, your engine can get overheated and seize up.

In mental health practice, there are numerous sources of friction. Some are external, such as ongoing conflicts with colleagues, or inefficient procedures that waste time and resources. Other sources of friction are internal - for example, resistance to completing paperwork, or ambivalence about dropping out of low-reimbursement insurance networks.

Maintenance involves reviewing your sources of friction and attending to them before they cause damage to your practice or to your reputation.

2. Check the tires

The tires are what your car sits on to move along the road. Wear and tear, plus minor punctures aren't generally noticeable until they cause a problem. And that problem often happens at the most inopportune time. Checking the tires periodically allows you to fix things so that you don't get stranded with a flat or a blowout.

The "tires" of your practice are your office lease and your insurances (malpractice, premises liability, disability). Mark you calendar to review these annually. As your practice grows and evolves, a lease or insurance policy that made sense a few years ago may now have holes that need to be plugged up. Or, there may be better choices for new locations or insurance policies available today than previously.

3. Adjust the steering, alignment and shocks

If your car is out of alignment or if the steering system is shaky, you have to work harder to maintain your direction. With worn shock absorbers, every minor bump is an annoyance, and major bumps can throw you from your seat, causing bodily injury.

In your practice, your steering, alignment and shock absorbers are part of your business plan. By creating a plan with specific measurable goals and built-in contingency options, you can keep your practice moving in the direction you have set for yourself. Your business plan also helps you prepare for and manage the unexpected bumps along the way.

4. Check the brakes

Brakes are essential to car safety, of course. But besides preventing you from running into other cars or people, brakes also help you slow down before your next move, such as turning a corner or finding an address. If your brakes are slow to engage, you might miss important details, such that you have to backtrack.

Brakes are important in your practice, too. Clinicians often have the goal of running their practices in "cruise control" mode, where administrative and clinical functions are more or less automated. That certainly makes it easier. However, as with driving, it's risky to get complacent in cruise control. Be alert to inconsistencies and warning signs, and prepare to put on the brakes, slowing down to examine what's happening.

5. Check windshield wipers

Many folks don't realize that their cars' windshield wipers have worn out until they turn them on during a storm and notice streaks that impair their ability to see the road and obstacles ahead.

Similarly, in private practice, the future may look fine, as long as referral patterns and income sources remain consistent and "sunny." However, things can change quite unexpectedly. Referral sources can move away or die. You or a family member may be faced with prolonged illness or other circumstances that interfere with practice.

To keep your vision unencumbered for navigating through life's storms, make sure that you have some backup plans in place, with the tools to use them.

6. Check the spark plugs

Spark plugs initiate the combustion that keeps a car engine humming. They operate in very high heat, and tend to wear out over time. Engines run on multiple cylinders, each with its own spark plug. Thus, a car can keep running even if some spark plugs aren't working. But it doesn't run efficiently that way.

The "spark plugs" in your private practice are your clinical skills and creativity. In order to fire efficiently they need to be cleaned or replaced periodically. Update your skills and stay abreast of new developments in your field. That will keep your sparks firing in all cylinders, so to speak, such that you do your best work.

7. Check your battery

The car's battery is essential for getting the vehicle running. Over time, the terminals can become corroded, making the battery less efficient.

The battery of your practice is your motivation, your reason for running a practice. When you find yourself discouraged, it may be that the load on your battery is too great, or that your goal-directed activities have been impeded (corroded) by accumulation of unfinished tasks. Make adjustments accordingly.

8. Don't let the gas tank run dry

Your car needs fuel to do what it's made to do. If you don't monitor your tank level and your car runs out of gas, it will simply stop.

The "gas" for your practice is your energy. If that runs out, you won't be able to work effectively. Clients will sense that you're not connecting with them or that you don't care. As a result, you may see referrals dwindling. In some cases your lack of energy may interfere with your attention to ethics, which could lead to a licensing board complaint or malpractice lawsuit.

Keeping your energy tank full is a matter of self-care. Take breaks, get enough sleep, eat well and exercise - the same things you would advise your clients to do. Don't wait until the tank is dangerously low. You should always have ample reserves, so that you don't run out, even when your day is all uphill.