Shuttering a psychological practice is not a step to be taken lightly. It’s not like one can simply hang a “Closed” sign on the door and turn off the lights. In reality, there are many issues to be taken into consideration, including the ethical, legal, financial, and practical aspects of ending relationships with patients, colleagues, insurance companies, and even with landlords and other vendors.
Then there is the question of what comes next, both personally and for your business. Should it be closed or sold? How do you help patients finish their therapy or move on to another therapist?
Can you afford to retire completely or would a partial retirement, a move to a part-time position within a group practice or maybe a teaching position help to ease the way financially?
“I think of it as a process that needs to be well thought out and done over time,” said Lise Motherwell, Ph.D, Psy.D, who closed her clinical practice in the Boston area in 2014 and recently gave a talk for the Maine Psychological Association on “the practical, ethical, clinical, and psychological aspects of winding down a clinical practice and gearing up for retirement.”
The decision to close her practice, in order to pursue other things, was made and announced 12 months before she actually closed her doors. Not having experience in the area herself, she decided to get some education in order to avoid any unseen pitfalls.
“I did a ton of research while I was going through this,” she said. “I read a lot about forced termination and about retirement in general. I knew that there were a lot of issues that might get in the way since I hadn’t done this before.’
According to AJ Centore, Ph.D, CEO of Thriveworks Counseling Centers and a private practice consultant for the American Counseling Association, closing a practice is something that really should be looked at even earlier in the process.
“Ideally the best time to think about closing a practice is when you get started,” he said. “It seems unusual but it is very important to start with the end in mind.”
It may feel like a far-away future to plan for but following a few basic guidelines can help ease the transition at the end, he said. For instance, naming a practice after yourself may hinder a future sale. Putting a plan together to grow the business beyond a solo practice can also give you a more attractive entity for future owners.
“If I represent 75-100% of the workload, it is really selling a job not a business,” Centore added.
Beyond legal and ethical rules, there are no set guidelines for much of the process. But, there are plenty of decisions to make. When should one tell clients? How does one help clients find a new therapist? What types of guidelines should one set up for post-closing communication with clients?
Motherwell chose to share an email address and keep any responses positive but not encourage on-going conversation.
A big decision in closing will be how to handle record-keeping to ensure that records are stored for the legally required time and are fully accessible during that period.
“You need to keep the records, of course,” Centore said, “but it is not just storage. A client could call you years later and you need to provide the notes.”
One other area not often addressed is the emotional toll that leaving a practice can take on the practitioner. From feelings of guilt that you are abandoning clients to a loss of identity, closing a practice, especially because of retirement, can be a more monumental change than expected.
“You are having deep, meaningful conversations every day with all those clients,” said Motherwell, “It’s like reading 30 novels at the same time and never getting to finish any of them.”
It is important to recognize that moving on is a major milestone.
“There is a shift in identity and sense of importance in the world,” said Motherwell, “You need to make sure that you are retiring to something and not away from something. You need to make sure to find another role.”
Catherine Robertson Souter is a freelance writer and social media agent based in New Hampshire. A contributor to New England Psychologist since its inception, she previously wrote for Massachusetts Psychologist among other media outlets.