One of the biggest concerns that psychiatrists bring up when they talk about starting their dream practice is that they are worried they will feel isolated practicing on their own. This is a valid concern - but it is a myth!

Let me ask you this. How isolated do you currently feel in your current psychiatry position, on a scale of 1 to 10? Many doctors report feeling lonely in their work environments - they no longer have the time to meet for lunch or go for a walk with a colleague. Especially in outpatient clinics, everyone's doors are closed and people are just too busy to discuss cases or ask clinical questions.

When you have your own practice, you will have greater ability to create communities for two reasons. You will have more time and you are less siloed by one healthcare system. I didn't know a single mental health clinician I could refer patients to outside of the system I worked in previously. Once you are free from the constraints of the siloed health care system, you get the opportunity to meet other healing professionals, such as yoga teachers, health coaches, naturopathic doctors, chiropractors, and dietitians.

If you live in a big city, community-building opportunities might occur in person. Living in rural area makes in-person meetups not possible; however, video options are a great alternative.

As for psychiatry colleagues, you can build your own community if you don't have one already. You can have psychiatry/physician communities on different scales too, using different platforms. For example, you might have a group text with your residency class where you can ask questions. You can also have individual psychiatry friends/colleagues who you can reach out to for impromptu questions. It's nice to have mentors who are well-seasoned as well as those at your experience level.

But what can be really helpful is to have a psychiatry or other healing professional community that meets regularly. Some ideas of what this can look like (and you can use any, some, or all of these options):

  • Monthly zoom meetings with current residents and graduates of your residency program. I attend as often as I am able with a group from my residency specific for women.

  • Join and pay for a recurring group course or mentoring circle around a specific clinical interest you have. There are groups for perinatal psychiatry, psychedelic therapy integration, integrative psychiatry, and more.

  • Start a case consultation group. This can be with even just one colleague. Find a time and day of the week that work for all of you and commit to meeting on zoom at that time. When you have your own practice, you can block off that time in your schedule without issues.

Community is essential for our wellbeing not only in medicine but also in life. Our jobs as psychiatrists can be challenging in many ways and it can feel so much more fulfilling if we have friends and colleagues we can meet and be authentic with. While it may seem counterintuitive, having your own practice can expand your community and lessen the amount of professional isolation you may be currently feeling.

Helpful tips for navigating life, finances, and practice after graduating psychiatry residency.

You've worked hard to do well in medical school and psychiatry residency and as you're thinking about 'what next?', it's easy to feel overwhelmed. Psychiatry residency is great for teaching you the skills you need to be a clinically sound psychiatrist. Residents get exposed to various practice settings and psychiatric specialities within the walls of academic centers and community health care systems. It's likely that most - if not all- of the psychiatrists you have met are employed by large health care systems.

Most, if not all, residencies will not adequately prepare you to start or run your own practice. Most residencies also don't provide any training in contract negotiation, billing, or burgeoning and innovative treatments such as TMS or psychedelic medicine.

Get interested in other aspects of psychiatry not offered within the walls of your training

Reach out to psychiatrists who are practicing in other environments - private practice, independent contract work, and locum tenens. Consider it to be an informational interview and prepare some questions you'd like to ask them over the phone or zoom.

Even in residency, you can possibly do "away rotations". These are opportunities to obtain additional training outside of what your residency can offer. If you are really interested in doing TMS after residency, obtain additional training now. I have always been interested in integrative psychiatry and during my fourth year, I was able to complete a rotation at the University of Arizona, learning Integrative Psychiatry in their residency clinic. I also completed Accelerated Resolution Therapy training over a weekend and obtained certification in Sports Psychiatry through an online curriculum.

Request didactics on contract negotiation and financial health

This doesn't mean having a financial advisor come in and talk about finances (with a clear secondary gain) or a disability insurance salesperson come in to talk about disability insurance and why its necessary. Oftentimes, attendings will have lots of valuable insight and experiences, if they are comfortable sharing.

Lean on your co-residents

Start conversations with your co-residents - what positions are they interviewing for and what is the salary/benefits/work week? It can really helpful to hear what types of positions are available and what salary they are being offered. This can help reduce gender and race salary inequities and provide a more solid foundation for negotiating.

Don't buy the big house

Don't buy the big house! Live under your means and keep enough money (at least 6 months) set aside to walk away from a job or position if you need to. Learn how to invest. Ask yourself frequently if money is more important to you than time.

Ready to start your private practice? We can help. Book a session here.

Healthcare professionals are experiencing high rates of moral injury, depression, trauma, and compassion fatigue as the pandemic continues on. If you decide to start your own practice, you are not immune to burnout. But unlike most employed positions, you have the autonomy and ability to prevent burnout and navigate out if you are experiencing it. Here's how.

1. Be intentional about what type of practice you want to have - and stick to it. This includes the hours you want to work, how you want to be available to patients, how people can contact you, and who you work best with.

2. Opt out of systems that don't allow you to practice in a sustainable way. This might mean opting out of insurance, capping how many patients you see in a day, or diversifying your days so you are involved in more than individual one-on-one patient care.

2. Integrate what you learn. Don't continue to pile on courses, conferences, and other learning opportunities without first integrating and actually putting what you learned in to practice first.

3. Set rates that are consistent with your worth. Are you providing care that is above and beyond typical insurance-based psychiatric care in a healthcare system? If you are practicing integrative psychiatry, the answer is probably yes.

4. Build systems that are sustainable. You might be only spending 50 minutes with a patient but take into consideration the time you spend on preparation, research and administration work with each patient. This might mean seeing less patients in a day and having higher rates.

5. Start small and keep overhead low. Don't buy equipment or new software until you realize that you need it to efficiently do your work. Not having a lot of costs (especially when starting out), will help foster an abundance mindset rather than a scarcity mindset.

6. Caring for yourself is a crucial aspect of your practice. If you are burned out and overwhelmed, it is difficult to serve your clients and the world. You need to care for yourself in order to hold space for your clients - and that amount of time has to be factored into your practice. The number of hours you need to restore and keep yourself whole is not the same for everyone.

7. Don't be afraid to say no to opportunities. As a healer in the mental health field, you are an incredible resource to your community and region. There will always be more that you have the energy and time to help with. Choose opportunities from a grounded, wise place.

8. Build community. It can get lonely in the private practice world. Building a network of other healers (not just other psychiatrists) makes your work less isolating, is good for your practice, and good for your clients. You can refer your clients to healers you recommend (when clinically indicated) and know that they are in good hands.