
When you are starting to think about opening your own private psychiatry practice, one of the first questions you need to be asking yourself is if you want to have a telepsychiatry-only practice, brick and mortar practice, or a hybrid combination of both.
While most of us are now very comfortable conducting virtual visits, you will find yourself with the most flexibility if you have a hybrid practice. Even if you are in a rural area (or an area that you don't think can support a cash only private psychiatry practice), I still recommend having a brick and mortar location. Here's why:
Despite the option of virtual visits, a lot of people still like coming to see you in person! Patients like having the option to drive to the clinic for an intake and maybe they might prefer to have follow up appointments by video. The important part is that they have the option.
Having a brick and mortar location gives your practice credibility - to potential patients, it seems more real than an online-only option. I recommend having photos of your clinic office or exterior on the main page of your website to convey that yes, your practice is legitimate and it's a real place!
You are able to prescribe a variety of medications, if indicated. During COVID, the Ryan Haight Act has been suspended, which has allowed psychiatrists and psychiatric NPs to prescribe stimulants over virtual visits and not require an in-person visit. The DEA is now requiring that psychiatrists and NPs have a physical office mailing address (that is subject to inspection) in order to register for a DEA license. It's a safer bet to have a physical office that you can register your DEA license under and have an option for patients to see you in person, if the Ryan Haight Act does get re-implemented.
Ketamine assisted therapy and psychedelic assisted therapy will be options for you to incorporate in your brick and mortar practice. Without a physical office, it would be difficult to expand your practice to include psychedelic therapies and ketamine assisted psychotherapy, which are part of the future of psychiatry. If you have any interest in offering these services in the future, do yourself a favor and think one step ahead now.
Separation of work and the rest of your life is easier with a separate practice. I had originally thought about having a telepsychiatry practice out of the shipping container that is in the field behind our farmhouse but decided against it after working strictly from home for the first couple of months of starting my practice. I realized I have a loud barking dog and didn't want the distractions of home when I was seeing my clients. The physical separation isn't a plus for some people, but I have enjoyed having a brick and mortar practice for this reason.