The reality is, most psychiatrists do not have an easy path to starting their practice for a variety of reasons. We will discuss what you need to consider before starting to build your psychiatry private practice while employed.
Let's start with current employment. If you are like most of the psychiatrists in the United States, you work for a healthcare system. Starting your own practice while staying employed is possible but there are certain considerations you need to keep in mind and be aware of.
Your Current Employer Contract
You likely have a contract and stipulations to pay attention to in your contract. For example, many employers put barriers into place to keep their employees from working with the healthcare system (or private practice) down the street or even as far away as 50 miles, such as non-compete clauses. Non-compete causes are terrible for patients and physicians but good for healthcare business. Another aspect to be aware of is if your employer requires you to report/request that you have a position outside of the healthcare system you work for. Many healthcare systems even want you to request and report if you want to work a few hours a week as a yoga teacher in your community. Your contract could also have a statement that explicitly states that you cannot have a part-time position outside of your employment with them or they require you to pay a certain percentage of your earnings from your outside work to your employer. Read and understand your contract.
If you are even remotely considering have a part-time private practice in the future, it's probably not wise to sign a contract that has a restrictive non-compete clause or outright bans external clinical work. I give this advice to all medical students and residents I speak with. Your freedom is too important to sign away and being trapped in a job you are miserable in is a recipe for demoralization and depression.
Requesting Outside Work
There's a good chance your employer will require you to submit a request to a committee to start a psychiatry private practice outside of your employment. They will want to make sure you are not competing with what their clinic offers, regardless of how long their patient waitlist is. This is a good opportunity to think about how you want to offer unique value-added psychiatric care - what do you wish you could offer but cannot in your current employed position? What is your niche? Is there a population you want to specifically work with in your private practice? If you are an inpatient psychiatrist in an employed position, it is easier to request outside work in an outpatient private practice because the nature of the work is very different. Maybe you hope to provide nutritional psychiatry in your outpatient practice and you do not market this or have much of an opportunity to offer this unique service at your employed position - include this.
Do You Stay at Your Employed Job?
You don't have to stay at your current employed position while you start your private practice - especially if you are truly unhappy and your mental health is suffering. A lot of this decision may hinge on your individual financial situation. While it is potentially easier to stay for financial reasons, know that there are other lucrative options.
You can do independent contractor work. One option is to do weekend locums work while you build your private practice in your region. Let a handful of locum tenens companies know what you are looking for and make sure they know that you are not interested in longer assignments or really, anything that takes you further away from your goal of building your practice. They will bother you but they will at least know you are looking and will let you know (even last minute) of any opportunities that you can choose to say yes or no to.
Even better, you can contact inpatient psychiatric hospitals without the help of locums recruiters. You'll likely be offered a better rate (since locums recruiters take a decent cut of the rate negotiated with the hospital) and can build a better relationship with the hospital administration.
Another option to consider if you're looking for outpatient work is to reach out to other psychiatry clinics in the state(s) you are licensed in and make a case for helping them 1-3 days a week and get paid as an independent contractor (also known as 1099 work). This means that you'll have to figure out health insurance and your retirement but remember, if you got through medical school and residency, you can figure out these things.
It is completely possible to effectively navigate from being a psychiatrist in an employed position to starting your private practice. Ready to take the next steps to open your dream psychiatry private practice? Reach out here for a free 15 minute coaching interest call.