Advice for early career psychologists

When you are starting out in private practice one of the important challenges you have is to develop a strategy for how you will track all the clients you have responsibility for. Today I’m going to share with you how I track my clients and share some of the reasons for why I do it the way I do.

In private practice when we take on a new referral, we accept the wonderful privilege of working with that client but we also accept the very significant responsibility of providing appropriate and timely care to that individual as well as taking on the responsibility of ensuring that we comply with the requirements of the funding body under which we see the client. We can’t afford to lose track of one of our clients or forget to write any letters that are a requirement of the funding body.

The way that I track my clients is via a very simple one page excel spreadsheet with three columns. The first column has each of my clients that have an appointment booked in, listing them by name, in date order of when that appointment is scheduled. The second column has each of my clients listed by name, that don’t currently have an appointment booked. The third column has a comment for each name in column 2. The second column is the really important one as this column will have the clients that we might be likely to lose track of, the client who cancels their scheduled appointment and didn’t rebook, the client who you received a review letter for but haven’t yet scheduled an appointment with, the client that was seen yesterday who needs a review letter or closing letter that hasn’t yet been sent.

Maintaining a system like this can be a little bit time-consuming. I spend about 10 to 15 minutes each week updating my spreadsheet and it does require a little bit of discipline to make sure that clients are added and removed as required (you also need an administration process in place that ensures you are notified when a returning clients referral / review is received). But it is the most efficient AND error proof way of diligently overseeing my caseload that I have been able to achieve. It is also an important way to minimise my own stress levels about whether I am meeting my responsibilities.

When I say responsibility for a client, the way I conceptualise it is like an actual physical ball of responsibility, and when the GP provides the referral to me and I accept that referral I am taking possession of that ball of responsibility (the GP hands it to me). When I start holding that ball of responsibility the client goes on to my tracker and then when I write the closing or review letter to the GP I remove that client from my tracker (I’ve handed the ball of responsibility back to the GP). The GP then does a review and sends that ball of responsibility back to me, I accept that ball of responsibility and put the client back on my tracker. So, some of my long-term clients might have been added to and removed from my tracker 5 or 10 times over a number of years.

This is one of the many reasons why I am very reluctant to book in a client subject to a GP review. I wait until I have received the ball of responsibility (valid referral) and then book an appointment. This also assists with not undermining or pre-empt the GP review process.

How you track your clients and fulfil your obligations to the various funding bodies is a really critical aspect of maintaining a high quality private practice and I encourage you to think about how you will track your clients.?