business demands

The boss’s boss or the unrelenting business demands in the mental health practice

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Some believe that becoming a business owner means having no boss. In truth every owner must make peace with a very serious and unforgiving overlord: what the business demands. I met mine within days of starting to practice independently. 

The details of what a business demands vary from industry to industry and can even change at different stages within a particular business. Yet these demands have some common features across all businesses. For example, all must have some way of creating and producing a service or product. It has to be valued by those willing to pay a price for it. The foundational demand then is the requirement to consistently maintain a system for creating the business’s services or products. Usually this is called “Production.” (To read more about this see these posts: Providing services.)

In order to succeed there needs to be a regular and consistent way that people learn about the service or product. We want them to acquire enough details to decide if they are willing to pay for it. This is usually called “Sales and Marketing.” (To read more about this see these posts: On Marketing.)

And every business must constantly work to let potential purchasers know about their product or service (Marketing).

Then a fee must be attached to the service or product. And once the service is provided (Billing) there must be a system for consistently collecting the fee (Collections).

These business demands bow to no one. The owners who thrive are those who become willing servants. They find ways to manage all these without paying too high a personal price.

Specific demands in mental health practice

There are daily and weekly tasks (demands) that occur in all mental health practices. If they are not met things come to a halt pretty fast. The daily key ingredients are scheduling appointments and providing therapy; then weekly we need to do the billing for therapy and collecting for therapy. Planning marketing, a fifth demand, while just as important, has a different pace that can create unique issues.

All these can be done in many different ways and still work very well. In fact, the methods will vary quite a bit depending on the organization’s size and structure. They must be done well and done consistently or the business will not succeed for long.

Another metaphor: Doing the chores of business

All of these can be thought of as the chores of keeping a practice afloat. Like household chores, the more systemic we are about doing them, the easier they are. Chores are easiest when we do them in small chunks, regularly and consistently. For example, cleaning up after a meal is easier if I do it right after dinner. Waiting until I am in the mood just means a mess. Somehow the clean-up-the-kitchen mood seems to arrive less frequently than my meals do. That is why we call them chores. We know we need to do them but are not always inspired to take them on.


Everyone would love to hire out all chores, domestic and business related. In most cases that is too expensive. And even then hiring out does not get you off the hook. If you hire, you still have to manage the people and processes. I remember talking with a practice owner about how he had hired a billing service.  Sadly he found that the service made so many mistakes that he had to create a second process to check that all the claims were filed correctly. The situation was not what he had hoped for.

So we are stuck with the unrelenting chores that only we can do. I have several posts on managing myself. (See Managing self.) The more orderly we are about the daily chores (scheduling and therapy) and the weekly ones (billing, collecting, and marketing) the better our business will flow. Delaying or procrastinating will only make them more of an ordeal and probably cost you business.

It is possible to develop your business systems, i.e., do your business chores, to the point that the owner’s experience is a “business running itself.” That of course is hardly the case. But if doing these business activities can feel that effortless, then we truly have arrived. And inevitably the result will be business growth.

Also see:

Daily business demands

Course building a mental health practice

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