I’m Packing my Bags!

[ T ] Cristóbal Toral  - Colorful Suitcases


Photo by Cea.

I love to travel.  So much so that the destination hardly matters—near, far, domestic, international.  I love it all.

I adore hotels, especially good hotels.  I like the little wrapped soaps, the feeling of clean sheets pulled really taut and don’t get me started on the wonders of room service.

And while I really enjoy the time on the road, I’m equally fond of the planning—choosing routes, destinations, sites, etc.  A couple years ago, we decided to take a two week road trip and I fully planned (and by this I mean I had typed, printed itineraries) two different trip options so the family could vote.  (Yes, I can be difficult to live with, but it’s really great to travel with me!)

So I’m very excited about attending the ASHA convention this year.  I’ve never been to San Diego (hooray!).  I’m booked at a fancy hotel (yippee!). Conventions require scrupulous reading of session topics and scheduling (whee!).

I’ll admit I approached the on-line convention scheduler with some trepidation.  I really like reading through the old fashioned convention programs.  I like the idea of kismet.  Though I work with pediatrics, primarily on articulation and language issues, something outside of that realm might tickle my fancy.  What if there is a research study involving geriatrics whose communication skills stayed sharp through red wine and mystery novels?  I want to be there!  Is there something involving animals and communication?  Count me in!  What about bizarre Oliver Sacks type stuff?  Please save me a seat!

So plugging in keywords, topic area and tracks seemed too limiting in some ways.  But I dutifully persevered.  I plugged in topics.  I selected interesting sessions.  I downloaded the info.  Uh-oh.  I had lots of double and triple booked sessions and big gaps in between.  I can go back and search by date only trying to fill in some holes, but that seems rather cumbersome.

And the scheduler shows a printed itinerary with only session numbers.  So I found myself paging back and forth trying to figure out what I had selected and which of the 2 or 3 would get my time.  Another uh-oh.  Several of the times on my itinerary don’t match that on the session description.  I’m assuming the session description is the correct one.  Huh.  Oversight on my part.  I didn’t realize that a course I “selected” is actually a short course.  Or actually I did, but didn’t register the fact that this meant an additional fee and separate registration to secure my spot.  I’m still debating that one.  At this point, I’m about 80% sorted out.

The last convention I went to (Chicago 2008) I ran around like the Energizer bunny trying to maximize my continuing education hours.  This time I arrive with all my hours completed and, while I’m eager to gain more knowledge, I’m planning to maximize the experience.  So this means getting to the zoo and probably an art museum.  I’m leaving myself enough time for lunch to enjoy the San Diego Bay Food and Wine Festival.  I’ll sleep in one morning and order room service.  I leave a couple hours open for kismet.

Are you coming?   Let me know where you’ll be!

(Kim is one of the official ASHA Convention bloggers! Stay tuned for more insights from her and the other bloggers before, during and after convention.)

 

Kim Lewis M.Ed, CCC-SLP has a private practice for pediatrics in Greensboro, NC. She is the blogger at www.activitytailor.com, providing creative ideas for speech therapy, and the author of the Artic Attack workbook series.

Talent is Overrated

I recently picked up the book, Talent is Overrated, by Geoff Colvin and it’s one of those books that continues to occupy my thoughts several weeks after reading.  The author’s argument, supported by numerous studies, is that there are very few instances of true giftedness or talent.  That in almost every case, performance is a result of increased time, effort and focus.

I’m a very competent cook.  I enjoy making everyday meals, elaborate holiday feasts and most kinds of baking.  (I don’t make pie; I don’t like pie).  I’ve received lots of compliments over the years on the way everything looks and tastes, how the menus go together and how “easy” I make it look.  But I’ve always known that it isn’t that it’s easier for me, it’s that I’ve had so much experience doing it that my methods are streamlined.  For example, my husband, who can also make a great tasting dish, uses about twice as many pots, pans and utensils as I do.  And the counters tend to be more…let’s say cluttered at the end of the preparation.  But it’s my years and years, hours and hours in the kitchen that bestowed “accomplished home cook” on me, and not an innate understanding of kitchen chemistry.

So, how does Talent is Overrated fit into speech and language?  This is what I’ve been thinking about:

For the speech-language pathologist:  Colvin lays out a very humbling truth which is that experience is not always the equivalent of better.  An SLP that shows up for work everyday and goes through the motions is gaining very little improvement from year to year.  Continuing education and then, more importantly, putting that into practice is critical.  Re-visiting those dusty old text books and notebooks from graduate school is a good idea from time to time.  Getting critiqued or watching a peer could bring ho-hum therapy and results to a much brighter place.

For our clients:  Deliberate practice.  This is one of Colvin’s cornerstones, that deliberate practice, not just repeating the same thing over and over again, is what improves performance.  We already know this, but it’s a great reminder.  The child that comes in, is hard to motivate and just repeats the target words each week is really just coming to practice his error pattern.  We need to stop those kids dead in their tracks, make them think a new way, make them produce something different–maybe even if it’s still not quite on target…yet.

I’ve got a busy fall ahead of me.  Screenings to do, warm stews to simmer and fresh bread to bake.  But I pulled down the stairs to the attic yesterday and I think I’m going to stick my Hodson textbook in my car for the next few weeks.  I noticed all sorts of notes in the margins.  I think that student might have some good advice for an experienced clinician.

(This post originally appeared on Activity Tailor)

 

Kim Lewis M.Ed, CCC-SLP has a private practice for pediatrics in Greensboro, NC. She is the blogger at www.activitytailor.com, providing creative ideas for speech therapy, and the author of the Artic Attack workbook series.

Forging Ahead–A Private Practice Checklist

Path...


Photo by Diego3336

(This post originally appeared on Activity Tailor)

Hooray! You’ve decided to take the plunge and start working for yourself. Now it’s time for some organization:

  1. Proper mind set: Grab a glass of wine or a cup of tea. Dream! What do you want out of this venture right now? What do you want in 10 years? Having some sort of framework for your business will help you make a lot of the decisions that lie ahead. Hey while you’re at it—write those dreams down!
  2. State license: I’m assuming your CCCs are all in order, but depending on your state and/or previous place of employment you may not be licensed by your state speech-language-hearing board. A quick phone call can save you future heartache. Most state boards will simply require proof of your degree, ASHA certification and yearly dues, but it may take some processing time. Also, be sure to find out if there are different ceu requirements. In my state, I was able to file a petition so my state and national continuing ed intervals ran concurrently.
  3. Pick an Entity: This is a fancy name for deciding how your business will be set up. You may choose to have your business income show directly on your personal income tax (sole proprietor) or establish a LLC and have the business as a completely separate enterprise. This is something to discuss with your accountant to determine the best decision for you. Invest in advice!
  4. City license/permit: I filed my “dba” (doing business as) name at the register of deeds and then applied for a city business license. Each year I’m required to calculate my gross income from services and/or goods and pay fees to the city. A dba might be “Kim Lewis, M.Ed. CCC-SLP” or “Activity Tailor”. Consider your decision. Your personal name might be very recognizable, but will it limit you if you hope to add clinicians or goods one day? Should you check if it’s an available domain name?
  5. Business banking account: You’ll want to keep your business transactions (income and payments) separate from your personal accounts. In all likelihood a checking account will suffice. However, if budgeting is not a strong suit you may want a savings account attached as well. Remember, you’ll be responsible for all your taxes at the end of the year. Transfer the estimated amount (based on that month’s earnings) on a monthly or quarterly basis if you think this will be a problem otherwise.
  6. Employer Identification Number (EIN): You or your accountant will need to apply for this with the IRS even if you are your sole employee.
  7. Malpractice insurance: You may already have this even if your employer provided some, but now that you work on your own, make sure you are covered. ASHA provides discounted rates that are very reasonable.
  8. Pricing research: Call around to some local practices and get information on pricing for both evaluations and therapy. Make sure you establish a rate that’s commensurate—don’t try to undercut the market; we all pay for that! Work out a fee schedule for various evaluations (i.e. screening vs. full eval) and therapy sessions (i.e. 30 or 45 min).
  9. Determine your wage: Be disciplined and set yourself an hourly wage. Just remember, in private practice you are only paid for patient contact hours. ***when I began to explain this item in detail, it became too huge to include here. I will post this separately in the next couple of days.
  10. Create forms and policies: OK, this is the part I dislike most, but it still needs to be dealt with—the paperwork. (*** Again, this is a line item in which the explanation went out of control. I’ll list what you need here, but will post in more detail within the week.) You will need at least the following: fee schedule, billing policy, cancellation policy, privacy policies, case history, insurance claim forms, treatment notes, monthly progress notes, evaluation summary form.
  11. Marketing Materials: At a minimum, you’ll need a business card with your contact info and perhaps space for noting appointment times, but you might also consider envelopes, letterhead or a marketing brochure. A local print shop can assist with a logo. ASHA.org has predesigned stationary that you add your info to for a reasonable price.
  12. Therapy/Evaluation Materials: This can quickly become an expensive endeavor. Tests and their forms can be quite pricey (anyone with great ideas for scoring bargains—let us know!) I would suggest purchasing the 2-3 you’ll need most frequently and adding as you see fit. Therapy materials are usually more economical and, again, you can add as you go.
  13. Make a Plan: Brainstorm some ideas for finding clients. This might include contacting local schools, pediatrician’s/doctor’s offices, or local social agencies. An ad in a local magazine might be helpful. Offer to give an educational talk at a mom’s group or senior center.
  14. Find Support: You’ll have some exciting and scary days ahead. Share it! Another private therapist willing to mentor you would be fabulous, but don’t underestimate an encouraging friend. For me, a positive attitude with limited knowledge would help me more that an experienced, but dour, practitioner.

Ask questions and good luck!

 

Kim Lewis M.Ed, CCC-SLP has a private practice for pediatrics in Greensboro, NC. She is the blogger at www.activitytailor.com, providing creative ideas for speech therapy, and the author of the Artic Attack workbook series.

Considerations for Taking the Private Practice Plunge

Waves crash in


Photo by Bruce Guenter

One of the great perks of being an SLP is flexibility in your work environment:  schools, hospitals, travelling therapist, out-patient clinic, nursing home…But to many, being in your own employ lingers on the horizon—a “someday” proposition both terrifying and thrilling to contemplate.  Wondering what this entails or where to start?  Consider the following:

  1. Money:  Being self-employed means an immediate increase in your pay/treatment hour.  However, this is offset by numerous factors.  You will have a lack of payment for hours without patient contact, lack of paid vacation time, lack of reimbursement for dues or CEUs.  There may also be a lag between time of service and time of payment.  Don’t forget to also consider loss of health benefits (or increased cost for self-pay) and an increased need for malpractice insurance.  If you choose to start your own clinic you will gain the additional expense of renting space.  Initially, you may want to only do home visits or contract with a school (usually at a very nominal charge per treatment hour).  Another possibility is to rent space within a practice (e.g. audiologist) that can give you an established infrastructure (office/billing assistance) with a built-in caseload.
  2. Time/Scheduling:  If you are currently overwhelmed with your caseload numbers, private practice can seem positively luxurious.  Due to insurance constraints (not to mention practical constraints if doing home visits), you will likely see only one patient/hour.  You can also schedule as it suits you, which may alleviate the stress of your own child care issues.  However, you will be responsible for increasing or maintaining your own caseload and the uncertainty is not for the faint of heart or financially tenuous.
  3. Lack of Co-workers:  There may be days where losing a coworker or two sounds just perfect.  But self-employment can be rather isolating.  You may not have easy access to other professionals to bounce ideas off of.  You may find yourself in your own company a lot as you travel around town.  Even if you contract in a school setting,  your “outsider” status will often have you feeling just outside the loop.
  4. My Way:  Of course your chance to call the shots will be a big draw.  Choose to specialize in one age group or with one diagnosis if you choose.  Make recommendations for treatment frequency/time and even techniques that may not have been possible to you in other settings.
  5. The Buck Stops Here:  Unless you employ a billing manager, you will find yourself with additional non-therapy responsibilities.  Be honest with yourself.  Can you firmly enforce cancellation/billing policies?  Do you have the time to pursue insurance filing? (Just a note:  I would recommend not being a preferred provider and asking patients to self-file initially.  Otherwise you’ll likely be too overwhelmed with “non-paying” tasks.  But be sure your market will support this!)

I’m sure there are plenty of other considerations as well that I’ve neglected to mention.  Please don’t be put off; be inspired!  You can do this!  Good luck!

 

Kim Lewis M.Ed, CCC-SLP has a private practice for pediatrics in Greensboro, NC.  She is the blogger at www.activitytailor.com, providing creative ideas for speech therapy, and the author of the Artic Attack workbook series.