Ethics of Private Practice

The Ethics of Private Practice helps mental health professionals understand the essential ethical issues related to the many challenges of being in independent practice. Seasoned clinicians Barnett, Zimmerman, and Walfish offer readers astute insight into building a practice that is designed to minimize unintended ethics violations and reduce associated risks. Each chapter focuses on a major aspect of the business of practice and incorporates relevant standards from the ethics codes of four mental health professions. Topics addressed include planning and successfully managing a practice, documentation and record keeping, dealing with third parties and protecting confidentiality, managing practice finances, staff training and office policies, advertising and marketing a practice, continuing professional development activities, and the closing of a private practice. Full of practical tips that can be readily implemented, this handy guide will be the go-to resource for all mental health clinicians in private practice.

Jeffrey E. Barnett, PsyD, ABPP, is a licensed psychologist with 30 years of experience in independent practice. He also is a Professor in the Department of Psychology at Loyola University Maryland, where he teaches courses in ethics and professional practice. He is a past Chair of the APA Ethics Committee and has published and presented widely on ethics and professional practice issues for mental health professionals.
Jeffrey Zimmerman, PhD, ABPP, has been in private practice since 1981. From working solo to managing a large multi-site inter-disciplinary group, Dr. Zimmerman has dealt with the complex challenges faced by clinicians who are trying to run a successful mental health practice in an ethically responsible manner. He is also a Founding Partner of The Practice Institute, LLC.

Preface
Acknowledgments
Chapter I: Starting Out: Ethics Issues in Beginning a Practice
Becoming Licensed to Practice
Accuracy and Integrity in Completing Licensure Applications
Supervision Prior to Licensure
Choosing a Practice
Practicing in Health Care Settings
Your Ethics and Legal Team
Location and Office Setting
Ethical Challenges
Key Points to Keep in Mind
Practical Recommendations
Pitfalls to Avoid
Relevant Ethics Code Standards
References
Table 1.1 The Supervisee's Checklist
Chapter II: Clinical Practice
Scope of Practice
Clinical Competence and Accepting Referrals
Wait Time and Waiting Lists
Understanding Informed Consent Assent
Exceptions to Confidentiality
Boundaries and Multiple Relationships
Additional Boundary and Multiple Relationship Challenges
Emergencies and Crises
Termination and Abandonment
Ethical Challenges
Key Points to keep in Mind
Practical Recommendations
Pitfalls to Avoid
Relevant Ethics Code Standards
References
Sample Termination Letter
Chapter III: Documentation and Record Keeping
Documentation
How to Document
Financial Records
Use of Technology and Electronic Health Records
Records When More than one Person is Being Treated
Record Keeping, Storage, and Disposal
What Happens When a Client is Deceased
Ethical Challenges
Key Points to Keep in Mind
Practical Recommendations
Pitfalls to Avoid
Relevant Ethics Code Standards
References
Chapter IV: Dealing with Third Parties and Protecting Confidentiality
General Policies
Special Situations
Ethical Challenges
Key Points to Keep in Mind
Practical Recommendations
Pitfalls to Avoid
Relevant Ethics Code Standards
References
Release of Information Checklist
Chapter V: Financial Decisions
Fee Splitting Practices
Setting Fee Scale Arrangements
Increasing Fees
Collections
Collection Actions
When a Client Does Not Want to Use Their Insurance
Medicare
Informing Clients About the Nature and Limitations of Their Insurance
Accurate Billing
Table 5.1 Accounts of Insurance Fraud by Mental Health Practitioners from an Internet Search
Not All Inaccurate Billing is Due to Fraud or Deceit
Information to be Communicated to Managed Care Companies
Denial of Care by an Insurer
Ethical Challenges
Key Points to Keep in Mind
Practical Recommendations
Pitfalls to Avoid
Relevant Ethics Code Standards
References
Chapter VI: Staff Training and Office Policies
General Professionalism
Confidentiality, Confidentiality, Confidentiality
Delegation to Subordinates
Boundaries and Relationships
Security of Records and the Facility
Policies and Procedures: A Safety Net
Ethical Challenges
Key Points to Keep in Mind
Practical Recommendations
Pitfalls to Avoid
Relevant Ethics Code Standards
References
Ethics Quiz for Staff
End of the Business Day Lock-Up Checklist
Chapter VII: Advertising and Marketing
Advertising and Public Statements
Testimonial Endorsements
Uninvited In-Person Solicitations
Marketing Professional Services
Interacting with the Media
Marketing in the Community
Ethical Challenges
Key Points to Keep in Mind
Practical Recommendations
Pitfalls to Avoid
Relevant Ethics Code Standards
References
Chapter VIII: Continuing Professional Development
Readings
Training
Use of Listservs
Peer Consultation Groups
Mentoring
Personal Psychotherapy
The Role of Self-Care, Burnout Prevention, and the Promotion of Wellness
Staying Aware of Local Laws, Regulations, and Changes
Ethical Challenges
Key Points to Keep in Mind
Practical Recommendations
Pitfalls to Avoid
Relevant Ethics Code Standards
References
Chapter IX: Leaving a Practice
Notifying Your Group That You are Leaving the Practice
Telling Clients That You Will No Longer Be Practicing
Assuring for Continuity of Care
Informing Referral Partners
Maintenance of Records
Selling a Practice
Malpractice Insurance into Retirement
The Professional Practice Will
Business Issues
Ethical Challenges
Key Points to Keep in Mind
Practical Recommendations
Pitfalls to Avoid
Relevant Ethics Code Standards
References
Chapter X: Closing Thoughts