The 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. Steven Walfish, PhD, is a licensed psychologist and has been in independent practice since 1982. He has built three successful private practices in Tampa, Florida, Edmonds and Everett, Washington, and now Atlanta. He is also a Founding Partner of The Practice Institute, LLC. He has been the Editor of the Independent Practitioner, and author/editor of six books. In 2013 he served as President of APA Division 42 (Psychologists in Independent Practice).

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