Successful Private Practice in Neuropsychology and Neuro-Rehabilitation (eBook)

Front Cover 1
Successful Private Practice in Neuropsychology: A Scientist-Practitioner Model 4
Copyright Page 5
TABLE OF CONTENTS 8
Foreword 16
Preface 20
CHAPTER 1. THE CHALLENGE OF PRIVATE PRACTICE IN NEUROPSYCHOLOGY: OVERVIEW OF KEY ISSUES AND EFFECTIVE SOLUTIONS 22
Pros and Cons of the Institutional Setting 22
Maintaining High-Level Skills 23
The Interdisciplinary Network 24
Do Not Go Gently into That Research Decline 25
Creating Educational Opportunities 26
Productively Managing Anxiety: Income 27
Protectively Managing Anxiety: Malpractice 28
Personality Factors in Private Practice 29
Ego Needs and Decreased Prestige 30
Ongoing Consultation: Are You Willing to Seek It? The Buck Stops Here 30
Exercise: Is Private Practice Really Right for You? 31
CHAPTER 2. OTHER POTENTIAL INDIGNITIES 34
No Paid Sick Leave or Holidays 35
No Additional Reimbursement for Professional Fees 35
No Guaranteed Salary or Health Care Benefits 35
Overhead Expenses 36
Billing, Collections, and Taxes 36
Exercise: Personal Balance Sheet for Direct and Indirect Costs 36
CHAPTER 3. THE GOOD NEWS 38
Integrating Skills and Interests in Patient Selection 38
Creating the Optimal Schedule 39
Setting Your Own Fees 42
Determining Salary 42
Choosing Your Own Support Services 43
Office Location, Space, and Atmosphere 43
Developing Your Own Letterhead and Brochures 44
Personalized Report Formats 44
Test Selection 44
Tax Advantages 45
Exercise: What Appeals Most to Me about Private Practice? 45
CHAPTER 4. GETTING STARTED: PRACTICAL PRELIMINARY QUESTIONS 46
Are You Experienced Enough To Be on Your Own? 46
Individual or Group Practice? 47
Interdisciplinary Practices 48
Full-Time or Part-Time Private Practice? 49
Consultation or Supervision Practices 50
Teaching 50
Medical-Legal Work 51
Neuropsychological Evaluations and Expert Witness Work 52
Hospital and Clinic Affiliations 53
University or Medical School Positions 54
Adjunct Appointments 54
Part-Time Clinical Faculty 55
Exercise: How to Explore and Define Your Options 56
CHAPTER 5. A PRACTICAL GUIDE FOR OPENING YOUR BUSINESS 58
Don't Burn Bridges 58
Clinician, Know Thyself 59
A Moveable Feast: The Menu of Practice Options 59
Maintain a Part-Time Practice with Your Previous Employer 60
Developing a Safety Net: Starting with a Group 60
Offering Contract Services to Inpatient Rehabilitation Units 60
Offering Contract Services to Private Clinics 61
Membership in Managed Care Panels 61
Obtaining Adjunct or Clinical Teaching Appointments 62
How to Determine Fair Fees 63
How to Find Good Help 64
Developing a Business Plan and Practice Management Statistics 65
Exercise: Timeline for Implementing Your Practice Template 67
CHAPTER 6. MARKETING AND OTHER MATTERS 68
First and Foremost, Do Good Work 68
The Introductory Letter: Be Specific, but Not Too Limiting 70
Develop Seminars and Workshops 71
Give Guest Lectures 71
Offer a Memory Course to the Public 71
Contact Private Practice Physicians 72
Contact Independent Nurse Case Managers 72
Contact Private Vocational Firms 73
Attend Weekly Hospital Teaching Rounds 73
Supervise Residents, Interns, and Postdoctoral Fellows 74
Obtain Graduate Student Help for Research 74
Conference Participation: Yours and Other Related Professions 75
Publish 75
Exercise: My Five Preferred Modes of Marketing 76
CHAPTER 7. CREATIVE APPROACHES TO FINANCIAL ISSUES 78
Trading Consultation Time for Office Space 80
Sharing Testing Materials 80
Advice on Billing and Collections 81
Obtaining Basic Data from Your Patients 82
Obtaining Insurance Authorization 82
Contract and 50% Down for Private Neuropsychological Evaluation 82
CPT Codes 83
How to Bill and Collect for Legal Work 85
Reduced Cost Malpractice Insurance 86
Contract Assistants 86
Tax Deductions, a Good Accountant, and Type of Business 89
Exercise: Practical Planning 89
CHAPTER 8. MEDICAL—LEGAL WORK 90
The Problems with Legal Work 90
True Believer Polemics in The Absence of Strong Scientific Data 91
Integrity and Reputation—Are You a Plaintiff Or a Defense Expert? 92
Potential War of the Clinical and Legal Worlds 92
Subtle Influence and Examiner Drift 93
Inadvertent Promotion of a Litigious Zeitgeist 94
The Benefits of Forensic Work 94
Spine-Firming Exercises 97
CHAPTER 9. CONSULTATION AND SUPERVISION PRACTICE 98
Clinical Psychologists, Primary Care Physicians, Nurse Practitioners, Physician Assistants, and Neurology or Rehabilitation Nurses 99
Neuropsychologists Who Wish to Augment Their Training 100
Therapists in Social Work, Counseling, or Pastoral Counselors 102
Rehabilitation Therapists—Occupational Therapists, Physical Therapists, Speech Pathologists, Vocational Counselors, Rehabilitation Specialists, Recreational Therapists, and Case Managers 103
Consultation with Psychologists Preparing for Licensure 103
Exercises 104
CHAPTER 10. PSYCHOMETRIC CONCERNS 106
The Interview: Who Should Be Present and Why? 106
The Collateral Interview: When, Why, and with Whom? 107
Preparing the Patient to Be Tested 108
Test Selection 109
Selective Additional Testing: Areas of Concern 111
Evaluating Personality in Neuropsychological Assessment 113
Cross Cultural Issues 114
Use of Psychometrists 115
Report Formats 116
Review of Test Results 118
Dictation versus Typing It Yourself 119
Dissemination of Reports 120
Preservation of Testing Files and Raw Data 120
Exercises 120
CHAPTER 11. TREATMENT PRACTICES FOR NEUROPSYCHOLOGISTS 122
Your Training Background and Future Training Needs 122
What Kind of Practice Do You Want? 123
Other Parts of Good Clinical Practice Development 124
Establishing Short-Term and Long-Term Groups 124
Individual Treatment in a Neuropsychology Practice 125
Billing and Reimbursement Issues 126
Other Practice Options: Employee Assistance Program Contracts 126
Other Practice Options: Case Management Services 126
Exercises 127
CHAPTER 12. NUTS AND BOLTS OF YOUR EVALUATION PRACTICE 128
Referrals 128
Educating Referral Sources 129
Purpose of Testing 130
Mechanisms of Feedback to Referral Sources and Patients 132
Insurance Preauthorization of Services 135
Timely Billing and Collections 137
Exercises 138
CHAPTER 13. HOW TO DESIGN AND IMPLEMENT A COGNITIVE GROUP 140
Introduction 140
Which Patients? 141
Basic Clinical Rules and Procedures 143
Basic Billing and Documentation 146
One Model for Cognitive Group Treatment 147
Exercises 148
CHAPTER 14. RESEARCH AS A DAILY REALITY 150
What are Your Research Interests? 150
Grants 154
Conference Presentation 155
Journal Articles 155
Chapters 155
Journal Groups 156
Collaborations 156
Exercises 157
CHAPTER 15. SUMMARY AND CONCLUSIONS 158
The Importance of Relationships and Mutual "Best Interest" 158
What Sort of Work Do You Want to Do? 159
Where and How Do You Want to Begin? 159
What is the Best Way to Minimize Costs and Maximize Income? 160
What Sort of Financial Floor Do You Need? 160
How Will You Monitor and Promote Growth of Your Practice? 160
What Do You Do If Plan A Isn't Working as You Expected? 161
What Are Your Short-Term Intermediate, and Long-Term Goals? 161
Practical Ways to Vary Your Practice 162
Periodic Or Long-Term Contract Work 163
Clinical Faculty Appointments 164
Be Alert to Clinical, Teaching, and Research Opportunities 164
Enjoying Your Private Practice 164
APPENDICES 168
Appendix A 168
Appendix B 170
Appendix C 176
Appendix D 180
Appendix E 182
Appendix F 184
Appendix G 186
Appendix H 188
Appendix I 190
Appendix J 192
Appendix K 208
Appendix L 210
Appendix M 212
Appendix N 216
Appendix O 218
Appendix P 220
Index 222