The Ethics of 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