Welcome to The Testing Psychologist podcast, episode #002. I’m Dr. Jeremy Sharp. Happy to be here with you today. I am looking out my window here in Fort Collins, Colorado, and it is snowing. We have had a pretty mild winter lately, and this is only about the second time it snowed, but it looks like it’s going to be coming down for a little bit here. So, finally starting to look like winter. It’s kind of nice to be tucked away here in a warm office, just talking to y’all about testing.
In the last episode, our first episode, we talked a lot about just general pieces of testing: what it is, what it’s about, different [00:01:00] types, who can do it, and that sort of thing. Today, I really wanted to start digging in. And as we go over the next few episodes, I’m going to dig into pretty specific topics probably over the next four episodes that will really be aimed at getting you to think about some things that you can put into place and really be thinking about and acting on to get a testing practice started, or even streamline your testing practice if you’ve already got some of that going on.
So, today’s topic is what to consider before you launch a testing practice. This is really aimed at people who want to integrate testing in their practice but maybe have not taken those first few steps. So, we’re going to talk about just basic business ideas. I won’t talk a whole lot about that because there are so many folks out there who do good business coaching, but we’ll talk about basic business stuff. [00:02:00] We’ll talk about the pros and cons of testing. We’ll talk about insurance versus private pay for testing. We’ll talk about what kind of testing you’re going to focus on, where to purchase materials, forms, marketing, all sorts of stuff. So stick with me and let’s dig into it.
First, I wanted to talk about just basic business items to think about before you get into testing. The biggest question here, I think is, are you integrating your testing into your existing practice, or are you just starting cold? So, do you have a private practice already or are you opening your practice and specifically doing so to build it around testing?
Now, that’s going to influence, of course, how you go about starting the practice. If you’re integrating it into an existing practice, then we’d be talking a lot more about how to maybe change your website, change up your marketing a little bit[00:03:00] versus, starting a practice cold. I think that gives you a lot of liberty to really just build it from the ground up.
Basic business items also, there are many other folks out there, like I said, who do a great job with business coaching, private practice building, and consulting. Just a few that come to mind right away, there’s Joe Sanok at Practice of the Practice, there’s Kelly & Miranda at Zynnyme, there’s Melvin at Selling the Couch, and any number of other folks who do mental health practice consulting. I’ll have links to their websites in the show notes but just wanted to throw those out there. If you need really good consulting just about building and starting a practice in general, any of those folks will be great to turn to.
Basic things you want to consider, this will be really quick, but you want to make sure that you have your office [00:04:00] space, of course, a website, you need your business cards, and you want to be thinking about networking. I’ll talk about networking specifically for testing in an upcoming episode, but for today, like I said, office space is a big one.
If you’re just starting your testing practice, you probably want to be thinking about things like do you need an extra office space where you would like to do testing or would you like to combine your testing into one office where you have… A lot of folks will do an L desk where you can do testing on one side and then have your computer and writing materials on the other side. Just make sure that your office is big enough then where you could also set up some chairs or love seats and have a sitting area to do feedback sessions and interviews. So you’ve got the one-office approach.
Now, if you have any thought of hiring other folks to do testing for you, again, which we’ll talk about in a later episode in more detail, but I will [00:05:00] call that a tech model where you have psychometricians working for you administering tests, then you might think right off the bat about having a multiple office suite where you can have a specific testing room. That’s a setup that I have had pretty much from the beginning. Not really intentionally, to be honest, but it just lucked out that way. I had an extra office in our office suite and was able to utilize that for testing. So something to be thinking about with office.
And then, like I said, website, business cards, networking. We’ll talk more in detail about that in future episodes, but those are things to be thinking about.
Let’s get into the pros and cons of testing. If you’re really trying to figure out, do I want to do this? Here are some things to be thinking about.
In terms of the things that work really well with testing, one of the things that I really like about it is that it utilizes a clinical skill that is specific to our training as psychologists. It offers a unique [00:06:00] service that other mental health practitioners do not at the master’s level, for the most part. I know we talked last time about school psychologists. Some of those master’s level folks can do testing and interpret testing, of course, and do a great job, but for the most part, testing and test interpretation are really specific to psychologists, which is pretty cool. It sets us apart and it’s a unique skill.
Now, for myself, I kind of lucked into this. I did not know maybe like some of you. I was the first person in my family to go to grad school and certainly the first one to go to grad school for psychology. So, I didn’t know that testing was specific to psychologists. I went into it thinking I just wanted to do therapy, and the way you did that was if you got a Ph.D. Well, I found out down the road, of course, that testing is one of those things that are really pretty specific to the Ph.D. level education. So looking back, I’m just so thankful that I [00:07:00] stumbled into that and didn’t really even think about going the master’s route because testing is now what I love and what I made my career out of.
Another thing that works really well with testing and as I think an advantage of testing is that, for me, it allows you to get to know the client in a very different, but I would say, intimate way that does not happen in therapy necessarily. You gift them with knowledge about themselves that people very rarely actually get. I think it’s pretty rare to have a good sense of what your brain is up to, your IQ, your cognitive strengths and weaknesses, and then doing a certain type of evaluation, of course, you get to weave that information into personality, emotional functioning, environment, and you really get to know people in a pretty deep [00:08:00] way. Even though it is data-driven, I do have a pretty strong emotional connection to the client that comes from knowing them so well through the testing information that we gather.
Another piece that was really attractive to me, more logistical, is the flexibility and schedule. I talked a little bit last time about how I transitioned to testing as my primary focus in my practice and flexibility and schedule were a big one. It was right around the time that my first kiddo was born. And I’ve been finding myself getting burned out really on just doing so much emotionally involved therapy throughout the day. I would come home and was just a wreck. Pretty beat.
Testing gives you more flexibility in your schedule. The face-to-face time, at least for me, and I think for most folks is split [00:09:00] somewhere around 50/50 with your writing time. I spend about half my time face-to-face feedback and testing and interviews, but then the other half is really spent writing reports. And for me, I like that. I can write at home. I have things set up here where we have cloud-based records where I can access the information from any computer, which is great. So, that allows me a lot of flexibility to work at home or anywhere. I can go to a coffee shop if I want. I can chill out and don’t necessarily have to be in the office. So that’s pretty nice.
Otherwise, testing, I think this is something that people really appreciate here in our community, at least as it really gives you an excellent guide for treatment recommendations. I think for a lot of us, that’s the main outcome of testing is that you get pretty explicit recommendations and can really pair that with good treatment recommendations, which is what a lot of [00:10:00] clients and other professionals are looking for.
Another pro is that it can answer questions very specifically for clients, at times with more certainty than therapy. I get that a lot with folks who come here. They have a pretty specific question in mind, whether it’s, does my kiddo have ADHD? How can I help my kiddo in school? Do I have autism spectrum disorder? The goal, I think with testing, even if it’s not a diagnostic question, is that it can answer really specific questions for people and that’s really valuable.
So those are just a few things. I’m sure you might be thinking of other aspects of testing that are valuable, but those are some things that I wanted to touch on here just as we’re getting into it, things that you’re thinking about.
Now, there are some downsides to testing as well. Let me talk through those. One big one is the time involved. [00:11:00] Testing takes a lot of time. If you have the type of practice model set up where you are doing it all yourself, then that’s a huge time commitment. We’ll talk a little bit more, actually in the next episode about time allocation and how to manage your time with testing. Actually, that might be two episodes ahead. Either way, time management is really big and testing does take a lot of time.
If you are starting from scratch, which is fantastic, and testing is going to be your primary focus, I think this is a little bit less of an issue because you can build your schedule around the testing. For me, I transitioned from having basically a full testing practice, which for me was, I apologize, a full therapy practice, which for me was 20 to 25 contact hours a week with some testing on the side. I transitioned from that to full-time testing [00:12:00] practice. That was quite a process.
There is a lot of time involved in testing if you’re doing it all yourself, especially. You need to be efficient with writing reports. And it’s really easy to get behind and feel like you have homework and feel like you’re in grad school again. I have had more weekends than I would like to admit over the years where I’m just hanging out. Oh, I have to go into the office or, oh, I have to work tonight to try to catch up on reports. And a lot of that happened back when I was splitting my time and trying to build that testing piece of my practice when I was still doing therapy. So you got to be efficient and you have to be aware of the time involved.
Now, the other piece that is a downside is that testing involves significantly more overhead than therapy. With therapy, you pretty much pay for your office and, I don’t know, maybe a [00:13:00] couple of legal pads, right? With testing, the overhead is significant. I’ve heard from many people over the years when I’m talking to them about my practice and they’re like, oh, I can only imagine how much money you’re making doing testing. And every time I’m like, well, the overhead is actually a lot more expensive.
At this point, and again, we’ll get into the financial aspects in more detail next time, but there is a lot of overhead. You have to pay for testing materials. If you have a separate office for testing, then that’s additional office space that you pay for. It is a myth, I think that insurance companies reimburse more for testing. I’ve had several people say that to me as well that is not true for all the insurance companies that I can think of, at least in the outpatient office setting. Basically, you get compensated the same per therapy hour but the overhead is more. So [00:14:00] that’s something to consider as you get going.
Related to that is the startup cost. The startup cost for testing, again, we’ll get way into this next time, but it is substantial. Depending on what kind of testing battery you’re going to put together and what kind of testing you plan to do, this can be pretty expensive ranging from very basic where you might pay, let’s say $10 if you just administer one sort of behavioral checklist, maybe a SASSI if you’re doing a substance abuse evaluation that is fairly common around here. That’s pretty inexpensive, but all the way up to thousands of dollars, $5000 to $10,000 if you are thinking about getting into full neuropsychological testing or Psychoeducational testing. So startup costs can be a barrier.
And then the last thing is cost for the clients. In the grand scheme of things, clients are [00:15:00] not generally paying any more for testing than they do per therapy hour, but the difference being that, that cost comes usually at a one-time payment and in some cases a two-time payment. Here at our clinic, we break payments into two parts for the most part unless folks are using insurance, or even if they are using insurance, actually. If they have a bigger balance, they break payments into two parts.
But that can be pretty expensive for folks. If you’re paying out of pocket for an evaluation or if you have a high deductible, folks who are coming for a pretty comprehensive evaluation, that can range from $1000 to $3000 to even more than that. And so, that’s a pretty big chunk of change for people to outlay all at one time. So that’s another consideration.
Now, we got to talk about insurance versus private pay.[00:16:00] As you’re thinking about integrating or launching a testing practice, you got to think about which of those routes you’re going to go. Insurance is a big topic. And we will get into that again, next episode, which is really focused on the financials of testing. But I’ll just put that out there generally right now that you should be thinking, do I want to take insurance or do I want to just go private pay? There are advantages and disadvantages to both, but this is definitely something to consider.
You also want to think about, of course, what kind of testing you’re going to focus on. That might include, let’s see, considering your training, that should probably be the main driver for what kind of testing you’re doing. You don’t want to be practicing outside the scope of your expertise. Just speaking from experience, if you start to get known as someone who does testing, you can get a lot of requests and there are a lot of different [00:17:00] types of testing, and I think it can be easier to maybe get lured into doing testing that isn’t exactly your area of expertise. So consider your training, certainly.
I would also really consider the need in your community. There may be a saturation of neuropsychologists. So maybe you would want to focus more on psychoeducational testing, for example, or maybe there are no folks in your community that do forensic evaluations. So that could be a need to fill, but you want to consider the need in your community.
And then, I would say one of the most important things is thinking about what do you actually enjoy. This is true with any job, true with any therapy client or population, but certainly true with testing as well that you’re going to be doing this for a lot of hours of your week. I hear a lot [00:18:00] of complaints from people or maybe struggles with particularly getting the reports done. A lot of people will say love testing, but I hate writing reports. And I might say, well, writing reports is a big part of testing. So if you are not someone who really enjoys writing or pulling data together or synthesizing information and turning that into a written report, that is something to consider as maybe it’s not the best way to go for you.
Now, there are some tools out there that will really help you with report writing. And I think we’ll be getting into that maybe 2 or 3 episodes down the road. Think about what you really enjoy, what type of testing you like and go in that direction.
One of the psychologists in our practice started out doing what she is good at, so adult ADHD evaluations, learning disorders, autism spectrum. But over time, she’s found that the burden of report writing [00:19:00] and that length of evaluation just is not satisfying for her. So she’s transitioning right now to doing more brief evaluations. So adoption therapy, animal support, career evaluations, things like that. So there is some flexibility, but do what you like. That’s really important.
Other things to consider just briefly, we can talk about where to purchase testing materials. We’ll get into that a lot next time, but there are many avenues for purchasing testing materials. Forms and policies, I think that’s huge to have your paperwork straight and there are some differences in your paperwork and your informed consent that are important for testing.
One of the big differences for me and for other clinics is the cancellation policy. This in a way falls under those business coaching pieces that I talked about at the beginning, but a cancellation policy is huge. I talk with people very explicitly because we do block [00:20:00] out a whole day for each testing client and that’s 4 to 6 hours of our time. People’s eyes pop a little bit when I say, if you don’t show up that’s $500 for a cancellation fee, but once I explain it, most people seem to understand and totally get on board with that. But that is just one piece that you would want to consider in writing your paperwork for a testing practice.
Now, you also want to think about how are you going to market your testing and get clients. We’ll touch on that in detail in a couple of episodes. You also want to think about where are you going to find the time in your schedule. We talked about this as one of the cons for testing, but you really want to be deliberate about where are you going to find this time? Does your schedule support the amount of time it takes to truly do testing?
I have found that some clinics and folks have gotten into the trap, I guess, of making plenty of time for [00:21:00] interviews and getting people in the door, but then getting overwhelmed with the report writing and falling way behind on reports. And that’s not where you want to end up where you’re doing a bunch of interviews and testing, but then take 3 to 4 months to get somebody their report.
We’ve touched on a lot of different things. This is really just meant to get you thinking about different pieces to consider before you even launch your testing practice. In a perfect world, you would have all these pieces figured out. Of course, that never happens. And that was definitely not the case for me, but these are just some things to consider as you’re getting started. We’re going to talk a lot more in the coming episodes.
Next time, we’re going to really get into the financial aspects of testing. We’ll talk about startup costs. We’ll talk about what kind of evaluation you’re going to do and how that drives startup costs. We’ll talk about financial planning, purchasing, where to get them, insurance, [00:22:00] billing software, all sorts of good stuff.
In the meantime, if you want to get a little bit more information, you can always go to the website, thetestingpsychologist.com. There are a lot of articles and other good information posted there that can go right along with the podcast. Also, if you’re interested in really getting started and making some steps toward building or integrating testing services in your practice, you can check out the four-week email course that I’ve got going on there at thetestingpsychologist.com. If you go to www.thetestingpsychologist.com/fourweekblueprint, you can sign up for this four-week email course that’ll give you a different action item every week to really take some concrete steps to get some testing going in your practice.[00:23:00] Thank you as always for listening. I look forward to talking with you next time.