Business models at work…
Chris Mackey and Associates has been operating as a group practice for more than 20 years. Chris, the practice director, reports that central to the practice’s success is a strategic focus on maintaining sufficient diversity in all areas of the business to ensure sustainability and growth.
Diversity in expertise
Chris Mackey and Associates currently employs 12 psychologists with a mix of full-time and part-time appointments (approximately seven full-time equivalent practitioners). The psychologists of the practice have a range of expertise spanning health, mental health, counselling and neuropsychology among other areas, which allows the practice to service a wide range of clients.
Adopting a company structure, the practice employs all of its psychologists, which Chris says helps the practice pursue a number of practice-wide goals, such as conducting sophisticated outcome evaluation research on all clients (e.g. the company now has representative client outcome data for more than 2000 adults and 300 children). Chris also reports that having salaried employees can make the sharing of knowledge (e.g. on important practice matters or updates about broader relevant issues) with other practitioners in the practice easier to do in a systematic way.
In the earlier days of the group practice, psychologists were engaged as ‘contractors’ but for Chris, setting up an employee arrangement helped to develop a collaborative, high quality, integrated service with clear lines of direction and guidance from the practice principal. Chris notes that one of the risks associated with engaging psychologists as ‘contractors’ is that they are technically conducting their own separate business within an overarching practice setting and in some cases may be less inclined to contribute to the broader practice ethos.
Diverse referral base
Although approximately 70 per cent of referrals come through the Better Access scheme, Chris reports the practice also receives referrals from other sources including WorkCover, Transport Accident Commission (TAC), National Disability Insurance Scheme (NDIS) and other private referrals. Chris considers diversifying one’s referral base as important to sustainability.
Diverse range of services
While the mainstay of the practice is providing individual therapy, the practice is also invested in the provision of a number of additional services including some group treatments e.g. for those with avoidant personality disorder, wellbeing counselling consistent with a positive psychology approach, regular free public talks, engaging with the media and providing clinical information to the general public through the practice’s website (www.chrismackey.com.au).
Ongoing quality improvement and support
At Chris Mackey and Associates, offering good support to staff to facilitate effective performance and wellbeing is key. Chris reports that in order to achieve this, case loads are closely monitored and regular supervision and extensive administrative and peer support is provided. This includes weekly group supervision, regular individual supervision for starting psychologists, and at least occasional individual supervision for all psychologists. Staff typically average approximately five clients per day, although newer staff see fewer and more experienced staff may see more.
To uphold quality, routine evaluation of all clinical work with adults and children is undertaken with results reported on the website and at conferences.
Sufficient administrative and other expert support
From an administrative perspective, the practice employs seven administrative staff (approximately 3.5 FTE staff). This includes a well-qualified practice manager who works four days per week who Chris says is a great advantage in running a well-integrated service.
In addition to this extensive administrative support, the practice seeks legal and accounting advice whenever required as well as advice from the APS when encountering complex ethical issues.
Diversifying is a theme that characterises Chris’s work week as practice principal. After 20 years in business, Chris now only spends approximately one-and-a-half days per week seeing clients in clinical work so he can dedicate sufficient time to managing aspects of the practice, including practice development and supervision of staff. Another one-and-a-half days each week is reserved for writing, research, preparing talks, staying abreast of changes in the profession and networking.
Chris says that his business is quite an undertaking, but a great challenge with plenty of rewards.