When You Leave a Clinic: Keep Your Reputation

It has been a pleasure working as a psychologist, in Minnesota, since the early 90s. During that time, I have learned many lessons that were not taught to me in graduate school. Some simply take common sense to figure out, while others are the result of falling down a few times. Here, I present a lesson never taught to me in grad school.

What happened? My first position as a psychologist was at a very large clinic in the Twin Cities. I was so proud to be hired by a place so well known. During my interview, I met the owner, manager, and several therapists. They certainly knew how to recruit. When I showed up for work a few days later, the only people there were the owner, one of the clerical staff, and a couple therapists. There were papers all over the floor, as if the place had been vandalized. I was told that one of their lead therapists, and others, had spent the night in the clinic copying clients’ charts. They had secretly told each of their clients they were opening a new clinic. The owner of my new clinic knew nothing about it. My new clinic eventually went out of business. To me, it was very sad for the owner, and quite greedy, or disheartening, for the therapists to take the business away from the clinic that spent much in time and money to obtain these referrals.

After about a year, when I announced to my clients and employer that I would be leaving, some of the clients asked me if they could stay with me.  I shared this information with the owner of the clinic and made arrangements for them to be transferred gradually to other therapists in the clinic. It made no difference to me if the initial referrals came to me through the clinic, or if I had established the referrals myself. The bottom line is that I wouldn’t have received these referrals if I hadn’t worked there. If I was to go on my own, I would do the trench work myself—not draw from the hard work and expense of others. This decision was not based on me trying to be pious or morally superior, because frankly, I’m not. But, it is following basic ethical guidelines, and being a responsible therapist and business person.

Lesson Learned. When started my own clinic, I took no clients with me. As a new business owner, I was sure to include provisions in our clinic contract, approved by an attorney, that therapists could not get away with what happened on my first job. Of course, I allowed for exceptions, on an individual basis, if it was in a client’s best interest to stay with a therapist. In philosophical terms, “Nothing is black or white.” There are exceptions to just about any rule.

After a while, I sold my two clinics. I made sure that I had no contact with any previous clients, unless it was agreed upon by the new owners. When you leave a job….leave; don’t steal their livelihood. Perhaps it is like working in a store selling a product, but secretly telling customers that you can sell it to them “on the side.” In plain English, it’s stealing.

A few years later, I happened to run into one of the therapists who had been part of copying clients’ files and starting their own clinic with the clients from the clinic they had abandoned. I asked the person how it felt to take just about all of the clients from the other clinic with them. The response was something to the effect that they had developed relationships with “their clients.” Thus, it would be in the clients’ best interest to go with them. Of course, this makes some sense on one level. However, clients can be transitioned from one therapist to another, usually over a few sessions. If the client is so dependent on a particular therapist, I clearly question the relationship. We are helpers, not people who become enmeshed with clients in a manner in which they depend on us. This dependency only makes the client worse in the long run.

Not Just Me: Recently, a clinic director/owner, who is friend of mine, phoned me. This person was quite frustrated, and wasn’t sure what to do, because some therapists did the same thing in their clinic as what happened at my first job. Over half of the clients were gone. The cost of running a clinic remained the same, but now the income was less than half of what it had been. Just as in the previous case, little or no warning was provided, and no transition period for the clients for transferring to a new therapist was mentioned. The therapists, whom had left, were rather new to the field, so much of what they had learned was at this clinic. Now the clinic director/owner is scrambling to find new therapists and clients to keep the business above water. The clinic director/owner has now decided to have a clear contract, approved by an attorney, and within the ethical stances of the APA, to avoid this happening in the future.

Free Advice: If you are in the field, working for someone else, do everything you can to support your clinic. No clinic is perfect. It is your choice to stay or leave. The owner has put in a great deal of time, effort and finances to be in business. If you are not happy with the clinic, or if, for any reason, it is your time to leave, you will feel much better about yourself, if you leave with clean hands. There are few things worse than establishing a bad reputation. Enough said.

Donald E. Wiger, Ph.D., LP, is a licensed psychologist with a private practice in St. Paul.  He has conducted seminars and consultations in documentation since the 1990s.  He has written several books on topics such as clinical documentation, practice management, clinical interviewing, and record keeping.  Dr. Wiger earned his Ph.D. in 1989 from Fordham University in New York City from the Department of Psychology, specializing in psychometrics.  He has an MA (1986) in experimental psychology/psychometrics from Fordham University and an MS (Ed.) (1984) degree in counselor education from the State University of New York. 


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