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As states return to “normal,” should my practice?

October 14, 2021
Therapy Practice

For practitioners among you who have leases expiring in the near future, a question is likely weighing on your minds: should I renew my lease or transition fully to remote sessions?

Humans are great at adapting. What was initially an uncomfortable adjustment for you and your clients might have become the suitable new normal. And while the transition to Telehealth was necessary, the suitability of long-term remote therapy depends on the needs of you and your clients. For instance, some practitioners provide EMDR therapy, in which case in-person services are critical and must be resumed.

While states are just beginning to reopen after nationwide stay-at-home orders, the American Psychology Association (APA) still recommends practitioners continue to practice via Telehealth when possible. To get the most up-to-date guidelines by state, you can consult the APA’s resource here.

Even if you do have the choice to go back to your office, you might be unsure about what is right for you. While nobody can make this deeply personal decision for you, we’ve served up some food-for-thought to help you weigh your options.

Four Trade-offs You Should Consider

1. In-person will never be the same. Masks and social distancing are recommended.

Keeping office space gives you the benefit of having in-person contact with your clients. The intimacy and trust needed for successful therapy can come more naturally when you are both in the same physical space. However, just because we can return to shared spaces, does not mean our behavior will be the same as before. The APA is still advising clinicians practice social distancing and wear masks when in close proximity to others. Although you will be in the same room as your clients, neither of you will be able to read facial expressions beneath a mask. Perhaps a pixelated face is easier to connect with than a half obscured one.

2. Savings from breaking your lease vs. losing clients who prefer in-person sessions.

Aside from the question of Telehealth efficacy, there are a number of financial trade-offs that can be factored into making this decision. If you resume sessions in your office, it is possible only a fraction of your clients will feel comfortable with the risk. The cost of renting an office under these conditions could be prohibitive enough to rule out this option altogether. Not having an office means no rental, transportation, or supplies expenses. While you might save money on operations costs, it is possible remote-only therapy has unexpected negative financial implications to your practice. There is not enough data to make an informed assessment of how Telehealth affects retention rates, but it is worth considering the potential downstream effects of forgoing office space entirely. Have you noticed any significant changes in your practice size or caseload since going remote — whether that is an increase or reduction?

3. Potential lower reimbursement over Telehealth.

In the past, you may have noticed different reimbursement rates from insurance when conducting telehealth sessions instead of in-person sessions (although depending on your state’s parity laws, that may be illegal). Due to COVID-19, many insurers made changes beginning in March to their telehealth reimbursement policies that have ensured reimbursement rates remain the same as in person office visits. These policies are not likely to change, but you can email us (info@meetnirvana.com) for more information.

4. Remember your personal preference. You can also always change your mind.

It is important to remember, the decision to give up your office space is reversible. If you decide down the road you’d like to return once things have moved from kind-of-normal to normal-normal, you will always be able to find new office space. No change is permanent.

What if I’m still undecided? Your personal checklist.

That is completely understandable! This is a big decision and there is no need to rush. Regardless of what you decide to do, we’ve made a checklist to help make the transition from in-person to partially or fully remote Telehealth as seamless as possible:

  1. Renegotiate your lease.
  2. Make sure to update your address with NPPES and insurance companies.
  3. Ensure your practice is equipped with a HIPAA compliant Telehealth platform. Here are a few of our favorites: SimplePractice, TheraPlatform, Doxy.me.
  4. If you are returning to your office, this article has a lot of information for reopening your practice.

Need more help?

From billing to office leases, Nirvana Health guides therapists through the financial operations of their practice. Reach out to us through our website or email (info@meetnirvana.com) if you’re interested in learning more.