ACA Blog

Doc Warren
Jan 05, 2012

Leaving Your Comfort Zone; Expanding A Practice.

I am not sure how many clinicians by definition would be categorized as gamblers; if I had to guess I would say that few would qualify. As a whole we just don’t have a reputation for throwing caution into the wind, calling out of work for a week or two and betting our lifesavings at the track or Vegas or wherever. I personally do not even buy a lottery ticket due to the lack of probable return on my dollar. Still, sometimes in private practice or in the running of a program be it not for profit or a for profit enterprise, we find ourselves in a position where we can stay in our current familiar safety blanket that we have arguably outgrown or we can take a great risk and attempt to expand in hopes that the new program will be a great as ever, possibly greater. There is no right or wrong, just a feeling that change must come, must be defined and chances taken. Or not. “Or not” is often much safer though it runs the risk of becoming stagnant. My not for profit finds itself at a cross roads; we have never had any debt but never had any possessions to speak of either. Sure, we have couches, computers and the like and our office though simple, receives a great deal of compliments but truth be told it is a one man show clinically speaking. Though we have independent contractors and an occasional intern, I do all the sessions, all the clinical work. While we have additional office space available, zoning regulations and a lack of parking really prevent us from growing. Sadly dozens of people are turned away because we have no one to offer them session times. The more people you turn away due to lack of space, the less people that may call you in the future should word spread that you are never taking new clients. It is a vicious cycle. For the past year or two I have wrestled with the inevitable; leaving this great office or expanding to another office and taking on additional licensed clinicians to help with the load. The problem is that as a not for profit we typically are broke; that comes with sliding scales, pro bono services and a host of free programming but no corporate, private or government sponsors. Being truly independent can be a pain. So here we are embarking on a huge expansion with no safety net and little financial back up. But still we believe. We recently leased some very rough space, ok, it is a barn that was built in the early 90’s in the hopes of becoming a large farm market but which never took off. It has sat like a time capsule since that time. No water, no septic, no heat to speak of but great bones. Learning from the issues of the past user of the space, before opening we have sought all the proper approvals from the local government, secured the permits via a public hearing and now are paying lease payments while we get everything in order in an attempt to purchase not just the building but several acres of land that will become (drum roll please) the “Docwarren.org at Pillwillop Therapeutic Farm.” It has the makings of a great program that will provide opportunities not just for clinical growth but also for the community in general. It also has the makings of an ulcer if I am not careful… I am not alone in this situation as most folks who go into business for themselves or run a program eventually have to struggle with this type of issue. Some decide to stay as they are, one of the specialist I go to as needed has an office that is right out of a time warp. Paneling on the walls that is older than I am, paper based schedule book, dated and old looking everything. No worries about expanding or remodeling, just a happy and competent doc who helps me breathe well. I have never thought of going to another doctor due to the looks of the office and felt happy to be able to squeeze into his always busy practice but I know those who have. Still this is not always the right choice depending on many factors… So for those of you who have expanded or are in the process as I am, I offer you both my congratulations and my heartfelt condolences. You are fortunate enough to have been successful enough to need to expand, but unlike our MBA brethren, we are not necessarily wired to gamble our lifesavings or careers on the next big thing. Too often the next big thing becomes an empty building with “for sale or lease” in front. Sadly I have known many people who took the plunge and went big who then went belly up. So with an iron will and a knowledge that I cannot be defeated (or as a more honest person may say “full of fear, stress and reservations”) I set out the next stage in the story that is my office. I did my homework; though the town the new office will be in is much smaller (15,000 versus 60,000 people) it is in reality only 3 miles away from where I am now. While I may lose a few clients, the majority would likely move with the office. Both office locations are suburban or rural but the new location is on a main rural road as opposed to my current location which is on a quiet side road in a very residential area. The new location is on the same road as two town schools and within a few minutes’ drive from the third school; the mortgage though it will not be cheap, has been designed with my business in mind; the terms are very favorable to us while being fair to the lender. Plus, ok, we are hoping that people will both like our new location and what we do enough to want to take a tax write off by making donations which will help pay for it. That is where the believing part comes into play. So whether you are sitting on a stack of gold or a stack of dreams, my hope for you and your expansion is that you do your homework, eat your vegetables, dream and believe in your project before writing that giant check. Oh, and do check with zoning…

Warren Corson III (Doc Warren) is a counselor and the clinical & executive director of a community counseling agency in central CT (www.docwarren.org).

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