Initial decisions to consider

There may be one or more reasons as to why a psychiatrist decides to close their private psychiatry practice. The main reasons include retirement, changing work-life balance, accommodating personal illness or carer role for family members, competing professional interests, and burnout. Irrespective of how many years of service a psychiatrist has given, the personal decision to close up is often a difficult one.

In making the decision to close a psychiatrist may like to consider seeking professional help. When a psychiatrist feels strongly ambivalent, seeking professional advice may be wise to obtain support and to exclude therapist factors such as depression. What may also be of help is to seek out graduate contemporaries to learn about comparative experience. The final decision, however, requires trusting one’s intuition, judgement and giving one’s self permission.

Psychiatrists may wish to consider the ‘transitions to retirement’ series published in the April 2016 edition of Australasian Psychiatry.

Setting the date

After the decision to electively close a practice has been made the next important step is to set the date of closure. A good rule of thumb is to allow approximately 12 months for closing up but the length of time will vary according to the circumstances of the practice. When deciding the date of closure the following issues should be taken into consideration:

• practice size
• patient profile:
  • number of active vs. inactive patients
  • proportion of patients being transferred vs. discharged
  • length of termination process required for individual patients
  • arrangement of handover with equivalent specialist care
  • review of patient files and preparation of handover documents
• balancing income with practice costs during close up phase.

New referrals

Psychiatrists will need to consider how they wish to manage new patient referrals during the period of ‘closing up’. They should keep in mind that during the period of closure patient assessments and short-term patients are beneficial in that they help maintain income.

All newly referred patients, and/or the referring medical practitioner, should be informed that the psychiatrist is seeing new patients only for assessment or time-limited treatment. They should also be advised of the approximate time at which the patient will be handed back to the referring medical practitioner.

Your health and wellbeing

The transition to retirement can be psychologically challenging for some as the event may provoke fears about self-identity, sense of purpose and direction. For medical practitioners important psychological challenges may relate to the loss of a long-time self-identity shaped by their vocation, the loss of a work-life structure and of engaging in a new retired life structure.

While the motivation of a senior private practice psychiatrist who is contemplating the closure of their practice may have waned relative to the beginning of their career, they may still wish to continue working in another capacity, either paid or voluntary, that will allow the more discretionary use of their time. Options that psychiatrists may like to consider to accommodate this include: medico-legal work, psychiatric assessments, tribunal work, and the provision of supervision and work based assessments for trainees.

Given the challenges associated with winding down a practice and the transition to retirement, psychiatrists should be mindful of their own mental and physical health and wellbeing and exercise self-care accordingly.

There may be one or more reasons as to why a psychiatrist decides to close their private psychiatry practice. The main reasons include retirement, changing work-life balance, accommodating personal illness or carer role for family members, competing professional interests, and burnout. Irrespective of how many years of service a psychiatrist has given, the personal decision to close up is often a difficult one.

In making the decision to close a psychiatrist may like to consider seeking professional help. When a psychiatrist feels strongly ambivalent, seeking professional advice may be wise to obtain support and to exclude therapist factors such as depression. What may also be of help is to seek out graduate contemporaries to learn about comparative experience. The final decision, however, requires trusting one’s intuition, judgement and giving one’s self permission.

Setting the date

After the decision to electively close a practice has been made the next important step is to set the date of closure. A good rule of thumb is to allow approximately 12 months for closing up but the length of time will vary according to the circumstances of the practice. When deciding the date of closure the following issues should be taken into consideration:

• practice size
• patient profile:
  • number of active vs. inactive patients
  • proportion of patients being transferred vs. discharged
  • length of termination process required for individual patients
  • arrangement of handover with equivalent specialist care
  • review of patient files and preparation of handover documents
• balancing income with practice costs during close up phase.

New referrals

Psychiatrists will need to consider how they wish to manage new patient referrals during the period of ‘closing up’. They should keep in mind that during the period of closure patient assessments and short-term patients are beneficial in that they help maintain income.

All newly referred patients, and/or the referring medical practitioner, should be informed that the psychiatrist is seeing new patients only for assessment or time-limited treatment. They should also be advised of the approximate time at which the patient will be handed back to the referring medical practitioner.

Your health and wellbeing

The transition to retirement can be psychologically challenging for some as the event may provoke fears about self-identity, sense of purpose and direction. For medical practitioners important psychological challenges may relate to the loss of a long-time self-identity shaped by their vocation, the loss of a work-life structure and of engaging in a new retired life structure.

While the motivation of a senior private practice psychiatrist who is contemplating the closure of their practice may have waned relative to the beginning of their career, they may still wish to continue working in another capacity, either paid or voluntary, that will allow the more discretionary use of their time. Options that psychiatrists may like to consider to accommodate this include: medico-legal work, psychiatric assessments, tribunal work, and the provision of supervision and work based assessments for trainees.

Given the challenges associated with winding down a practice and the transition to retirement, psychiatrists should be mindful of their own mental and physical health and wellbeing and exercise self-care accordingly.