Building Private Psychiatry Practice in India

Prosenjit Ghosh

Department of Psychiatry, Silchar Medical College, Cachar, Assam, India

Corresponding Author: Prosenjit Ghosh, Department of Psychiatry, Silchar Medical College, Cachar, Assam, India, Phone: +91 9435072563, e-mail: p_ghosh72@yahoo.com

How to cite this article: Ghosh P. Building Private Psychiatry Practice in India. Ind J Priv Psychiatry 2024;18(2):55–56.

Source of support: Nil

Conflict of interest: None

Keywords: Private practice, Psychiatry clinic, Psychiatric practice, Psychiatry in India.

In today’s world, the importance of mental health and seeking professional help is more recognized than ever before. As a mental health practitioner, there is an incredible opportunity to make a positive impact on the lives of others by building a thriving private practice. However, the road to success in this field can be challenging and overwhelming. From attracting clients and managing finances to creating a strong online presence and maintaining ethical standards, there are numerous factors to consider when establishing and growing a mental health practice.

Psychiatric practice in India is marked by an increasing demand for resources in the form of qualified manpower not only in cities but also in rural areas. The National Mental Health Survey 2016, has found that the treatment gap may be as high as 87% for severe mental disorders.¹

So, there is a huge need for psychiatric services across the country and Private Psychiatry Clinic/Chamber is an accessible and affordable option for service delivery in the field of Mental Health. There is no “Right Time” for starting a private practice and one can start any time after obtaining the necessary qualifications. However, one must have a proper plan and motivation before jumping in. One must engage in private practice for its inherent satisfaction or goals. It is important that the private practice set-up resonates with you and aligns with your professional values. One must have an alternative source of income for at least for initial few months. To start a private practice is not an easy task, particularly in Metro Cities, but one should be determined and not waste time once the decision is taken to start private practice.²

A successful practice needs various qualities in the individual like-professionalism, readiness to update one’s skills/knowledge, ability to understand the needs of individual patients, to offer diverse treatment options as per the client preference, effective networking, intelligent marketing, creating awareness, maintaining ethical standards, etc.

The doctor-patient relationship is a unique social relationship with the ultimate objective of helping the patient achieve treatment goals. The best model is where there is mutual respect and free communication. The patients and their caregivers should get the appointment without much difficulty. The chamber timings should be fixed and one should stay in the chamber even if there are no patients (in the initial phase). The practitioner should be available to his patients either physically or virtually to answer their complaints regarding medicine side effects/no improvement. India is a huge country with diverse ethnic, religious, cultural, linguistic, and socioeconomic groups and the psychiatrist should be aware of this and offer therapy that his patients appreciate. The clinician should not reject or ridicule the belief systems of the patients and caregivers.

A clinician should remain updated in knowledge. Clinicians should identify relevant deficiencies in knowledge regarding practice and actively search for such expertise.³ Clinical skills should be improved by identifying the knowledge gap and the need for specific skills. The clinician should actively participate in CMEs/Workshops/Conferences, read journals, and search relevant websites to sharpen their skills.⁴ A clinician should also try to increase his expertise by acquiring knowledge in the fields of sub-specialties through certificate/diploma courses like–the Psychosexual Health Certificate Program by JSS Academy. Short-term courses can also be done in hybrid mode like the advanced certificate course in Management of Addictive Disorder by NIMHANS Digital Academy.⁵

To increase the retention in treatment for illnesses that take a long time to improve Schizophrenia, OCD, etc., various practical steps may be taken. User-friendly appointment booking procedure, reminder call for follow-up visit, asking about reasons for a delayed revisit, psychoeducation of caregivers regarding the need for long-term treatment and timely follow-up, a home visit by the clinician, etc.

Some clinicians due to their unique style of interaction have a better response rate in the treatment of depression.⁶ This underlies the positive role of empathy, active listening, and communication skills on the part of the clinician. Clinicians should give due importance to the needs and expectations of the patient and his caregiver. A good clinician should try to formulate a treatment plan in discussion with the caregivers.

All data of the patients sociodemographic, history, and mental status examination should be recorded and preserved as far as practicable. Most of the patients are usually nervous, they start talking about their problems as soon they enter the chamber as they are apprehensive that they may not get enough time. The initial interaction is crucial and the patient should be convinced that he will have enough time to share his problem. Listening to patients trying to understand their thoughts and feelings is crucial to effective communication.

While answering queries regarding prognosis and time to recovery, the clinician should be tactful and explain that response to drugs is not uniform in different individuals and should give a broad time range. Regularly the caregivers will ask about the side effects of prescribed drugs the clinician should respond that all effective drugs will have side effects and except a few most drugs have minimal side effects.³ The prescription should be written clearly and in capital letters with clear advice regarding the next follow-up visit. In specific cases, the clinician should record the early signs of probable serious side effects and measures to be taken in such events itching and rashes with Carbamazepine.

Here are a few ways you can be successful as a budding private practitioner:

Have a plan most professionals just start a website, and rent an office hoping clients would start to magically come to their doorstep. It is absolutely necessary to have a plan for getting a stable and consistent client base before starting your business.
Location: It is common to decide to practice in a busy area, particularly adjacent to other medical establishments.² While deciding the area of practice, important points to remember are the initial investment, the location of a proposed clinic regarding the convenience of the patients, the presence of a well-known landmark in the area, car parking facility, facility for differently abled, availability of toilets, etc.
Grow and network by joining different social organizations: This is a technique that has been proven time and again by professions from law to medicine. It just takes some time, patience and personal social involvement.
Increasing contact: Budding clinicians should be introduced to medical consultants of the area, social workers, NGOs, social welfare agencies in the area, schools/colleges in the area, and their principals and teachers. He or She should become a member of professional organizations like IPS, IAPP, and IMA, etc.
Lectures: The psychiatrist should take every opportunity to deliver lectures on television, at professional meetings, social events, etc. Clinicians should take the initiatives to deliver lectures in schools/colleges, in organizations like banks, bar associations, in police/defense establishments, etc. Psychiatrists should also write regularly in popular press about common mental illnesses.
Good rapport: A successful psychiatrist should maintain a good rapport with the patient and their relatives. He should also maintain touch with referring sources like general practitioners, social workers, and old patients and inform them that their patient is doing good.
Marketing: Digital marketing is a really upcoming outreach technique in our field, and it’s not saturated. This can help you grow in a reasonable period. Social Media is an ideal platform for healthcare professionals. Many patients and relatives search social media before deciding to consult a particular clinician. However, the best advertisement is a satisfied patient. The clinician should keep in mind that every recovered patient is a brand ambassador for the clinician.
Fee: It is always advisable to keep the professional fee slightly below the prevailing rate in the initial phase of the career. A clinician should remember that it is better to maintain professional courtesy and avoid giving any adverse remarks on the treatment of a colleague.
Reach out to a mentor/guide: There are a lot of other challenges you will be facing after starting your practice. From legal concerns to negative reviews and ethical dilemmas, you will need to have someone who can help you.

Hopefully, this will help you go out there with confidence, and start your own private practice and be your own Boss.

REFERENCES

1. Gururaj G, Varghese M, Benegal V, et al. National Mental Health Survey of India, 2015–2016: Mental Health Systems. National Institute of Mental Health and Neuro Sciences. NIMHANS Publication; Bengaluru. 2016. Available from: https://main.mohfw.gov.in/sites/default/files/National%20Mental%20Health%20Survey%2C%202015-16%20-%20Mental%20Health%20Systems_0.pdf.

2. De Sousa A, De Sousa A. Setting up private practice in psychiatry. Mens Sana Monogr 2015;13(1):3–15. DOI: 10.4103/0973-1229.153289.

3. Agarwal AK. Psychiatric practice: Some personal observations. Indian J Psychiatry 2020;62(6):644–649. DOI: 10.4103/psychiatry.IndianJPsychiatry_249_20.

4. Kim BY, Sharafoddini A, Tran N, et al. Consumer mobile apps for potential drug-drug interaction check: Systematic review and content analysis using the mobile app rating scale (MARS). JMIR Mhealth Uhealth 2018;6(3):e74. DOI: 10.2196/mhealth.8613.

5. Advanced certificate course in management of addictive disorder. NIMHANS Publication; Bengaluru. Available from: https://nda.nimhans.ac.in/wp-content/uploads/2022/10/advanced-certificate-course-in-management-of-addictive-disorder.pdf.

6. McKay KM, Imel ZE, Wampold BE. Psychiatrist effects in the psychopharmacological treatment of depression. J Affect Disord 2006;92(2–3):287–290. DOI: 10.1016/j.jad.2006.01.020.

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