The Social Work Future is Agency Based & Collaborative (or the End of Private Practice As We Know It)

In looking at #SocialWorkFutures, of one thing I am sure: the future of our profession is agency based and collaborative. In what I am sure will rankle some private practice feathers, below are my thoughts on this as we move into the unknown return to the new-normal.

First, as the world gets more complicated, we as social workers are going to continue to need to rely on a network and team of people to serve our clients and communities that cannot be replicated in pure private practice (e.g., hanging a shingle outside one’s home office).

From consulting across modality and research specialties, to working with clinical pharmacists, nurse practitioners, nurses, and medical doctors: private practice options for even the most network savvy social worker cannot replicate these experiences or agency based brain trusts.

Ethically there is a case to be made that to forgo this brain trust in search of solitary practice intentionally and negatively impacts our client populations.

There is a business component as well. As a freelancer and consultant for many years in New York, I specialized in rebuilding corporate books for business owners who didn’t keep records (outside of maybe some receipts that looked like they had been lit on fire and run over before being shoved in a box). Few people are actually prepared to run a business, let alone a private practice.

Expertise in one area (social work, counseling, EMDR, etc.) does not translate to expertise in all areas, and less so in the world of business, billing, and taxation. Agencies offer billing specialists, payroll departments, marketing, accounting, IT (in the world of ransomeware more important than ever).

As someone who no longer has to market their services outside of my web presence, I would rather everything go through my agency than have to handle billing or scheduling or multiple learning management systems. I would happily sacrifice a not insignificant percentage of my speaker fees for the kind of support my agency offers in all the areas that I am not an expert in.

I believe we are going to begin to see the hybridization of private practice and agency practice first, more fully than currently exists (because it does exist). Then, I believe there is going to be greater democratization of the existing agency structures for two reasons: first, it follows trauma-informed principles. Secondly, because everything I ever learned in my MBA shows better employee engagement, satisfaction, and bottom lines when this happens. It becomes a win-win for shareholders and stakeholders alike. In the end we are going to see a modern agency based structure that embraces multidirectional collaboration, working for the betterment of all stakeholders.

While I believe this will first happen at the micro level of the social work world, I believe it will also occur at the mezzo and macro levels.

With the push for a single-payer healthcare system in this country (while a bit far away in the present political…climate), I believe that there will be a greater incentive for agency based collaborative practice: once clients no longer have a reason to pay out of pocket when insurance can cover their social work needs across the board, when there is no longer any discernible benefit to engaging a private practice therapist in comparison to the breadth of options and resources only available through those engaged in agency based practice, when cash is taken out of the picture, I believe we will see a very different playing field.