This book was designed to be a helpful guide for neuropsychologists in the USA who are considering establishing an independent clinical practice. The author addresses the book to those who want to establish a practice, those who have been in practice for several years and want to expand or refine their business, and also to those more advanced practitioners who want to compare notes with another experienced neuropsychologist.

The author maintained a private practice providing neuropsychological services in Seattle for six years. Prior to this her practice included a mix of psychotherapy and neuropsychological services.

This paperback book is comprised of 15 chapters and 16 appendices. The multiple topics discussed in each chapter are precisely named and presented in the table of contents. This allows the reader to quickly select the particular topic or topics of immediate concern. The index in back of the book is also comprehensive and accurate.

A helpful feature of this book for individuals considering issues related to the development of a private practice is the inclusion of practical exercises at the conclusion of each chapter. For example, at the end of a chapter addressing marketing issues, the prescribed exercise directs the reader to “make a list of the five marketing approaches that are likely to be most effective and most comfortable for you to pursue … select three items from your list above, and develop a plan for implementation.”

The first several chapters discuss the challenges found in a private practice of neuropsychology and consider an overview of effective solutions. The author frequently relates her personal experiences and preferences. End-of-chapter exercises include formulating a personal balance sheet for direct and indirect costs, listing what appeals most to the reader about private practice, and considering how to explore and define available options. Practical business issues are discussed in chapters 5, 6, and 7.

In chapters 8 and 9 the author discusses possible options for consultation and specialization. There are also sections on educating referral sources, designing and implementing a cognitive treatment group, and issues involved in billing and reimbursement for services provided.

Chapter 10 examines psychometric concerns including interview structure and test selection. While interesting, I would hope that a neuropsychologist considering establishing a practice already would be well versed in these topics!

The author includes 16 appendices which include consent forms, informational handouts, a patient information form, ICD9 diagnostic codes, and current procedural terminology (CPT) codes. There are marketing letter samples and a suggested interview format.

While this book is helpful to all who want to explore or establish a private practice, it appears best suited for individuals in a larger metropolitan area who wish to supplement teaching and research activities or part-time agency/institutional employment. Individuals who wish to start a full-time practice in a smaller city or a rural area will find parts of the book disappointing and of limited assistance. Such individuals will not have a large enough population base to draw from that they can afford to turn away certain patient groups, e.g., patients with Medicare, Medicaid, etc. Also, many practitioners will want to provide services to these needy population groups and be responsive to their regular referral sources.

This book was published prior to the enactment of the Health Insurance Portability and Accountability Act (HIPAA) which strictly regulates record keeping and communication of patient information. Individuals considering a clinical practice would need to research this information carefully. Also, since the publication of this book, helpful web sites regarding practice issues have been initiated and maintained by the American Psychological Association (www.APApractice.org), the Division of Clinical Neuropsychology of APA (www.div40.org), and the National Academy of Neuropsychology (www.NANonline.org). Information published on these sites can be of great assistance to all practitioners.

In conclusion, I recommend this book as a comprehensive starting point for neuropsychologists who wish to examine the wide range of issues involved in establishing and maintaining an independent clinical practice.