Show Notes

Welcome back to the Designer Practice Podcast and I’m your host Kayla Das.

Since the pandemic many of us therapists have opted or at least tested out providing telehealth or virtual therapy. And since then, some of us even decided to practice across provincial lines to increase our client reach and caseload.

However, when it comes to practicing in multiple provinces, there are some key considerations to keep in mind in order to effectively grow your caseload and protect your practice.

In this episode, I’ll share with you eight considerations when practicing virtually in multiple provinces.

And without further ado, let’s dive in.

Consideration #1: Gain Registration or Licence to Work with Clients in that Province

First, we’re going to talk about consideration number one. Gaining a registration or license to work with clients in that province.

So, the first question is, are you registered or licensed to work in that province?

Different provinces have different regulations when it comes to registration or licensing in that province. So, some provinces are considered regulated provinces for specific professions. So, it’s important to understand, is there a college or a licensing board in that province for your specific profession so that you can be registered or licensed to work with clients in that province.

Also depending on the regulatory body, there might be different registration routes to provide virtual therapy in that province. So, it’s important to understand, are you allowed to provide virtual therapy in that specific province if you gain registration? And do they even have a registration that might even be a discounted rate for providing virtual therapy in that province?

Every province and every profession has its own specific rules and set up, so it’s important to reach out to the regulatory body in that province to ask them all of these questions on can you provide virtual therapy and what’s the rate if you do provide that.

Consideration #2: Obtain Canada-Wide Professional Liability and Malpractice Insurance

The second consideration is to obtain a Canada wide professional liability and malpractice insurance.

So, the next question you want to ask yourself is does my professional liability or malpractice insurance cover me outside of my province of residency? Because different insurances have different criteria, it’s always important to understand what is covered under your specific insurance policy. Some are province specific; others are Canadian wide. So, it’s really important to understand, if I do work with clients in different areas, will my insurance cover me as long as I’m registered and regulated in that specific province?

It’s also important to understand the criteria of your professional liability insurance with respect to coverage if you as the therapist, or if the client themselves are outside of either your or their province of residency. And that also goes with registration as well. So maybe you live in Alberta, and you want to travel to BC, are you allowed to work with clients in a different province? Maybe you also work with people in Ontario. While you’re outside of your province of residency, are you still allowed to work in that province, will your insurance cover you and also does the regulatory body allow that to happen?

If a client is outside of their province of residency, it’s also important to understand if your professional liability covers this. Because if they are outside of it, they are no longer within the jurisdiction that you are practicing. So again, if you are registered in Alberta. And you’re working with clients in Ontario because you also register with Ontario. If your client goes to BC, can you still work with them? So, these are important questions to ask your insurance, but it’s also important to understand the regulation requirements as well.

And that’s one of the challenges when it comes to virtual therapy, is that because people can be everywhere, sometimes we think we can work with people that are everywhere, but that is not always the case. So we need to make sure that, again, do we need to be registered or licensed wherever our client is or wherever we are sitting? And do our insurance company cover should anything happen if either the client or you are outside of that particular jurisdiction?

Consideration #3: Understand and Follow Standards of Practice in that Province

Consideration number three. Understand and follow the standards of practice in the provinces that you are regulated, specifically when you’re working with a client in that province.

When you work across provincial lines, it’s important to review, understand, and follow the standards of practice for your profession in that province. Depending on your registration route and standards, you may be simultaneously required to follow both your province of residency’s standard of practice, as well as the standards of where your client is, and this can sometimes be nuanced as standards of practice is very province-to-province. So, it’s important to know and understand the expectations of you and to reach out to your regulatory body or a legal professional if you have any questions regarding this.

I also encourage you to review the standards of practice within the provinces that you work and maybe even look at what might be the differences. For instance, I’m registered in Alberta and Ontario as a social worker, and there are certain standards that are different from one another. So, it’s important for me, to understand and compare and contrast what are the requirements? What can I do and what can’t I do, especially if I’m working across provincial lines. So, I encourage you to review all of the standards of any of the provinces or regulatory bodies that you are currently registered in, so that you really know and are informed about what you can and can’t do.

Consideration #4:  Identify Time Zone and Practical Scheduling Needs of Clients and Yourself

Consideration number four. Identify time zone and practical scheduling needs of the clients as well as yourself.

One of the biggest challenges of working across provinces is the time zone differences. So, when you choose which provinces you want to register and start obtaining clients, you’ll want to consider both your schedule, and of course the time zone, and also compare it to the overall needs of that particular province.

Let me give an example, when I first started out, I registered in Newfoundland and Labrador as that is my home province, but I live in Alberta. So, I quickly realized when I started getting clients from Newfoundland and Labrador that it was almost impossible to logically maintain a caseload of Newfoundland and Labrador residents because of the three and a half hour time difference.

And there was two things that I noticed. So first I always had to take a few minutes to calculate the difference in time to fit my schedule. So that just took time, it took brainpower, sometimes it didn’t look that professional because I’m trying to figure out my time and their time, so that was one issue with the time zone difference. The other is If a client wanted to meet with me at 10am Newfoundland time, that was actually 6:30am in Alberta. And that just didn’t work practically because that was way too early for me to book clients in that time. The same could be said for like late at night, right?

Also, the reverse, if you’re in Newfoundland and want to work with someone in Alberta. If you are a therapist in Newfoundland and you want to expand your caseload, and again, it’s three-and-a-half-hour difference, but now it’s the other way. If someone wanted to meet you at 5pm Alberta time, that is late at night for you, right? That’s three-and-a-half-hour difference. That’s 8:30pm for you. So, it just doesn’t always work. So, you want to make sure that when you do start registering into different provinces that it’s, it actually makes logical sense with the time zone differences.

Consideration #5: Marketing Yourself in Provinces that You’re Registered

Consideration number five, marketing yourself in provinces that you’re registered.

The old adage, build it and they will come, just doesn’t work when it comes to building a private practice. Whether it’s a private practice in your own province of residency, or another province. And it certainly doesn’t work when it comes to virtual, because really, you’re hidden behind a screen. People can’t walk past your office space and just see you.

So, you’re going to want to market your services to get clients. And the reason this is a consideration is because when you get registered in various provinces, it’s really easy to get registered in all the provinces if you want to, right? If you want to pay the money to be regulated and licensed and all of them. But the practical side of it is, how are you going to get clients in these specific areas? And that’s the next question you want to ask yourself is how am I going to attract clients if I do get registered in a particular province?

Some therapists choose to be registered in various provinces in order to open up their independent contractor pool. And this is fine because once you accept a contract, usually the company gives you the clients. So, if you’re registering in different provinces so that you can open up your independent contractor pool, you might not necessarily have to market as much because the company is marketing and they are giving you the clients. So that’s obviously one way.

But if you’re looking for your own clients, for your own private practice, you’re going to want to spend some time advertising your services in that particular province, as well as the province that you are currently living in, right? Because I would assume that you already have a private practice or you want to have a private practice within your own province as well. So, it’s still important to think about or consider the fact that you will need to start marketing in these provinces because it’s not just good enough to be registered or licensed and never market because you’re never going to get clients and you’re paying for registration or a license on something you may never ever work with.

And like all marketing though, it can certainly become overwhelming having to show up in multiple spaces across provinces. So, this is why I say, before you decide to register with every single province across Canada, is really consider where logically and practically you can spend your time advertising your services. Because no one expects you to start advertising in every single province, because the truth is you’re going to be spending your whole day marketing. But really thinking about what is one or two provinces that I think that I can show up, that I know, that has a relevant time zone where I can logically schedule clients. Really thinking about some of these things and choosing those provinces instead of applying for all of them.

Consideration #6: Understanding the Demand for Virtual Therapists

Consideration number six, understanding the demand for virtual therapists.

Like I mentioned in my intro, most of us have moved towards, at least temporarily, during the pandemic, doing virtual therapy. But that was also because there was a specific circumstance, obviously the pandemic, and the demand, because people could not necessarily see therapists in person, telehealth and video counseling were the only option. So of course, there was a significant spike in people wanting and accessing telehealth and video counseling.

But since then, there has been a demand shift back towards clients desiring in-person therapy. Now, of course, there’s still a need and desire for clients to remain virtual, for many reasons, which include, but not limited to the accessibility piece of it, the time constraints for travel, and just even being able to access from the comfort of their own home. So, there is still a demand for virtual therapists, but also understanding that if you’re comparing it back to the pandemic, it might not be as relevant because there was a demand spike.

And how this all applies is that you want to understand by providing virtual therapy, especially if you are providing in person therapy most of the time, you might have a significant caseload and maybe you just want to have some extra side income with virtual clients in another province. It’s important to understand there may be a difference between who wants to access virtual and in person therapy. And also, this even goes back to the marketing piece, is how you market to in person clients and how you market to virtual clients might be very different. So, these are just some of the considerations to think about.

But when you’re working across provincial lines, it will help you in the long run to do your research and determine are there some provinces that access virtual therapy more than others? You might not always know the answer to this, but the more you know about a specific province that you want to be registered in, the better you’ll be able to market yourself and get clients long-term.

It’s also important to know the demographic side of it as well, because if certain provinces have people who have difficulty accessing in person therapy, maybe they live in remote areas, maybe there just is a shortage of therapists in that specific area. Virtual therapy may be their go to. So, these are things that you want to consider.

Consideration #7: Understand the Average Fee Discrepancy Across Provinces

Consideration number seven, understand the average fee discrepancy across provinces.

Now I’ll be the first to tell you to never choose a fee based on what other people are charging because it might not support your individual or professional finances. And fees aren’t always a determining factor on whether someone will come and see you or not.

However, it is important to know and consider that not all provinces average rates are held equally and if you do search other therapists in a particular province, you may notice this as well.

For example, from my own research, and I would encourage you to do your own. With a quick search on therapist directories, I’ve noticed that the average rate for a social worker in Alberta is between $150 to $200, give or take. Whereas, if I look for Ontario social workers, I’ve noticed an average rate between $130 to $160, give or take.

Of course, this doesn’t mean that a social worker in Alberta is any better than an Ontario social worker. It’s what I call the price climate. Different provinces have different pricing climates. Now, there’s probably many factors that influence price differences, and I’m not going to start making assumptions on what all of those things are. But what this means is, that it’s important to understand that if you’re a social worker in Alberta who charges say $200 an hour and you start advertising in Ontario for that same price, depending on the clientele searching for a therapist, it may influence the number of referrals you receive.

And I did say earlier that price may not be a factor for some people and that is very legitimate. Sometimes it might be. It doesn’t mean that you as a therapist have to start changing your price, but it is a consideration that if you start noticing maybe you’re putting effort into marketing in a specific area and you notice maybe you’re only getting two or three clients a week. Whereas you get five or six in your home province it may or may not be connected to price.

But again, going back to the research the more you know about the demographic and geographical area of the specific place that you want to be registered, the more information you have to help solidify why things might be happening the way they are. Still, if you get two to three clients a week or even every two weeks, that’s still better than zero. So, there’s nothing wrong with that. But it’s important to just be aware of that not all provinces quote unquote average rates are the same.

It’s also important to know that an average fee discrepancy may not even be across the entire province, but a subsection of that province. So, for instance, when I did my quote unquote very quick research for this episode, I looked at one specific area. I didn’t go to North Ontario. I was looking more in the larger centers. But maybe in the northern areas, there might actually be a higher price. So, it’s really important, again, the more information you have, the more you know, the more you can start advertising yourself and set yourself up for success when you are trying to get clients in those other provinces.

Consideration #8: Following the Provinces Privacy Law Legislation 

The final consideration, and this is consideration number 8. Follow the province’s privacy law legislation.

In Canada, we have a federal privacy law called PIPEDA. But there are actually provinces across Canada that have their own provincial privacy laws. So when you are practicing in a particular province, it’s important to know, is there a specific provincial legislation that you’re expected to follow? And if there is, understand the requirements of that law so that you ensure that you’re following that.

Recap

So, there you have it, eight considerations when practicing across provincial lines.

And I’m just going to do a little recap.

1. Gain registration or license to work with clients in that province.

2. Obtain Canada wide professional liability and malpractice insurance.

3. Understand and follow standards of practice in that particular province.

4. Identify time zone and practical scheduling needs of client and yourself.

5. Marketing yourself in provinces that you’re registered. But, side note, don’t overwhelm yourself while doing it.

6. Understanding the demand for virtual therapists in that particular province.

7. Understand the average fee discrepancies across provinces.

8. Following the province’s provincial law legislation if it applies and is different than PIPEDA.

Thank you for tuning in to today’s episode, and if you like this episode or the Designer Practice Podcast overall, I would really, really, really appreciate if you could share this podcast with a colleague or another therapist so that other therapists and coaches can benefit from these episodes too. The more people that can hear this, the more we can help other therapists so that they can design a practice that they love as well.

Until next time, bye for now.

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