We caught up with the brilliant and insightful Erica Burger a few weeks ago and have shared our conversation below.
Alright, Erica thanks for taking the time to share your stories and insights with us today. Setting up an independent practice is a daunting endeavor. Can you talk to us about what it was like for you – what were some of the main steps, challenges, etc.
When I realized it was time for me to start my practice, it couldn’t have been worse timing. I had resigned somewhat unexpectedly from my current position as an outpatient psychiatrist in a big healthcare system and the week before I resigned, we bought a vacant cabin at an auction in our county that needed a full rehab. I think that it actually forced me to make decisions more quickly and just start with what I had.
Many of us in medicine are used to not having to take many risks and the path is laid out in front of us during medical school, residency, and in any employed position. So it was all very new and scary to take this big leap of faith – but the important part was to take that leap and just start, no matter how imperfect it is or feels.
The biggest obstacles I faced were having to learn the language of business. I started listening to podcasts about marketing and listening to my husband’s business books on audible that I never would have listened to before. I also experienced a lot of self-doubt – Could I start and successfully run a psychiatry private practice in a very rural Midwest location? Could I support my family? There was a lot of uncertainty. But reflecting back, I think the important thing is that despite the self-doubt and uncertainty, I kept at it and didn’t let the fear or self-doubt stop me.
Fortunately, I have specialized training in integrative psychiatry, which is a more holistic approach to mental health that includes medications, supplements, nutritional aspects, lifestyle, mind-body practices, and ketamine therapy. I knew that was the type of practice I wanted to open and then was able to really build my brand and marketing towards individuals looking for this approach to psychiatry.
Since opening my practice, I have learned how to be more comfortable with (and actually enjoy) taking measured risks. An unexpected benefit to having a psychiatry practice is the ability to be more creative in my work; as someone who has always been creative, I had thought that aspect of me would never be present in medicine because so much of modern medicine these days is very technical and conveyor belt-like. Having my own psychiatry practice has given me the freedom to innovate and use my creativity to best help my patients and that has been so fulfilling. I also dont’t have to make clinical decisions based on insurance companies or administration, which has lessened the amount of burnout I was experiencing before resigning from my previous position.
I care deeply about healthcare professional mental health – there is so much burnout and moral injury that health care professionals are experiencing these days in the current system. My hope is that my practice can offer an example of what is possible in medicine and how solo private practice can help physicians lessen burnout and moral injury. I have really enjoyed providing coaching to other psychiatrists to help them pivot to opening their practices or making their current practices more aligned with how they want to practice.
I’d recommend that anyone who is interested in starting a psychiatry or medical private practice is to build a team of a “wise counsel”. They don’t need to be employees but moreso, are people who you trust and can give their advice and feedback. I work with a business coach, accountability group, therapist, and ask my husband and a couple of friends when I am making big decisions.
Solo private practice can also become lonely so the more that you can build a network of allied colleagues (my network includes physicians, therapists, and alternative health professionals), the less isolating it can be. It’s also really helpful to build a network of fellow solo private practice psychiatrists!
Erica, love having you share your insights with us. Before we ask you more questions, maybe you can take a moment to introduce yourself to our readers who might have missed our earlier conversations?
My name is Dr. Erica Burger and I’m an integrative psychiatrist in the rural Midwest. I founded the clinic, Driftless Integrative Psychiatry and offer a holistic and down-to-earth approach to helping people improve their mental health and prevent mental health symptoms. The clinic is located in Lansing, Iowa which is a small town of 1000 people and while we are physically located in Iowa, I am also licensed in Minnesota and Wisconsin and can see individuals remotely.
As someone who is from rural Wisconsin, I knew that I wanted to return to the rural Midwest after my medical training. Fortunately, my husband agreed to relocate from St. Paul, Minnesota to a farmhouse in rural Wisconsin.
Driftless Integrative Psychiatry is a pioneer in ketamine assisted therapy, which is an effective, safe, and legal modality that empowers people to heal through psychedelic effects. We offer personal ketamine retreats with lodging on-site that bring in individuals from around the country. We also offer ketamine experiential training for healthcare professionals looking to practice ketamine assisted psychotherapy. So far, there are only a few other psychiatrists in the Upper Midwest offering ketamine assisted therapy and I am passionate about other healthcare professionals getting trained in this modality since it has been so helpful for many patients.
What’s most important to me is that people feel empowered in their mental health care. I work with a lot of individuals who identify as highly sensitive and/or have experienced medical trauma. Rather than a rigid approach, my goal is to meet people where they are at and come up with a plan together that often involves more than one modality. Often “just meds” either doesn’t work or people are interested in other options besides medications. While I do prescribe medications for mental health, I also want to help people safely discontinue psychiatric medications. I also tend to work with many healthcare professionals and help them with burnout, anxiety, trauma, depression.
Learning and unlearning are both critical parts of growth – can you share a story of a time when you had to unlearn a lesson?
I had to unlearn the idea that once I finished psychiatry residency, everything would be easy. While this may sound silly, due to the delayed gratification and years of sacrifice that goes into medical training, I believed to some extent that I “deserved” certain things and my hard work had now paid off. When I quit my comfortable position in corporate medicine, I had to cut expenses and get to work. I learned how to be scrappy again and picked up temporary hospital shifts on weekends and holidays in order to pay the bills as my practice got established.
How’d you build such a strong reputation within your market?
Building a network of aligned healthcare professionals has been something that I started doing from the start of my practice and has helped me build my reputation. As someone who has always been community-minded and appreciative of the perspectives of those in allied fields, network-building comes very natural to me. Social media such as Instagram, has really helped me get to know others and initiate conversations and meetings. I think there is a misconception that physicians and psychiatrists are only interested in prescribing medications and it’s helpful for my allied professional colleagues to know that we can and do use other modalities – and that we psychiatrists are interested in collaborating with them!
Contact Info:
- Website: www.driftlessintegrativepsychiatry.com / www.flourishpracticebuilding.com
- Instagram: drericaburger; driftlessintegrativepsychiatry
Image Credits
Savannah Steiger Photography