“The Big Shoes” Private Practice Corner
Mark Matta, DO, DFAPA
January 2026
When I was asked to give a speech at my father’s retirement, I
thought to myself, “I need to wear the biggest shoes I have.” In a small
rust town 60 miles north of Pittsburgh, it was clear to everyone present
that I was being entrusted with the private psychiatric practice he had
established three decades prior. I had graduated from my residency just
11 months earlier, but due to medical reasons, his succession plan was
accelerated.
In the beginning, I leaned heavily on my experienced staff. I was
frightened by what I did not know about the business and system of
medicine. Over the years, my confidence grew and I began to learn more
about risk tolerant decisions, contract negotiations, managing
personalities, and navigating the complexities of the healthcare world.
The greatest lesson I learned overall is that the business of medicine
is the worst thing that happened to medicine.
“Do no harm” is our core principle. I quickly learned where the realm
of business and medicine collide, and it is on this playing field. It is
a not black and white, all or none principle, but rather like many
things in medicine, has found itself on a spectrum of analysis.
Decisions that are made regarding patient care and/or the private
practice may inevitably affect our patients. The question is how much?
What is the balance between impacting the patient versus the overall
well-being of the private practice which has implications for many
patients and one’s livelihood?
For example, what if a patient with schizophrenia who has been stable
on a long-acting injectable antipsychotic has a change of insurance and
now starts owing a copay for the visit and refuses to pay? Ethically,
that patient can be referred out to a community mental health clinic or
another facility; however, the chances of that patient decompensating
have now escalated. Have we done harm due to a business-related
decision?
Similarly, I was never prepared by medical school or residency to
handle staff challenges. Navigating interpersonal dynamics, resolving
conflicts, and ensuring the smooth operation of the practice were skills
I had to develop out of necessity, rather than formal training. It
seemed to me at times that treating patients, as I was trained to do,
was less complex than managing staff. Having to hire someone based on a
resume, references, and one or two interviews ill prepares an employer
for the true essence of what the business is actually investing in.
Then, dealing with payroll companies, tax withholding problems, benefit
decision making, and the incredible landscape of unemployment has added
gray hairs and taken years off my life.
Experience and time have been my biggest allies. I learned to
surround myself and put the most important people in the most
significant positions to allow me to do what I need to focus on the
most. The practice must operate with a team mentality. While everyone on
the team is expected to perform their duties and responsibilities
individually at a high standard, we as a collective also help each other
when necessary. In times of crisis, staff shortage, or other unique
situations, I have learned the value of having a strong well-rounded
team. Likewise, the shortcomings and challenges of not having strong
team players can have a powerful ripple effect on patient care and team
morale.
Perhaps the most beneficial aspect to owning and managing a private
practice is the flexibility of molding the business towards what you
believe are the most optimal standards of operation. Quality of patient
care, schedule, staffing, charting, sampling, etc., all are under your
control. At the same time, it is also under your liability. While this
can seem daunting, so is trying to manage the life of a suicidal patient
or one who is delusional or manic.
Medicine is an art and the essence of that was created within the
province of private practice. I chose to go into medicine and
specifically private psychiatry due to the influence of my father. His
impact and legacy in our hometown were an inspiration to me. More than
the pressures of filling those big shoes, it has been a blessing and an
honor to succeed him. I look forward to managing the future challenges
of private practice and guiding my team forward.
“The practice of medicine is an art, not a trade; a calling, not a
business; a calling in which your heart will be exercised equally with
your head.” – Sir William Osler
About Dr. Mark Matta
Bio Dr. Mark Matta
Presently, Dr. Mark Matta is the CEO and Medical Director of Psych
Med Associates, P.C. in New Castle, PA. He is also the medical director
of People in Need and Community Alternatives, two community mental
health clinics in New Castle. Chatham University has awarded Dr. Matta
as the Psychiatric Preceptor of the Year in 2012 and Clinical Preceptor
of the Year in 2013. He has also been awarded Best of the Best
Psychiatrist by the New Castle News from 2009-2017, 2019, 2022, 2023,
and in 2025 was “Elected as Distinguished Fellow” with the American
Psychiatric Association in 2020 in recognition of his significant
contributions to the field of psychiatry.
He is the President-Elect of the Pennsylvania Psychiatric Society and
previously served as the president of the Pittsburgh Psychiatric Society
for the 2021-2022 year and presently sits on the Lawrence County Mental
Health Advisory Board. Dr. Matta was also a previous recipient of the
Pennsylvania Medical Society’s 40 under 40 award, recognizing physicians
who have provided significant service to their field.