[ALISON PIDGEON] You are listening to the Grow a Group Practice podcast. Whether you were thinking about starting a group practice or in the beginning stages, or want to learn how to scale up your already existing group practice, you are in the right place. I’m Alison Pidgeon, your host, a serial entrepreneur with four businesses, one of which is a large group practice that I started in 2015. Each week, I feature a guest or topic that is relevant to group practice owners. Let’s get started. Hi everyone. This is Alison Pidgeon your host. I hope your summer is off to a great start. My kids of course, love summer. They love to play outside, so we’re having fun. Today I have a great interview for you. I spoke with Dr. Ajita Robinson. She is known as the experts therapist. She is an amazing powerhouse of a business owner. She’s a grief and trauma therapist, a best selling author, an international speaker, an income strategist. She has been in all kinds of national media outlets, like the Wall Street Journal, Huffpost, Washington Post and she really made her career being a grief and trauma expert and then leveraged her clinical experience and her previous career as a corporate consultant to launch a mental health practice and scale it to seven figures. She is a first generation trauma and poverty disruptor who helps mental health entrepreneurs create living legacies and financial freedom while helping communities heal. She has an amazing story of overcoming adversity and she is doing all kinds of amazing things in her business. She was so inspiring to talk to because she is starting all kinds of different programs and different streams of income in her private practice. So if you are one of those people who would like to maybe start something a little outside of the box in your private practice, this is definitely a great episode to listen to. So please enjoy my interview with Dr. Ajita Robinson. [ALISON] Ajita, welcome to the podcast. [DR. AJITA ROBINSON] Thank you so much for having me. [ALISON] I’m excited to talk with you today. Can you give us a quick introduction of yourself and your practice and all the things that you do? [DR. AJITA] Absolutely. So I’m a licensed clinical professional counselor. My clinical specialties are grief and trauma. I work primarily with African American doctors who are first gen. I have a clinical team of 67 now. We are a hybrid practice, so we accept some insurance. We’re about 60% insurance, 40% private pay. We’re located in Bethesda, Maryland. So yes, I’ve been in practice for, we’ll be celebrating our 10 anniversary, so that is exciting. [ALISON] Amazing. Congratulations. [DR. AJITA] Thank you so much. When I’m not doing the running of the group practice, I also provide consulting and support for therapists wanting to not only launch and scale group practice, but also scale beyond group practice, such as speaking and certification programs, curriculum, so on and so forth. So I love talking about all things diversifying income, especially for clinicians. [ALISON] Excellent. That’s actually why I wanted to have you on the podcast because I know you have some unique perspectives on that. We were talking a little bit before we started recording about diversification of income within a private practice setting. So can you explain that? What does that actually look like? [DR. AJITA] Yes. So I think oftentimes we start our practices and our main revenue source is direct client pay whether it is their insurance or their private pay. But diversification I think is so important because it stabilizes the revenue. It can stabilize and increase cash flow, things of that nature. So some examples of things that I think are super important for group practice owners to consider is whether or not they can compete for contracts at the state, local and federal level. Department of health and human services, your local schools, universities all of these organizations generally have contracts. So that’s actually how we scale to seven figures for the first time. We get out of that process of only being paid when a client shows up because those contracts allow us to be paid a pretty recurring income that is stable. Doing things, like we’ve run summer camps and offering training to the community, other professionals and parents and so that not only diversifies and stabilizes income for the practice, but it also creates stabilization and really some buffering against burnout for your clinical team, if they’re able to generate income in other ways. [ALISON] That’s so smart. I wonder if someone’s listening is like, well, how do I get started with maybe getting some contracts from my private practice? Do you have any recommendations on where they could look? [DR. AJITA] Yes, absolutely. So your state has a, if you just search Google, your state and procurement you will find the state’s procurement site and what their funding proposals are in a good indicator of what they will pay for is what they have already paid for. So I like to go and look at closed funding proposals. It gives you some idea of what types of services have been paid for, what types, what the need is in your community. But also, private companies have RFPs, so those funding requests for proposals. I think that it’s very, very important to also leverage the fact if you are, let’s say a minority or a woman or disadvantaged or a veteran, all of those business certifications can also help you compete to secure contracts. And you don’t have to be the primary person or the primary company going after the contract. That’s again, actually how we got started. So we had a local organization that was a nonprofit that had the larger contract and we came in and did the parent skills training. So they subcontracted a portion of the services or the training out to us and that was really nice because it wasn’t direct counseling. So there were no, there was an attendance record, but there were no notes my clinicians had to write. We didn’t even have to have the space because it was already being facilitated at either the county’s location or the primary contract holder’s location. So we just had to show up and actually deliver a pre-developed curriculum. So it was low-hanging fruit as far as diversification and getting started with that. I would say as we have grown, we have partnered with a dedicated grants person that actively looks at funding proposals, as well as writes those, of course it requires some input for me and my team but it’s a whole different ball game than when, if you’re trying to do it yourself. Our success rate has gone up significantly and it doesn’t divide my attention as a practice owner trying to secure these types of contracts. [ALISON] Amazing. So this might be a dumb question, but you can get those grants, even if you’re a for-profit business because I always think of grants as being for like nonprofits? [DR. AJITA] Yes. So again, remember that we’re not talking about startup grants. A lot of startup grants and those funding grants tend to be with nonprofit, but the pandemic has really changed that a bit where there’s more startup grants available to small businesses. But what we’re talking about here are government sponsored grants to provide services, which is not the same as startup funds. So you were paid as a vendor or a service provider and so it really is a contract, but they are, it’s a grant. So we also received a grant from SAMSA. We competed for a grant. We had to partner with a community organization to train 300 law enforcement officers in mental health First Aid. We secured another SAMSA one with a local school. We wrote the grant, we brought them in as the community partner to train educators, parents and staff on how to recognize on mental health First Aid, but also to recognize homelessness when we first went virtual. So recognizing homelessness and youth is different when you’re doing remote learning than perhaps if you’re in person. It’s a federal requirement that they’re trained to do it. So those are the types of grants that we have secured that are more technical assistance or training related. Again, we can do it four times a year and we’re out so it also means that there’s less lifting all the time because it’s not a day-to-day thing that is required. So I found that the team has responded really well to those types of opportunities. [ALISON] That’s great. Tell me about what are some other ways that you can diversify your income in a group practice model. [DR. AJITA] Yes, so some that are direct practice related, one way that I actually was able to reduce my income without reduce, not my income but reduce the number of direct practice hours was I put six of my one on one clients in a group together. Then they rotated into three individual spots. I’m now down to two spots because my goal was to remove myself from direct practice entirely. So I think offering alternative methods or options for support, I think groups are a great way, one to increase income, but to also create access. folks may be able to pay a $45 copay for a group as opposed to a $200 individual session fee and get some of the support that they need. So other things that we do that we’ve done prior to COVID, and this will actually be the second, the first time that we’ve done it since COVID is in the summertime we work with a lot of, we work with a lot of kids in general, in our practice is we really work with the entire spectrum, but kids are a big portion of the population that we serve. What we were noticing is, and just what we know is that kids often go somewhere else in the summertime whether it be their traveling or summer camp. Sometimes even if they’re not going away what we find is that oftentimes parents or even the child believes that some of the things that they were struggling with have alleviated because school is out and school is a source of some of the struggle. So we began to look at well, if the kids are going to go to summer camp anyway, and what we know is that the issues actually haven’t resolved the trigger has been removed over the summer for many of them. So how can we serve them in a way that meets their needs while also again, stabilizing the needs of the practice and the clinicians? We began offering summer camps like day long, 9 to 3 summer camps. We brought in someone that did photography and we did photo journaling. We utilized selfies as a way to improve self-esteem. We brought in a yoga therapist and an art therapist, and we did a lot of those things. Again, it was focused on teen girls and self-esteem and that is a very, very profitable program, but it also meets a direct need that shows up during winter break, during summer break. Again, it’s something that our clinicians look forward to. A really cool thing is when we have interns over the summertime, because we are a training facility, they can get almost 40 direct hours in one week because we’re doing both group sessions pretty much all day. Then many of our girls would also have individual sessions with the therapist while they’re in camp. So that allowed for just a richer experience, giving our interns and our campers another place and another way to access and to get some support and also to build friendships and relationships with the other campers. That’s an awesome way in the summertime to stabilize income. Even my clinicians make more money during that camp because of the level of involvement in services that are being offered. So there’s — [ALISON] Yes, I love that because you know every year that child, teen population is going to go down because, the same thing happens in our practice, they don’t want to come over the summer because they’re busy with other stuff or they like you said, school’s not an issue at that moment in time. So I love that out of the box, thinking about how do we continue to serve our clients, but also help the business and help our staff keep working because otherwise you might not have enough work for them to do [DR. AJITA] That’s right, very true. Similarly, if we look at another population, we also provide a lot of training for our teachers and educators over the summer because they have to have some training every year in suicidality and depression. So we always begin those conversations in usually February for new schools that were picking up, but that’s also recurring revenue. We have recurring contracts with schools. Of course, if they, we come in and we’re doing the training in two schools in a particular district. My clinician only has to go travel once. And they don’t have to send each individual educator out to a training. So it costs them less to just bring us in and everyone gets that particular training. So we always position the value that’s being added that meets a need that they were going to pay for anyway, as a way to get into some of these schools. So we always do that particular training. What’s interesting is that we have also secured contracts with other camps because, especially we focus specifically on those camps that have a residential component because the same issues show up in those residential camps or overnight camps and day camps as well. But they’re more likely to see this overnight where the kids are there for a concentrated period of time that the mental health challenges are going to show up and they very rarely have therapists on staff. So we have signed on to come in and be a part of their onboarding training to talk about recognizing mental distress among their youth and then also being the, we will sign a contract to be there, essentially their private EAP for their campers. If they have a crisis situation, they know that we will respond to those and they pay for a dedicated number of spots each month so that they just have consistent support. That’s another way that, again, we don’t have to provide the service as a camp provider. We can support the camps. So those are just always that we could diversify what we are doing in those settings. [THERAPY NOTES] Is managing your practice stressing you out? Try Therapy Notes. It makes notes, billing, scheduling, and tele-health a whole lot easier. Check it out and you will quickly see why it’s the highest rated EHR on Trustpilot with over a thousand verified customer views and an average customer rating of 4.9 out of five stars. You’ll notice the difference from the first day you sign up for a trial. They offer live phone support seven days a week so when you have questions, you can quickly reach out to someone who can help. You are never wasting your time looking for answers. If you’re coming from another EHR, they make the transition really easy. Therapy Notes will import your clients’ demographic data free of charge during your trial so you can get going right away. Use the promo code Joe, [JOE] to get three months to try out Therapy Notes, no strings attached. Remember telehealth is included with every subscription free. Make 2022, the best year yet with Therapy Notes. [ALISON PIDGEON] Yes, that’s an amazing idea. Anything else that you wanted to mention before we move on to a different topic? [DR. AJITA] We could talk about this piece all day. I think, in case something comes up and we revisit it, but I think those are the ones that we see practices, I like to think about what’s the existing infrastructure of most practices. Most practices have what they need to run a summer camp. If you can run a group, you can do a camp. If you already have access to your population, you can diversify how you’re serving them and then continue to extend that. So we like to think about what’s the biggest population we serve and then who else is serving them? How can we serve those population? So serving teenagers and kids naturally leads us to the school staff, university faculty and things of that nature. We often can get there by just doing the coordination of care, building that relationship with the school counselor or the assistant principal or what have you. So I like to use those kind degrees of separation of coordinating providers to build those relationships and revenue streams. [ALISON] Awesome. What do you see the benefits being to the staff for having these other types of programs and other streams of income within the practice? [DR. AJITA] Again, being able to diversify their income because things get a little sketchy over the summer or when we have these little dips and this is one way to stabilized it, but it also gives them an opportunity to do something different than one on one therapy. So we have created programs that have been staff’s ideas. We’ve helped co-create curriculum that staff continue to receive licensing revenue from. It also helps buffer from burnout. So I think those pieces are definitely beneficial, but the other cool thing that I really like about contracts and funding proposals in particular is that especially if we’re talking about local or state ones. And federal for sure is that often benefits and administrative costs that you can build into the grant itself or the proposal that then we’re able to take that and pass a lot of those benefits to our team. So that’s actually, we used one of these licensing agreements to fund our professional development fund for our clinicians came directly from a contract. We just re-diverted those funds. It also allowed us to do things like fully staff our admin team, because these funding proposals will pay for administrative costs and they’ll pay them at a certain capacity level and if you can optimize, let’s say this particular grant takes 40% of the admin’s time, but the amount that they allow would essentially pay a hundred percent of their salary, you have freed up revenue to reinvest in the practice in other ways, to be able to offer benefit packages and PTO, and maybe even salaries, some folks because you have consistent income. So those are all ways in which the team benefits from us going out and pursuing other revenue streams. [ALISON] That’s amazing. I think too, just from my own experiences with my own staff, I think they appreciate having the opportunity to do something different than just traditional outpatient therapy. There’s just some clinicians who like that variety. So I’m sure you have staff who like that as well. [DR. AJITA] Absolutely. Absolutely. We have art therapists. We have a clinician that is a registered yoga therapist. We have Reiki and there’s all different ways that we can leverage and support their unique interest by diversification. So we run them into contracts. I’ve helped my clinicians create workbooks that while they’re working with the practice, we get to utilize it for, let’s say it’s a workbook on grief. I have a handbook on grief. They get to use that when they’re running their programs, but if they leave the practice, it is their intellectual property. So it shows that we’re also invested in them and it creates that long-term partnership so that even as they move beyond the practice, they become a referral source, but we still, we now have a licensing agreement in place. They got to learn how to build as a result of the experience of their leadership team. I think that when we can leverage that type of knowledge and mentorship and leadership for our team it also makes them feel like we’re investing in them. That’s a real investment that we’re making that they get to utilize for the rest of their career. So I think that is, I get a kick out of doing those types of things. I think that it’s not a threat to me for my clinician to be able to expand their lens about how they can leverage their skill outside of direct practice. [ALISON] That’s an incredible opportunity for them. Switching gears a little bit when you have a practice as large as yours, and you’re obviously like we were just talking about, have lots of different contracts and places where income is coming from rather than just traditional outpatient therapy, how do you end up spending your time as the CEO? [DR. AJITA] My number one responsibility and job as a CEO is to drive revenue. I function more as a chief development officer. I love going out and securing partnerships and contracts and things of that nature. I don’t have to be on the front end of that. I just need to be able to close. Eventually I’ll move myself out of that, but that’s the piece that I love. That’s what I did in corporate, was brokering these multimillion-dollar partnerships between huge companies. Now I get to do that on behalf of my team and my organization. So that’s where I spent that a lot of my time. The second place that I think is probably equal, I function as a servant leader. So I believe that my number one responsibility outside of revenue, so I guess it would be number two that they compete, is to serve my team well, and they will then take care of our clients if they always feel taken care of, valued, appreciated, seen, and heard. There’s some things I don’t have to ask them to do because I set the tone and the model of the culture and how we take care of one another. That is the expectation I have for the way that they take care of our clients. So I spend a lot of my time, especially now that the team is remote maintaining that culture and checking in with my team and knowing what’s happening for them both clinically, as well as in the ways in which they desire to share personally, because that impacts how they show up at work and whether they show up at work. So that’s a big part of a responsibility. Sometimes it weighs heavier than others, but it is still a privilege that I have as the CEO. [ALISON] Yes, I agree. I would say those are my two priorities as well. Obviously, I’m really the only one who’s looking at the financial side of things, but also making sure the team feels taken care of. So then what does your day to day look like? Are you having lots of meetings with people to try to make those connections in the community or are you meeting with your team? Do you still do hiring? What are you doing? [DR. AJITA] So I’m two steps removed from hiring, thankfully and for many reasons. That, in and of itself, is a necessary function. It’s just not one that requires me. It also gives my clinical director and my director of client care the autonomy to build their team because first they’re the first point of stop or contact and mentorship for their teams. I think that piece is important. So I’m two steps removed. By the time they get to me, it’s mostly a formality at that point, which again, I enjoy and appreciate the ability to take my hand off of that, but still be involved in the ways that that makes sense. So my day does consist quite a bit of meeting with my team. One of the things that we instituted was Friday, where we’re not allowed to talk about clients or business. We just get to connect with each other. So we do that once a month. It’s interesting because when we were in the office, I’m the one on the team that if there’s a cancellation, I’m like, you want to go, you want to walk next door and get pizza or ice cream? Then the new hire would find out that I’m lactose intolerant and they probably should not have had ice cream with me, but it’s a wonderful way to break up the day. You get to, you learn these things that you wouldn’t learn if you just were having staff meetings. So I enjoy that. We’ve done karaoke. I found that my team is very competitive, which is very, it’s great and it’s interesting, but they wanted more time with me, not in a supervisor role or a clinical role. They just wanted their people and we spend lot time doing this work and really community building. So I do those pieces within the organization. We switched from having normal, I guess, traditional team meetings to having co-working sessions. I found that that increased not only our productivity, but the perception of support, especially among my leadership team to say, “Hey, I’m in the Zoom room this block of time.” They would come with their questions sometimes I’m like, “Hey, I’m going to go ahead and do a quick loom tutorial on this,” and then give them back the task of writing the written SOP because they’re doing the thing. I may have the knowledge or what have you. It also just gave us an opportunity to, I think, tighten up and highlight some of our workflows, what we do well, where the gaps were and of course we get that time together. So those are the ways in which I’m shown up in the business. I strategically look at building relationships outside of the business and meeting people, attending virtual summits or networking events. But it just has to be in alignment with what the organization needs or desires. So I think a big thing that I am working on now is to try and get my team down to a four-day work week. That’s a big goal of mine, again, is to give them more of their time and their life back. That does require that we hire a bit more so that we can have folks down to a four-day work week. I think that would improve their quality of life. I think it also would improve retention. There’s plenty of data that says, that talks about that, but for that to be a real thing. So I think I probably have my innovator hat on and my execution hat on more often than not these days. [ALISON] Let me know when you figure that out, because I want to know how to do it. [DR. AJITA] We’re working on it, still testing. [ALISON] I know you do business consulting as well. So can you give us a brief overview of what you specialize in? [DR. AJITA] Absolutely. I think what I do really falls into two main places. What I do really well is provide income strategy for mental health entrepreneurs, whether they’re launching or scaling their direct practice, or for those who are ready to pivot beyond direct practice. Again, I came from a corporate background and so I use those principles to help therapists do things like launch their books or relaunch products or get into corporate speaking or consulting things of that nature. So I play in that spectrum from a business consulting perspective. Then I love all things insurance, so mastering insurance is also my baby. We have a full-service credentialing agency and an academy where I teach either clinicians or their team how to navigate insurance, getting paid, getting credentialed billing. Whether they’re in network or out of network. I think it’s a way that we can advocate for ourselves and for additional access to services for our clients. Again, whether we accept insurance or not. At minimum we know enough so that we’re not taking advantage of if we outsource those tasks. So I think wherever I serve a thing that is a commonality is that I’m always talking about legacy building, so living legacies while healing generations. That’s a pretty consistent way that I serve, whether I’m doing therapy or consulting or speaking. That’s what that centers, all of those things. [ALISON] That’s amazing. That’s such a neat, those services are so needed. So that’s great. I know you have a giveaway for us for the audience, can you tell us about that? [DR. AJITA] I do. So just an alignment with what we’ve been talking about, I have a free 30 ways to diversify your income workbook that again, identifies 30 ways. There are so many more, but these are the most common ones that I think also are low hanging fruit and sustainable for therapists and so it covers those, but it also helps you brainstorm what you should create. I think far too often, we create things that we’re excited about and we don’t take our customer and consumer into consideration, and then it doesn’t do what we want it to do. So I help, in that workbook, there’s some exercises that help map those out so that you build a product or create a service that actually aligns with what the customer, consumer is asking for. So I think it sets us up for greater success and greater impact when we intentional in what we create [ALISON] Would be the best for connect with you? [DR. AJITA] So ajitarobinson.com has all information about what we’ve talked about today. You can find my therapy practice, my master in insurance and consulting services and programs. I’m Dr. Ajita Robinson on all platforms, except for Twitter. Someone helped me get my handle. No, I’m kidding. I’m Ms Ajita on Twitter. I probably spend less time there, but I spend most of my time on Instagram and Facebook. So that’s a great way to check in, to follow, to engage. [ALISON] Awesome. Thank you so much for your time. I’m super impressed with everything that you’re doing and the practice that you built. I feel like we could have a whole day, a whole day seminar by you and we would be learning all kinds of new things, but unfortunately, we are running out of time. So just wanted to thank you so much for your time. [DR. AJITA ROBINSON] Thank you so much for having me. This was wonderful. [ALISON] Well, I wanted to say thank you to Therapy Notes for being a sponsor of this podcast. We know your EHR is awesome and we are happy to tell other people about it. So if you want to get Therapy Notes for free for three months, use promo code Joe [JOE], no strings attached, and you can check it out and see if you’re ready to make the switch. Thanks so much for listening to today’s episode. I hope it was inspiring for you just as much as it was for me. If you are interested in hanging out with other group practice owners who are doing amazing things, definitely check out our membership community Group Practice Boss. You can find out all the details at practiceofthepractice.com/grouppracticeboss. I’ll talk to you all next time. If you love this podcast, will you please rate and review on iTunes or your favorite podcast player? . This podcast is designed to provide accurate and authoritative information in regards to the subject matter covered. This is given with the understanding that neither the host, Practice of the Practice, or the guests are providing legal, mental health, or other professional information. If you need a professional, you should find one.