[ALISON]: Starting a group practice can be really overwhelming. So if you’re wanting some help to figure out how to start and grow a group practice, please go to practiceofthepractice.com and click on Work With Us. There you’ll find information about everybody on the Practice of the Practice team, including me. I specialize in helping people grow a group practice, and I would love to work with you. So please fill out the contact form on the website or email me, [email protected].
You are listening to the Grow a Group Practice podcast. Whether you are thinking of starting a group practice or in the beginning stages of a group practice, or want to learn how to scale up your already existing group practice, we have lots of great content for you. I am your host, Alison Pidgeon, I’m a serial entrepreneur with four businesses, one of which is a 15 clinician group practice that I started in 2015. I’m also a mom to three boys, wife, coffee drinker, and love to travel. I’m excited that you chose to listen to this podcast.
Hi, and welcome to the Grow a Group Practice podcast. I’m your host, Alison Pidgeon. And this is our very first episode. I am going to tell you a little bit about how this podcast came about. I’m going to share with you my journey in becoming a group practice owner and I’m also going to talk to you about what to expect on this podcast and also kind of my style, my values, the things that I’m interested in so that you can know what types of shows we’re going to be producing for you. So I really appreciate the time that you’ve taken to listen to the podcast today. I have recorded a whole bunch of episodes already, even though this is the first episode, because in the world of podcasting, you batch record a whole bunch of episodes before you actually release them. So I’m about 10 episodes in, and I’ve been having a lot of fun talking to a lot of really smart fun people and I’m really looking forward to sharing those interviews with you, but I wanted to take you back to last fall, so fall of 2019 and tell you the story of how this podcast came about.
So, if you know, Joe Sanok, who started Practice of the Practice, he is who I’ve been working for for the past, I would say about three and a half years now, so since 2016. And Joe went to a podcasting summit and he was very inspired by a lot of great ideas. He started texting me and the consultants on the Practice of the Practice team about how he wanted all of us to start podcasts. And I was like, “Oh, I never thought about starting a podcast before. I’m not really sure if that’s something I want to do.” And with ideas sometimes, you know, in the moment it seems great and I thought, well, maybe Joe will come home and then sort of reality will hit him and then he’ll think like, “Oh, well, it’s too much work or I don’t want to do this right now or not take the business’s direction or whatever the case may be.” So I kind of was maybe somewhat skeptical, sorry, Joe, that he was actually going to follow through with having us all start podcasts, but he did, he was very excited and he continued to put together the framework and the structure for us all to start podcasts and I had to get used to the idea.
So just to give you some frame of reference, I had a business coach once that called me the wizard behind the curtain, meaning that I am one of those people who I can do amazing things, but I don’t necessarily want to be out front and center, I don’t want to be the life of the party or on the stage or, you know, whatever you, however you want to describe it. But I am excited now that I’ve had some time to record and to think about what I want to put together for you in terms of this podcast. So I’m definitely glad that Joe pushed me to start the podcast. So I wanted to take this opportunity as well, to tell you a little bit about my journey as a group practice owner, because obviously it’s not all smooth sailing once we decide to start a business, especially when we have no previous business experience. And my kind of, I guess, path to becoming a group practice owner came out of a bad situation. So my career really was working my way up through a community mental health system.
I worked for a really large mental health hospital system here in the Lancaster County, Pennsylvania area where I live and thought that as I was kind of working my way up the ladder, that I would just keep kind of getting promoted and one day I’d become this sort of hospital administrator. I really liked the business side, I liked managing people, I was the director of an outpatient clinic, one of the many outpatient clinics that they had in that system. And I enjoyed it to some extent as what tends to happen in big healthcare systems is that you know, things are constantly changing, you’re getting more job responsibilities, but they’re not giving you any more time or any more resources to make those things happen. And so I just got to a point where I felt like I was just putting out fires all the time and that didn’t feel good to me.
At the time I had a baby and a toddler at home. This was back in the fall of 2014 and I just had this sort of lightning bolt realization that I just couldn’t do it anymore. So what had happened was I had been up all night with my then two-year-old because he was coughing and, you know, at that age you can’t really do much for them. You can’t give them cough medicine. So I was just kind of staying up with him, holding him, trying to hold him upright so he wasn’t coughing as much. So he and I finally fell asleep, maybe five o’clock in the morning and I got him up and took him into daycare late, even though he had been sick all night because there was so much going on at work, but I just felt like I couldn’t miss. And my schedule was so tight that I couldn’t reschedule things and I got to the meeting maybe at 11 o’clock in the morning and I sat down and I just thought like, “This is crazy. I took my poor sick baby to daycare, to rush here for what? You know, like, “Is this job really worth all of that?” And I just thought, I can’t keep feeling like I’m not doing a good job as a mom, and I’m not doing a good job here as the director of the outpatient clinic, because I’m just putting out fires all the time. And I just had this lightning bolt of a moment when I was just like, “I got to do something different here.
So, I went and talked to my husband and said, “Hey, I’m thinking about leaving.” And somebody suggested to me, “Well, why don’t you start your own private practice?” And I was like, “Yeah, why don’t I do that? That sounds like a good idea. It had never really occurred to me before.” So I quit around, I think it was around Christmas time and I gave them six weeks notice. And so I left the end of January of 2015. And so really in between by the time Christmas was over and then I had left, it was about four weeks. I put together the bare bones of a solo practice, I, filed LLC, I got a website going, I printed some business cards. I didn’t do too much. I got enough stuff together that I was able to start my own practice and I had some of my clients from the community mental health clinic follow me. And so you know, I really kind of jumped in with both feet in a very short amount of time.
So, I didn’t have a ton of clients starting out, but I started to figure out what I was doing. I started to research the business side of private practice and I ZinnyMe online, and I found Joe online and his podcast and just started consuming all of the information I could find. And when I found Joe’s website and his podcast, I got really excited about the idea of starting a group because I was the director at the outpatient clinic and I had management experience and I really enjoyed that piece of it. And I was like, “Well, I can start really not having my income tied to me seeing clients.” And that really appealed to me, obviously, being a mom and needing a lot of flexibility with taking care of kids. So I decided to just start the group practice in September of 2015. So I changed the name of the practice to Move Forward Counseling and I hired my first contractor.
So, in the beginning I decided to do contractors and made a lot of mistakes along the way, which I’m sure I’ll talk about at various points throughout this podcast but I started to figure out what I was doing. And I started to see that we were making a good amount of money and we were making a positive impact on the community and I wasn’t lonely anymore because I had coworkers. So in the summer of 2016, I decided that we were going to move into a two-office suite. So a new space in the same building came open so we moved into there. And then in April, 2017, I rented a third office in the same building, because again, things were going well, our clientele was building up, we were getting, the word was getting around in the mental health clinician community that Move Forward was a good place to work. So I kept expanding as I found people that I really liked to hire.
In December of 2017, we ended up renting a fourth office in another building because I had run out of space in the building that I was in and decided around probably at some point in late, maybe late 2017 that I wanted to buy a building. I had an accountant who said, “You know, you could really build a lot of wealth and you’d be paying yourself rent if you bought a building.” And I was like, “That sounds great. I have no idea how to do that.” And that’s actually a whole another episode that we’re going to do about how I bought the building and what that looks and how that works and everything related to that.
So, I ended up buying a building in August of 2018, we renovated it and it got totally gutted, and we opened it in March of 2019. So we kept the original location and then we doubled the size of the practice by moving into there. So I think by the time we moved into there, I probably had about 12 clinicians, and I had made a choice early on in the beginning to make the practice focused on women’s issues. So we exclusively market to women, although we don’t turn men away. If, you know, males call and we can help them with whatever their particular issue is, we will see them, but we only market to women and we have a whole bunch of specialties related to women’s issues that we market.
So, I had, obviously a really nice thing going there by the time we doubled the practice. We do take three different insurances. In the beginning, we took more and then as we grew and got a good reputation we were able to drop some of the lower paying insurances. We do have a good chunk of our clientele that is self-pay, which is nice, and so, yeah. So that’s kind of the overview of the practice at this point. So in the beginning of the practice, I was really wearing all the hats, right? Like I was answering the phone, I was cutting the checks, I was buying the supplies. I was doing everything and realized that I couldn’t keep doing that, and so hired an assistant and you know, started delegating various tasks. And then I realized probably around the fall of 2017 that I really wanted to be the CEO of the practice. I wanted to be that big picture person who works on you know, really the big picture, things like expanding the practice or something related to marketing or not necessarily getting bogged down in the day to day like, “Oh, this insurance claim got denied, let’s fix it.” Or, “Oh, this therapist has a question.”
Those types of things kind of became tedious to me and so I started training a clinician to kind of take over the day to day aspects of running the practice. I called her the clinical director, and then I stopped taking new clients as well. So I didn’t necessarily stop seeing clients altogether, but I just stopped taking new ones and just sort of let the ones I have sort of titrate naturally. So I was able over, I would say from the fall of 2017 until the beginning of the summer in 2019, I was stepping more into that CEO role, I was shutting clients, and then in June of 2019, I retired from being a therapist, because I went out on maternity leave. So that was a really natural time to transition my clients out since I was going to be out for three months, and that person that I had trained to be the clinical director ended up running the practice for me while I was out, which was wonderful. So I got to be at home for three months with my baby, which was an amazing blessing and also collect my salary.
So at this point in the practice I came back in the fall of 2019, and unfortunately my clinical director left, and so I took that opportunity to kind of look at restructuring the practice and all of the things that she was doing, I broke up into different roles and then allowed the staff to apply to do those roles. So for example, she was doing like the marketing and, you know, was training new clinicians when they came into the practice and this and that and the other thing. So I took all of those and separated them out and now we have one person who trains the new clinicians, we have one person who does the marketing, we have one person who does the clinical supervision. So it’s like probably six or seven different things that are all done by different people, and so far it’s working out pretty well. We’re still trying to cement exactly what that all looks like, but it is still allowing me to be that CEO big picture person. And I think the therapist enjoy having other things that they can do just to give them a little bit of variety or, you know, maybe appeals to their skillset or their strengths.
So, I’ll talk about that in another episode as well, kind of what those roles look like and how that is structured in the group practice now. But the other piece of it too, is that, excuse me, I realize that the contractor model wasn’t really working anymore as I had gotten bigger. So it seemed like once I hit 12 therapists, I would have somebody who would leave because they’d go start their own practice and then hire one more and then somebody else would leave. And I just kept hitting a ceiling at 12. It’s like I couldn’t grow beyond 12. And then I realized if I really want to have long-standing motivated staff, I’m going to have to hire W2 employees. So that what I did starting at the beginning of 2020. Everybody that was with me became a W2 employee, and I offered health insurance and PTO. And so far it’s really made a big difference with the quality of the candidates I get who are applying to our positions. But also I feel like it’s going to help with retention of the staff that I have as well.
So I am going to talk in another episode as well about the transition from contractors to W2 employees, because that’s a whole, you know, another ball of wax, how to make that switch, especially when you didn’t start out that way, and how to figure out how to add a health insurance and all of that. I know it can be a lot for people and it can kind of be an intimidating process, but if you take it step by step, it’s not too bad. I gave myself like three or four months to sort it all out and then by the time the new year came, it was just a nice time to sort of make that transition. So, that’s kind of my story at this point. I have worked my way out of the practice. I probably spend about 10 hours a week working in the practice and most of what I focus on now is expansion, I still do all the hiring and I still have a lot of control over the financial pieces. So everything else that happens in the practice really is done by the admin or the other therapists.
So that is another episode too, that we’ll do at some point talking about, you know, how do you delegate things, how do you kind of step into that CEO role, what does that look like, and do you actually want to do that? For me, I knew, you know, many years ago that I wanted to stop seeing clients. So this was a goal that I’ve been working towards since 2016, 2017. So I’m really happy with you know, the amount of time that I’m spending in the practice and my role in the practice at this point. But I know that’s not for everybody. Some people, you know, feel like they don’t ever want to give up doing clinical work and that’s totally fine.
So, I wanted to switch gears a little bit and just talk about who this podcast is for. If you are a brand new group practice owner, if you’re in the startup phase, even if you’re in the planning stages of, you know, thinking about if you really want a group practice or not, this is definitely a great podcast for you to listen to. We will be covering lots of topics related to people in those phases. And then the other set of group practice owners that we’ll definitely have content for is people who are more established. So maybe you have, you know, several therapists already who are working for you and you are finding that you’re dealing with a whole new set of challenges, or you want to scale up to be even bigger. Maybe you have 10, 12 therapists, and you’re wondering, “How do I have 20 or 50?” We will definitely be talking about that as well, and I’m trying to do my best to kind of give a variety so that no matter where you are in your private practice journey, there’s something here for you that you would find valuable.
So, I just wanted to kind of talk a little bit about what my values are as a business person and kind of my style so that you know what to expect in terms of the kind of content that I’m going to be bringing to the podcast and that kind of thing. And so the first thing that I wanted to talk about is how to design your business so it works with your life. There’s so many times when I talk to people, when we’re doing pre-consulting calls, when they say, “You know what? I would just love it if I could be done at three and I could go pick my kids up from school.” And I say, “You know what? That’s great because we know that is your goal and we can design your business so that you can leave at three o’clock every day.” And so the whole reason we become entrepreneurs and we take this risk of going out and starting our own business is because we want to make it what we want to make it. Like, I love that I get to work from home now and I don’t have to see clients anymore, and I can be flexible in terms of, you know, some days I take my kid to the doctor in the middle of the day, or I go volunteer at school or whatever the case may be and I always feel so lucky that I have the ability to do that. So definitely we will talk about how to design your business so it works with your life.
The second thing that I definitely believe very strongly in is delegating things in your business and at home. So it’s always amazing to me how many practice owners have such a hard time with delegation and giving up those pieces of things that they may be started out doing when the business was new and then once they get the courage to actually delegate what a game-changer it is for people. And so I strongly believe delegation is really what has helped me to take my business to a whole another level, and then I started implementing that delegation at home because I started to see how, if I had less, you know, chores around the house, then I get to spend more time with my kids, which is my motivation. So I started implementing kind of the same strategies at home as well.
So, the third thing I want to definitely talk about in the course of this podcast is money mindset. I think there’s so many therapists, unfortunately that have lots of hang-ups about money. You know, the brainwashing starts early when we’re in graduate school and they tell us like, “Oh, well, you’re never going to make money being a therapist. So just forget about it now. You’re just always going to be poor.” I don’t believe that at all. I think therapists can be wealthy. I think group practice owners absolutely can make great money. And I think we should be having more conversations about money and not be afraid or ashamed to say, “Hey, I want to make $300,000 off my group private practice.” If somebody tells me that, I say, “Great, let’s talk about how we’re going to do that.” So I definitely want to change the conversation around money.
And then the fourth thing I wanted to talk about is this concept of not using excuses to sort of hold you back from making progress in your business. So if you are familiar with the book by Marie Forleo called Everything is figureoutable, I feel like I could have written that book. That is my philosophy and has been for many, many years that if there’s something I don’t know how to do, I just keep working at it until I figure it out. Or if I run into some kind of obstacle, like I got this idea in my head, like I wanted to buy this building. I didn’t have money to buy a building. And you can see how it would be really easy to convince yourself like, “Well, you don’t have money to buy buildings, so you just need to forget about it.” Or you just need to, you know, put a little bit of money away every month for 10 years, and then maybe you can buy a building. I didn’t know how I was going to find the money, but I found the money and then I bought a building.
So, I don’t believe in this, “I don’t have time. I don’t have money.” You know, if you really want to find a way, you’ll find a way. And so I like to work with people who have that same philosophy. I think that many times in entrepreneurship, we have to take these calculated risks. We don’t want to be reckless in taking a risk, but we want to take an educated risk about how to grow our business or starting our business. And so that’s another thing that I believe that you, as a business owner, especially a group practice owner, you have to be able to tolerate taking some risks. You know, maybe you’re going to take $10,000 to start up the group practice. For a lot of people that feels scary, but even though it feels scary, you tolerate it and you do it anyway. And so that’s what I tell people in my consulting work all the time. Like,” I know this feels scary, but we’re going to do it anyway.”
And so, the last thing that I wanted to say is exactly what I just said. So about tolerating, the fear of doing something, doing it any way, I believe in that wholeheartedly. And then just to give you an idea of what my style is, I am a very logical person. I present my information in a very sort of nuts and bolts kind of style, I like creating step-by-step roadmaps for people so that it’s very clear what they have to do to build up their group practice, and I also like talking about mistakes as much as I like talking about successes. Because I feel like we can learn so much from other people’s mistakes. So I try to ask in my interviews as well, like about mistakes that people have made because, for as much as we want to celebrate people’s successes, we also want to learn from other people’s mistakes so then maybe we can avoid them as well.
So, all that being said, I hope that sounds exciting and appealing to you and I hope you stick with me to continue listening to some more episodes. There are definitely some great interviews that I have coming up and some deep dives that we’re doing with some experts related to various aspects of group practice. So thank you so much for listening and I will see you in the next episode.
Grow a Group Practice is part of the Practice of the Practice podcast network, a network of podcasts seeking to help you grow your group practice. To hear other podcasts like the Imperfect Thriving podcast, Bomb Mom podcast, Beta Male Revolution, or Empowered and Unapologetic, go to practiceofthepractice.com/network.
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.