What is the very first requirement to starting your new group practice? When exactly should you hire an assistant? How do you want the culture of your practice to look?
In this podcast episode, Joe Sanok speaks with Alison Pidgeon and Whitney Owens about how easy it is to start a group practice.
Meet Alison Pidgeon, Group Practice Owner
Alison Pidgeon, LPC is the owner of Move Forward Counseling, a group practice in Lancaster, PA, and she runs a virtual assistant company, Move Forward Virtual Assistants.
Alison has been working with Practice of the Practice since 2016. She has helped over 70 therapist entrepreneurs start and grow their businesses, through mastermind groups and individual consulting.
In addition, she is a private practice consultant for Practice of the Practice.
Meet Whitney Owens
Whitney is a licensed professional counselor who owns a growing group practice in Savannah, Georgia. Along with a wealth of experience managing a practice, she also has an extensive history working in a variety of clinical and religious settings, allowing her to specialize in consulting for faith-based practices and those wanting to connect with religious organizations.
Whitney has learned how to start and grow a successful practice that adheres to her own faith and values. And as a private practice consultant, she has helped many clinicians do the same.
In This Podcast
- Where to start with your new group practice
- Examine your systems and hire an assistant
- Hiring clinicians: 1099s or W2s?
- Marketing your new group practice
- Work on the culture
- Alison and Whitney’s advice to private practitioners
Where to start with your new group practice
If you are wanting to start your new group practice, make sure you have some of the prerequisites covered to make the transition easy, such as:
- Having your solo practice infrastructure be robust
- Make sure your website is fully set up
- Having business accounts set up and up to date
Ideally, I also like to see that [clinicians] are about 75% to their full capacity, and the reason we say that instead of 100% is if you are at 100% capacity seeing clients, you’re not going to have any time to start and grow a group practice. (Whitney Owens)
You do not have to be full to start a group practice, otherwise, your time and energy will be too sparse to launch it properly. Start a little before you are ready.
Examine your systems and hire an assistant
Once you have begun the transition, and even though your solo-practice infrastructure has been set up, you will need to examine your systems and start to make small but relevant changes.
Now that your practice will grow, you need to make sure that you have various other systems in place, such as:
- Accounting systems
- Phone systems with multiple extensions
Next, we look at hiring an assistant. Sometimes people like to do that at different phases, but we always recommend hiring sooner rather than later. (Alison Pidgeon)
Joe, Alison, and Whitney all recommend hiring an assistant sooner than you think because it is incredibly helpful.
Having someone take over basic admin so that you can grow the new practice is an invaluable asset that you should consider investing in.
Hiring clinicians: 1099s or W2s?
There is no right or wrong option when it comes to hiring either 1099 or W2 clinicians.
The question you must answer to help you decide which is better for you and the practice is: what kind of culture do you want in your group practice?
Do you want employees who are fully independent and self-containing, or do you want employees who are inter-connected and work as a team?
Whichever system you choose, Joe, Alison, and Whitney all recommend that you hire your first two clinicians at the same time.
You’re saving yourself a lot of time and money … you’ve already paid all these fees, got the contracts, offer letters and all that, so you might as well bring in two and double the amount of money coming into your practice and you can market for different specialties as well. (Whitney Owens)
Marketing your new group practice
Marketing a group practice from a solo practice will come with some growing pains.
The owner of the solo practice was the face and the name of the business, whereas now the practice is its own entity.
It will take some time, but after a while, the community will adjust to the shift and new clients will be happy to work with other clinicians at the practice instead of only wanting to work with the owner.
An administrative assistant will be helpful here as they can allocate new clients to your new clinicians.
Work on the culture
[Think] about the culture of your practice and how you want your staff to feel or perceive [how it is] working there. Obviously, people have different [requirements] for feeling happy and satisfied in a work environment … culture works [in tandem] with [clinician] retention. (Alison Pidgeon)
Constant staff turnover can be expensive for a business.
Therefore, the better you are at retaining your staff and keeping them happy and fulfilled working in your practice, the better for your finances and for the practice itself.
Alison and Whitney’s advice to private practitioners
Alison: Do not let impostor syndrome hold you back.
Whitney: It is easier than you think to start a group practice.
Useful Links mentioned in this episode:
- Check out this Free Webinar on March 2nd, 2022:
- John Clarke’s Fully Booked Dashboard
- Find out more about Group Practice Launch
- Visit Alison’s website, listen to her podcast, or consult with Alison
- Email Alison at firstname.lastname@example.org
- Visit Whitney’s website and listen to her podcast here
- Connect on Instagram or join the Faith in Practice Facebook group
- Email her at email@example.com
Check out these additional resources:
- Why you should start a group practice in 2022 with Alison Pidgeon and Whitney Owens | PoP 672
- Apply to work together
- Next Level Practice – next cohort opens in March 2022
- Sign up for Next Level Practice — Cohort Open!
- Events – click on the event’s dropdown
- Sign up to join the free webinars and events here
- Podcast Launch School
- Practice of the Practice Podcast Network
- Free resources to help you start, grow, and scale
- Apply to work with us — decision-making matrix for your next steps
Meet Joe Sanok
Joe Sanok helps counselors to create thriving practices that are the envy of other counselors. He has helped counselors to grow their businesses by 50-500% and is proud of all the private practice owners that are growing their income, influence, and impact on the world. Click here to explore consulting with Joe.
Thanks For Listening!
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[JOE SANOK] This is the Practice of the Practice podcast with Joe Sanok, session number 673.
Welcome to the Practice of the Practice podcast. Whether you have just joined us for the first time, or you’ve been listening for a while, I’m so glad that you are here. We’ve been doing this show for a little bit, 673 episodes to be exact and one thing that I continue to hear, whether it’s people starting a brand new counseling practice, a group practice, or maybe even passive income, as they grow outside of their practice is they often feel overwhelmed. They feel lonely, like they’re in their own area. They’re not sure what to do, and that they really want a step by step guide with clear milestones to know exactly what to do.
That’s what we’re talking about today. We are actually going to be talking all about why it’s easy to start a group practice and the step by step guide. We’re going to be walking through exactly what you need to do to start a group practice. So maybe you realize I’m pretty darn and busy. I don’t know if I want to see any more clients. I want to explore adding a clinician to my practice. I don’t know if I want just dip my toes in or go full tilt. That’s as stuff we’re going to be talking about today with Alison Pidgeon and Whitney Owens, who are both clinicians, they’re consultants, they’re group practice owners. They work with Practice of the Practice, through Group Practice Boss and Group Practice Launch and they are just dynamic ladies that kick butt and help other people do the same. So Alison, Whitney, welcome to the Practice of the Practice of the podcast today. Really glad that you’re here.
[ALISON PIDGEON] Thank you. I’m glad to be here.
[WHITNEY OWENS] Same.
[JOE] Well, in the last episode we talked about why 2022 is an awesome year to start a group practice. Today we’re going to be diving into the step by step, like, what do you do to start a group practice? So Whitney, why don’t you kick it off for us? Last time we let Alison kick it off. Where should people start when they’re thinking about starting a group practice?
[WHITNEY] So the first thing we walk people through, even sometimes before they start working with us, like in the pre-consulting phase is, is this best for you? Where are you in your current practice? Some things that we like to see for people to be ready to start a group practice is they have their solo practice set up all the way, that they have their name, they have the business account associated, they have the domain, they have their website, some of the things that we talk about with solo practice owners.
Then ideally, I also like to see that are about 75% to their full capacity. The reason we say that instead of a hundred percent is if you’re at a hundred percent capacity seeing clients, you’re not going to have any time to start and grow a group practice. So a lot of people get this idea, oh, I have to be full, or I have to have a wait list. You don’t have to have all that, but you do need to have at least enough marketing that you’re getting some calls, but you don’t have to be completely full. So that’s the first thing we look at as long as well as aspects about being a group practice owner, which would be managing money, doing more administrative side, doing more marketing because eventually, I mean, you can control how many clients you see, but if you want to grow large, you’re going to have to decrease your client load and increase your managing the practice. So making sure that you enjoy those things, to some extent you can hire out for a lot of it, but some of it that you have to be able to do yourself.
[JOE] Awesome. Alison, what should people do after that?
[ALISON] We really look at the systems and the processes that folks have set up because a lot of times they started a solo practice and didn’t really think about, oh, I need to choose systems for multiple providers. It was just them. So they picked something that worked for one provider. So just taking a look back at did you pick out an EHR? Do you have QuickBooks set up? Do you have a phone system that has multiple extensions because eventually you’re going to have an assistant those types of things. Then next we look at potentially hiring an assistant. Sometimes people like to do that at different phases. We always recommend hiring sooner rather than later, but people don’t often listen to us. They want to wait till they have that first person come on or they hire an assistant.
[JOE] Every time someone gets an assistant, they’re like, why didn’t I do this sooner? Like every time.
[ALISON] Yep. So that would really be step two. Then step three is, like we had talked a little bit about on the previous episode, really digging into, do you want to hire 1099’s? Do you want to hire W2s? What is the practice going to be all about? Do you want to hire folks who are going to have the same niche that you do or do you want to hire folks that have a different niche? All of these things that all have their pros and cons, there’s no sort of clear right or wrong answer for any of those questions, it’s just understanding all of those things and making sure you’re choosing the options that are right for you.
[JOE] So then after you’ve made those decisions, Whitney, what would come next after that?
[WHITNEY] You want to decide who you want to hire, which is super exciting. I was actually thinking about this after we recorded the last episode. Another one of the benefits that I love is that I get to hire people that I like, that I think are cool. I get to decide who I work with. That’s just so fun. So you get to start thinking about the type of person you want to hire and clinical skills that they might have, or that you want to add to your practice. There’s so much that goes into that. What calls are you getting what’s need in your area? Another quick recommendation is if you’re only going to hire one, which we actually encourage you to hire two at the beginning, but if you do hire one —
[JOE] Wait, why is that? Why do we hire two?
[WHITNEY] Lots of reasons. One, as sad as it sounds sometimes in our mental health area, people don’t work out or they quit early decide. They don’t want to do group practice. So the worst, and I was in this situation one time is you’ve lost all your people because when you’re small, it takes a while to build up. Then you’re stuck seeing clients that call. You don’t have anyone to refer them to. So that’s one reason. Also you’re safe yourself a lot of time and money because, we talked about this in the previous episode, you’ve already, already paid all these fees, you’ve already got the contracts, the offer loaders, all that. So you might as well bring in two double the amount of money coming into your practice and you can market for different specialties as well. So we do recommend that you hire two.
[JOE] I know that when I was bringing people into Mental Wellness Counseling, it was great when I’d hire two people at the same time, because then instead of having to go get a couple extra keys printed or extra contracts, we just sat down and did the whole onboarding checklist together, set up both of their emails at the same time. I was doing a lot of that on my own at the time, instead of having an admin do it like I should have. But it’s like to even just have two people at once, instead of it’s not twice as much work. It’s like 20% more work. So would I rather have 120 or 100%.
[WHITNEY] That’s right. You’re already going through that whole process of getting applications, reviewing them, interviewing people, which is exhausting. So if you do end up finding two good people at one time, jump on them. Good people don’t come around all the time, so don’t let those go away. But then with that next step is figuring out who you want to hire and then being able to write that job description, that job post and have all that out there and ready to go and then you’re going to be ready for the next phase.
[JOE] All right. Alison, what’s that next phase after that?
[ALISON] So you’re really get adding into the meat of the hiring process, interviewing potential candidates, checking references, trying to decide who you do want to hire. Then you’re moving into the onboarding phase where you’re actually like, we were just talking about bringing people in and training them and having them start seeing clients and then you move into marketing. So that’s a whole nother ball of wax, as I call it because you may be used to marketing for yourself and now you have to market for the group.
A common problem that people run into is that they were the face of the practice and everybody sort of knows them. Clients are calling asking for the owner and of course the owner is usually full already and you want to send those new folks to your clinicians that you just hired. So there’s always a growing pain of just having the community and your referral sources recognize you as a group now instead of an individual provider. So we talk all about what to do about that and how to start to change the tide so that people start calling for the other clinicians and not just for you, the owner.
[JOE] What are a couple techniques that work for people to make that switch?
[ALISON] What I typically recommend is that’s when having an assistant can be so valuable because I know when it was me answering the phone, I would start talking to the person and I’d be like, “Oh, I don’t have room in my schedule, but I’ll just fit you in somewhere.” When the assistant answered the phone, she was just like, “Nope, Alison’s schedule is full, but we have these other great therapists who,” one of my first hires was very similar to me in clinical orientation and that thing. So it was pretty easy to sell her once she said her schedule’s full, but there’s this other person who has pretty immediate openings. That helped. So I think just drawing that really and boundary of not taking any more clients really helps to have the potential new client go to see another clinician.
[JOE] Yes, for sure.
[JOE] Do you remember when you started your private being scared that you may not make enough money? You probably wondered if you would even break even. Then you did. After that, you may have wondered if you could actually make a living doing this work. Then you did. Now that you have a thriving business taking on more clients than you want, you’re wondering if starting a group practice will allow you to have the lifestyle you want while also not going broke. The answer is yes, it can. Join us for a free master class on how to make bank by starting a group practice.
This webinar is being hosted by Practice of the Practice consultants, Alison Pidgeon and Whitney Owens, who have helped hundreds of practice owners start and grow their practices while also making a profit. This special webinar will be on Wednesday, March 2nd, at 1:00 o’clock Eastern, noon central, 11:00 mountain, 1000 Pacific. To register head on over to practiceofthepractice.com/bank. Again, that’s practiceofthepractice.com/bank.
[JOE] So what’s next after that Whitney? You’ve done the marketing, you’re changing the way the practice is. It’s not just based on the owner. Now what?
[WHITNEY] Then we really look back at how things are running. Are you making the income and running your numbers appropriately? Looking at your calls, is your marketing working, where are people coming from? Where do you need to invest more marketing? Then looking at your staff, how’s their retention? Are they keeping the clients you’re giving them? That is huge. Because you want to go back and look at these things so you can figure out where are the problems and then we can go back and fix those problems because now you’ve got your group practice running.
[JOE] What tools do people use to really get those numbers easily rather than having the front desk keep a tally chart? That’s probably not very effective. How do people keep track of all those numbers and have that dashboard?
[WHITNEY] I do have a dashboard as well and people are always asking me, I use John Clark’s Fully Booked Dashboard that I did, actually it was through Practice of the Practice. Years ago, he did a mastermind group and talked about that and it was so phenomenal. So I’ve been using that. I also have a tracking method that we teach to group practice owners and those starting a group. Sometimes we do it to solo practice owners. It’s a Google Form that we share with people that are working with us and it tracks all of it. In fact, it was next level living room that someone introduced me to this and I have used it ever since.
The cool thing about Google Forms is it will track it in a spreadsheet, but it will also do a pie graph and you can really see everything going on within your a practice. So we do those once a month and I review all those with the Group Practice Launch people or anyone else that’s doing consulting. They have access to that. Then also being able to run financial numbers, you could create your own dashboard. Sometimes people work with a bookkeeper or an accountant and they do it for them. It’s whatever your preference is on that.
[JOE] Awesome. All right, so you got the numbers going, you’re keeping track of it, Alison what’s next when you’re starting a group practice?
[ALISON] I think really thinking about the culture of the practice and how you want your staff to feel or perceive about working there. Obviously people have all different motivations for being happy and satisfied in a work environment. They may perceive a work environment as being very important to them in terms of how long they’re going to stay in a position. So I have put in a lot of time and effort into thinking how do I really demonstrate to the staff that they feel value, they feel respected, they feel like they have autonomy and all these things that therapists typically like? We talk a good deal about culture and obviously that has to do directly with retention. So turnover of staff can be very expensive for a business. So the better you are at retaining staff, the more financially successful you’re going to be as well.
[JOE] Man, we started a group practice in 13 minutes. Look at us. Super easy. It sounds like now we’re getting into like that ongoing, like once it’s started what you keep doing. I think we’ll do more episodes in the future on the keeping a group pro practice going. What other things come to mind that maybe we missed or maybe one of you talked about a phase and the other didn’t weigh in on that phase. Any other things in the starting of a group practice that really in that step by step to keep front of mind?
[ALISON] I think what we see a lot of is folks having difficulty delegating especially if you had your own solo practice and you were wearing all the hats and doing all the things and you get this complex, like I am the only one who can do X, Y, and Z. Then you start hiring people, you hire an assistant, you might hire out for other thing, marketing other things. Then all of a sudden you feel like this loss of control, like, how am I going to know it’s being done well, or how am I going to know it’s being done at all? We talk a lot about how to delegate because you started the business so that you could free up some of your times so that you didn’t have to do all the things.
At some point the practice gets so big. It’s impossible to do all the things without totally burning yourself out. So we talk about how do you put those systems of checks and balances in so that you can delegate things to people. I know owners who are still doing all the insurance billing for their practice, or they’re still doing, they’re spending a whole day inputting numbers into the payroll system. It could just be as simple as train your admin to do the payroll all the way up until all you have to do is review and hit the submit button. There’s no reason why you’re the person who’s actually punching the numbers into the payroll system. So just things like that, that I think a lot of folks just don’t realize that you can delegate and still have a pulse on how things are going and making sure things are being done correctly.
[JOE] Yes. Whitney, anything we missed in starting a group practice that you want to make sure we add in here?
[WHITNEY] Yes, we did, I don’t think we talked too much about the onboarding phase. But we really have a process of walking people through that, creating checklists. We have a general checklist, but then you can create one that’s specific for your practice and talking through how do you onboard people or videos you can make or who else can do the onboarding for you? How can you set up expectations with your employees or your clinicians, whichever on what they can expect from you as a boss? I have learned over the years you really have to communicate with them. Here’s the best way to talk to me. Here’s what I want to hear from you and really setting those goes out in advance. Here’s what it’s like to see a client. Here’s what it’s like to come to work. So that way they’re completely prepared for what that’s going to look like.
[JOE] I think it’s so important to have just like regular feedback, be a part of the conversation and not just like a one or two times a year, I’m going to sit down and give you feedback. But to just say like, here’s what I noticed. There’s no, it’s not that you’re a bad person. It’s just, we had a miscommunication. Here’s what I saw, what you see. What should we do in the future? Just like, let’s go through that process. I think that when that happens, then feedback and growth become just a part of the conversation instead of it being this big, scary, like, am I getting fired? Am I firing you? No, it’s just, of course we’re going to give feedback on things so that we can improve.
Awesome. Well, the last question I always ask and you get to answer this again, because yesterday you got to answer it, if every private practitioner in the world were listening right now, what would you want them to know? Why don’t we start with Whitney this time. Or wait, no, we started with Whitney last time. I don’t remember. My brain’s foggy. We’re going to start with Whitney.
[WHITNEY] Oh yes. It is easier than you think to start a group practice. Alison and I hear over and over all these challenges that people say, like, I have to have a bunch of money or I have a lot of clients or that seems so difficult. I love how Joe just said, “Yes, we just basically started a group practice in 15 minutes.” It really is a lot easier and I can pretty much say hands down at the end people always say to me, “Wow, that was a lot easier than I thought it was going to be.” Of course we walk them through the process that makes it super but people are always very pleased with starting their practice and how well it went.
[ALISON] I would say, don’t let imposter syndrome hold you back. I talk to so many people who just think like, “Oh, well I’m not enough of an expert or who would I be to be a business owner,” when it is something that they really want to do, but they just don’t have the confidence in themselves. So if that if that’s, you definitely find some way to work through that because I think there’s so many people who are just held back by their own negative irrational thoughts around starting a group practice.
[JOE] So awesome. Well on March 2nd at 1:00 o’clock Eastern, 12:00 central, 11:00 mountain and 10 Pacific, you two are going to be hosting the webinar, how to make bank by starting a group practice. Super excited about this. If you want to register for that, go to practiceofthepractice.com/bank. Again, that’s practiceofthepractice.com/bank. So what are people going to get out of that specific webinar about making bank through group practice?
[ALISON] I think we really run through the numbers and give people very specific data about what does it look like to run a group practice, how much do you want to make and how many therapists would you need to hire to get there? I think that for a lot of people, it just seems like this mythical process and they don’t realize how easy it could be or you could have a six, seven clinicians and be grossing a million dollars. So it’s definitely not out of the ordinary to get to that level.
[JOE] So awesome. So that’s practiceofthepractice.com/bank. That’s going to be on March 2nd. Make sure you register for that so you can get access to that teaching. You’ll also get that recording emailed to you as well. Well, thank you so much for hanging out on the Practice of the Practice podcast today.
[ALISON] Thanks Joe.
[JOE] Well, for the next six episodes, Alison and Whitney are going to be hanging out with group practice owners, talking about their Group Practice Launch, what worked, what didn’t work, what was easy, what was tough, all the tool that set things up for them. So we’re going to have six episodes. So each of them are going to be interviewing three different people that have gone through that launching process. So make sure you tune into those. Then at the end of that series we’re going to be coming back and telling some of our own group practice stories of how we launched it, what worked and having that conversation all our own group practices.
Make sure you sign up for that webinar. That’s going to be again March 2nd, at 1:00 o’clock Eastern. How to make bank by starting a group practice. Again, that’s practiceofthepractice.com/bank. In fact, we think this webinar is so important that that’s our sponsor today. We don’t have another sponsor. We want you to go sign up for that over practiceofthepractice.com/bank. Thank you so much for letting me into your ears and into your brain. Have an amazing day. I’ll talk to you soon.
[JOE] Special. Thanks to the band. Silence is sexy for that intro music and this podcast is designed, provide accurate and authority to information in regard to the subject matter cover. It is given with the understand me that neither the host, the producers, the publishers or guests are rendering legal, accounting, clinical, or other professional information. If you want a professional, you should find one.