In this episode, Joe Sanok addresses listeners’ questions about starting, growing, and scaling a private practice.
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In This Podcast
In this episode, Joe addresses questions from listeners. From questions about when it is the right time to start a private practice to what you should be doing in Grad School to prepare to go into private practice, this podcast is filled with resources to start and grow a private practice.
Q: When do you know that you’re ready, in terms of your skills as a clinician, to go into private practice?
A: You never feel entirely ready. The more you do it, the more confidence you have. There are, however, things that you can do that will help you feel more ready like listening to podcasts and researching marketing tips and advice etc. Furthermore, only 8% of the US has a Masters Degree, therefore you are already in the top percentage of the general public. Right out of Grad School, find a job where you can get paid to network in order for you to become more well-known in your community. Finally, how much risk are you willing to take on? Are you in a financial position to open a private practice?
Q: What plugins are you using with your WordPress Site? Which ones are ‘have-to’s’ and which ones are optional?
A: Plugins are like apps for your website. They do tend to slow down your website, so you only want to have the ones you really need. These are:
- Akismet Anti Spam
- Content Form 7
- Google XML Site Maps
- Jet Pack
- Pinterest Pin It Button
- Pixel Cat
- Pretty Link
Q: I have a URL and a WordPress Site, how do I get started with that? When do I transfer the content and will I lose SEO traction?
A: Turn your Grad School papers into blog posts to build up your SEO. You can use a permanent re-direct to ensure that you don’t lose any content or SEO traction.
Q: What other income streams can you add to running a private practice?
A: Your private practice does not have to fulfill your entire income, especially initially. Perhaps look at finding a job that you love that is low-stress. For the rest of the time, work like crazy on building your private practice by networking / blogging, etc. Have enough saved up to keep your business afloat for three months. Do what you can to get rid of the financial pressure. Build habits of being smart with your money when you are struggling.
Q: How do you build a business plan and do market research?
A: You need to evaluate the market, research it, and understand it. People that say the market is saturated often have poor business skills in general. Push back against that mindset. I’m not a big fan of business plans, people usually create them and then they get put in a drawer and gather dust. Rather, identify goals / KPIs. Clear structure for what you need to do next. Subscribe for 28-step checklist to starting a private practice. Sign up for newsletters. Always think about ‘what is the function of what I’m doing?’
Q: How do you co-ordinate with client inter-disciplinary providers?
A: Is this more from a marketing perspective or from a care perspective? It depends on what the client wants. There is value in it from the client’s perspective as well as from a marketing perspective. From a limited time perspective, look at what your role is and isn’t.
Q: How do you help therapists make decisions to get involved in blogging, etc. themselves?
A: It depends what phase of practice they are in:
- Start-up phase: bootstrapping, focusing on ideal client, earning $50k gross.
- Growth phase: up to $100k, looking at outsourcing
- Scaling phase: over $100k, how do I remove myself from all of the non-essentials of the private practice
- World Changer’s Challenge: Write An E-Book In a Month
- September: Michigan Home Based Family Services Association
- October: Brew Your Practice
- November: Alabama Counseling Association
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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File: POP 241 Listener_QA_About_Private_Practice
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Joe: What a great question, Kate. I should get a hangout with Kate when Kelly, Miranda, and I hosted a meet-up out when the Gottman Institute had us out for one of their therapy summits. And it was fun to hang out with her and whole bunch of other therapists. We – Kelly, Miranda, and I – went to this big suite and we were [Inaudible 00:05:52.23] security camera like three times because we were having such a fun time. But I would start with Kate that in general you just never feel totally ready. I think people, there is this myth that you just kind of magically have this confidence and be ready for private practice. There is people that they have their Ph.D. They have practiced for years and they don’t have the confidence to just start a private practice. So I would start with that the more you do it more confidence you have. As in life, you know, the more public speaking you do, the better you feel about it. Same sort of thing. With that said, I think there’s things that you can do that will help you feel more ready. I know that you are an active listener of the podcast. You are reading lot of a marketing. So you are going to be ahead of the game, but I love you question sounded like it was clinically. How you know when clinically you are ready? Well, we do know from the Bureau of Labor Statistics stat that only 8% of the United States has a Master’s Degree. So right away. If you are in a room of 100 average U.S. citizens, there will be 8 of you in that room that have Masters degrees and statistically speaking, you’re probably the only one that has something in the mental health field. So when we were in Grad School, when we are at conferences, when we are surrounded by people that are as smarter or smarter than us, it feels like how big of a fish can I be? What do I know compared to all these PhDs and people that have been in the field forever? I would say you are probably comparing yourself to other people that are in the field more than your skill set with the general public. Next, I would say is there is a few things that make it a little bit more tough for a brand new grad, especially that you are not usually very well known in your community. So when people reach out to me, they want to join mental illness counseling right out of grad school, one thing I suggest is find a job where you can get paid to network. So a job where you are maybe doing little bit of a case management for an agency, that you are out there, you are on the suicide prevention community, you are in the poverty reduction community, you are on all sorts of community organizations, so someone else is paying you to network. Now this could be a full-time job or could just be like a 20-hour-a-week job. Then the last component of it would be how much risk are you okay with taking on. If you are single and you don’t have any other sources of income, don’t take on debt to launch a practice. That’s not going to serve you over the long term. If you have a significant other that brings in some money or if you saved up a bunch or if you have, you know, trusts or other things that can help float you through, then maybe you want to jump right out of the gate. Typically for the average person that comes of Grad School with some debt that really wants you to do a practice, to jump out, start brand new practice and have no job is a pretty risky thing. Even people that have full-time jobs that say I just want to jump into private practice, I usually suggest starting a part-time practice on the side, letting it kind of get going before you kind of put all your eggs in that basket. So Kate, that’s where I would land. Let’s go to the next question.[Plugins for a WordPress Site] Gordon: Hi Joe, it’s Gordon Bluemore from Kingsport, Tennessee. Just around in the car, I’m saying thanks. Well, it’s a great stuff you’re doing, especially with the podcast on how to become a consultant. I’m one of those people [Inaudible 00:09:02.8] you have started [Inaudible 00:09:03.21] so I have been listening rather and just really am enamored with [Inaudible 00:09:11.20], the content you are giving them and for your information. One question I did have is what plugins are you using with your WordPress Site, and which ones do you feel like are ‘have-to’s’ and which are optional? So, anyway, thought that might be an interesting topic.
Joe: Gordon, what a great question, and also so good to hear your voice again. Gordon did consulting with me and also came to Brew Your Practice and just rocks it. He has also been on the podcast while like, so this was actually a question he left a little bit ago. And so I am going to actually pull up my mental illness counseling page and let’s talk a little bit about plug-in. So if you have a WordPress website, there’s these little things called plug-ins. They are sort of like apps for your website. Now you can definitely overdo it. They slow down your website. So you want to really only have the ones that you need. So I am going to go through a couple here. These will be in the show notes also. So the first one is called Akismet anti-spam, that’s A-K-I-S-M-E-T anti-spam. So this is the best way to protect your blogs from spams. The people aren’t just posting comments, and do craziness on your website. The next one I would recommend is Contact Form 7. This is an awesome plug-in of contact forms. You can change things around. It really makes it easy for contact forms there. As well, I would add Google XML Sitemaps – so that helps to improve your SEO by using site maps which is how Google, Bing, Yahoo and others kind of find out about your website. Something that comes standard on WordPress is Jetpack. It’s sort of like this big pile of plug-ins that are all in one plug-in. So it does a lot of different things based on what you want to do. Again, you want to make sure you only have the plug-ins that are actually functional to the people that are on your website. Let’s see… ones that are also helpful… there is a Pinterest “Pin it” Lite button where you can have “Pin it” buttons if you have a lot of images. If you don’t have lot of images, that can be really annoying to people. Let’s see… the next one that I have is called Pixel Cat Lite… and all these are free so far. And so that’s an easy way to embed Facebook Pixels unto to your websites if you are doing any Facebook advertising. If you are not working with someone, you definitely want to be doing that Facebook Pixels so that you can retarget people. As well… let’s see… I would say there’s a couple more that you are going to want. One is Yoast SEO, that’s Y-O-A-S-T, Yoast SEO. It’s totally an all-in-one SEO solution for WordPress. So it gives you a page by page content analysis. It helps with XML Sitemaps, it helps with your meta descriptions to know how well you have written to your keywords. Then the last thing I would definitely add, it’s called Pretty Links Lite. This is probably one of the most important ones that you can have. So Pretty Links Lite, what it does is it allows you to redirect things. So for example I have www.practiceofthepractice.com/questions. So I did ‘forward slash’ questions, but all it does is it re-directs you to www.speakpipe.com/practiceofthepractice. So if you have things that you want to send people to and you want it to be easier to remember, it makes it way easier if you use that Pretty Link Lite. That’s probably the one that I personally use the most as well as the Yoast [Inaudible 00:12:36.15] when we do blog posts.[Starting a blog while still in school and its transfer of content issues] Kate: Hi there Joe, this is Kate Hedberg again in Seattle, Washington. I had a couple other questions of things I think grad student want to know when we are thinking about starting a private practice. One is I have read a lot of great material on your blog about how to start your own blog while you are still in school, blogging some of your papers and things like that, and I am definitely interested in doing that. I have bought a URL and I have a WordPress site, and I was just wondering for some more tips on how to get started with that, particularly is wondering is it a problem if I want to transfer all that content later to my own website. For instance, since I am still in grad school, I don’t know things like timing of when I want to go on a private practice, what that’s going to look like. So I bought a, kind of, nondescript URL, but I know if I went into a private practice, I would obviously change my URL to be the practice name or whatever. So I am wondering if I build SEO and start blogging now, can that SEO still benefit me if I switch everything over to a new URL and at different hosted site? So I hope that makes sense, but I would love if you speak to that.
Joe: Okay, what an awesome question. So in grad school, it’s such a smart thing to be taking all of those grad school papers that you are doing and turning them into blog post. I mean you’re running these like 30-page whoppers of a paper and then if you just, you know, add some stories, add some bullet points, make it a little less clinical, you could repurpose that and really be building SEO over time and it’s really going to help you rank when you end up switching over to a practice. And so people that are in Grad School actually have a whole kind of tutorial and video on what you can be doing in Grad School. And that’s over at www.practiceofthepractice.com/grad-school. And so if you are in a Grad School, you definitely want to be learning from that. So that’s what she is referencing in her question about kind of learning some of these things. So when you end up switching things over, you probably won’t lose much because what you can do is you can just do a permanent redirect. So it means that you end up keeping your site. But then if someone types in your old address, your old URL, it ends up going to your seattleconseling.com or whatever you end up having it be. Having a website person like Jaime Jay over Slapshot Studio will help with that is probably worth it. I wouldn’t recommend that you then leave that full website and just start another one because that’s just like starting from scratch. You might as well switch it over. If you are already on WordPress, it’s just a matter of changing the theme, changing the URL and you really won’t lose that much, especially if you have been around for three or four years versus just starting when you graduate. Way to think ahead. That’s so awesome that you are thinking ahead that much.[Question about a struggling practice] Next Question: I am not really sure that I know much of the differences or requirements or restrictions, of like State by State restrictions. I am currently an LLPC in Missouri and I have quite a few credentials in the area of substance abuse, and I went into private practice in October of last year. And there was three counselors renting from the owner and now it’s almost just me. They are leaving soon. So I am trying to freaking out. I think this month I made less than my car payment and that doesn’t include putting gasoline or paying for insurance on it. So luckily I still have the savings. I will be teaching [Inaudible 00:16:05.05] soon and I am just looking for other options to be able to add to what I do, so that I can stay in private practice and not have to return to where I came from. So I am hoping all of these things that I am signing up for with you will help with… I wish I could pay because you really seem often, I have been following you for a while. But anyway, I hope that made sense. So if [Inaudible 00:16:27.0] anybody could answer in to their questions like what made him go do that, how they got there, and is it better for them than what they were doing, that kind of stuff. I guess that’s it. Thanks.
Joe: I love this question about a struggling practice because it’s where a lot of people are. I have a LLPC super vision client where she needs to be supervised for her first 100 hours of supervision and like 2000 or 3000 hours of indirect. And recently lost her full-time job because they are downsizing all of that and is doing private practice. And I think what I see happen with lots of people is that they struggle and feel like the private practice has to be the entire income. Now that is what the goal is, but how do you make the best decisions for your private practice. I’ll say if you are barely making car payments, like the big thing that you want to do is have enough money coming in, that you are making decisions for your business that’s based on freaking out of money instead about what’s best for your clients and what’s best for your practice. So it may be that you find a job that you just love doing, that’s low stress that you have always wanted to do, just to bring some money in. So maybe you’re a wine pourer at a tasting room or maybe you work at a brewery or a coffee shop or you know you do something that for you is going to bring in a little bit of money to take that worry off, maybe you work 20 or 30 hours a week, and then you really focus on that, you know, 10 or 15 hours building that practice, networking like crazy, blogging like crazy, learning like crazy… lot of craziness in there, but you want to take that financial stress off. Because when you’re coming from a point of desperation, people smell that, people feel that. When you are networking with people, it’s going to feel weird. So you really want to start with, I think, taking that out. So when you are more established, what that means is usually having about 3 months of what it takes to keep your business afloat, saved up, so that you are never worrying about making rent as a part of your practice. So for me, I always keep like $20,000 just sitting in the bank, so that I have enough for rent, I have enough for… if I have big ideas I can go after them, and it’s taking a long time to kind of do that. At first, it was I just want a 1000 bucks in the bank and then it was I want 5000 and then it was 10,000, and so like these amounts that over time you build up because you realize, okay there is more liabilities. So I have Sam who is my chief marketing officer, I’ve got Emily who is my director of details. I have got all these expenses mix. Expenses per month are so much more than what my old salary was at my full-time job, that I want to feel like I am not going to have to say it to Emily, “Hey, I can’t pay you this month because I didn’t plan ahead.” And so really I think when you are struggling you can build in those habits of being smart with your money, keeping the risk low, and not investing in things you don’t understand, but also coming from a point where it’s like you got to have enough basic money coming in for your life so that you can be the best business owner as possible.[About building a business plan] Kate: Hello Joe, this is Kate Hedberg in Seattle there Joe, this is Kate Hardboard in Seattle one more time, I had one more question that I think grad students want to know, at least this grad student does. So I currently live in Seattle, Washington. I graduated in August and my plan is to move to a smaller city, Tacoma, about an hour south of Seattle. I was wondering if you could talk about, a little bit about how to build a business plan. I don’t have any kind of business backgrounds, but I am curious about just understanding the market better in this new city, Tacoma. F0r instance, I know that Seattle is very saturated with therapists and so I am googling how many therapists are in Tacoma, kind of making a spreadsheet of all the practices I can find and if their rates are listed on their website, I am noting down on the spreadsheet as well. I am kind of making notes on what kind of counseling they do etc. to give me an idea what the average going rate is, but I didn’t know how to be able to tell if the Tacoma market is saturated. Given the number of therapists per population, I don’t know if there is some kind of equation that helps you figure that out. Also I know that the Tacoma area is more blue-collar and different kind of like income demographic than Seattle which is fairly wealthy with the Amazon and tech industry. So I didn’t know if you could speak to how to build a business plan. Thanks.
Joe: I just love that you went for it, that you dropped three questions in there, and just that [Inaudible 00:20:57.16] was so amazing. I love it. Well, for one, our friend Moe who is a flight nurse in Tacoma, is one of our closest friends and she is amazing, and you guys should connect. She is awesome. And I love Tacoma, right at the base of the Olympic peninsula there. Such a cool place to move to. So the first, you’re picking up beautiful place to live, and then also… I think you are doing it right in that you are really evaluating the market. You are thinking about it. You are trying to understand it. But your central question of is the market saturated… when I was moving back here to Traverse City, my wife and I had got married in 2004. I was working in Marquette, Michigan, up in Michigan’s Upper Peninsula. Super rural… I mean, I would see eagles every day. Like it’s getting paid $30,000 a year to like drive through rural upper Michigan, and like we knew that time was coming to an end and we wanted to either move back to Traverse City or maybe Christina was going to go to grad school down in Kalamazoo. And I remember emailing some therapist in Traverse City to get a sense of Traverse City. And it was really sad. I got all these emails about private practicing was dying here. Nobody was making money here. It was counselor saturated, like don’t move back. You will never make it. No young people are moving back, and I was super discouraged. I wish I had those emails still. [Inaudible 00:22:25.03] old email that I ended up using as my spam email when I signed up for like old navy rewards and stuff. Ah, but you know if I had taken that advise and never moved back, that would have been a really bad decision. So we did end up moving to Kalamazoo, my wife did end up going to Grad School. We moved back in 2009 here to Traverse City. A couple of things that I have discovered is that people that say the market is saturated often have poor business skills in general, that they have not taken the time that even you have taken to listen to this podcast, meet people that are teaching business marketing to ask these questions. Instead, it’s just like, well, you can’t have a business here. It’s more like life happens to them rather than them happening to life. And so I would push back against that, that mindset. Because Traverse City is a counselor saturated area and I have a thriving private pay practice here. We have three grad programs that are all satellite campuses of bigger universities. Every year, we have 50 to 100 social workers and counselors that graduate and enter the market, and most of them end up working in a crisis center or other places, you know, making 12 to 15 bucks an hour with a Master’s degree. So the market in Traverse City for therapists is really sad. But we have discovered how we can have an awesome practice. The other biggest group practice in town, they’ve had the same website since 2007, when I started kind of watching people’s websites in town. Very similar to you, Kate, I had kind of my graph all the places to see who is hiring, what they are doing, what they are charging. Their website back then looked like it was from 1998 and it still hasn’t changed in 10 years. So the top group practice in Traverse City, other than mental illness counseling isn’t doing any good marketing. So basic marketing, basic blogging, basic connections in the community go really long way when you are looking to launch a practice. I would also say that your idea of a business plan – I know a lot of consultants talk differently about this, but for me I am not a huge fan of a business plan. Most business plans people create and then they put in a drawer and then they never look at them. That to me is a waste of time. Instead, I want to have something that’s functional, that kind of is what are the goals that you have for your business this year. So when you are in the startup phase like you, you know, really it’s creating a very clear structure for what you need to do next. So it might be the you subscribe to 20-step checklist email series that I have over at www.practiceofthepractice.com/start. Just work that list. Get the infographic. It is going to take some time, or maybe it’s that you end up getting into the private practice startup package or you get the $17 email list that I am figuring out what to call it, but I think I am going to call it the plan for your practice or practice plan [Inaudible 00:25:13.12] I will figure what to call it soon. But having some sort of step-by-step structure on what you want to achieve this year is more important than having some five year business plan for me, because I want you to be able to adjust and change, and not be like, well, here is my five year goal. I got to keep doing something that’s not working. What I prefer are what I call KPIs or key performance indicators, so things that really indicate success to you. So the amount of clients you are seeing, the amount of money that’s coming in. Maybe it’s the amount of networking that you do in a month. You have some clear measurables that you set for yourself as a goal that’s reasonable, that you can achieve, that can kind of stretch you. To me, that’s way more important than having some business plan. Everything I do, I think about what’s the function of what I am doing, Is that actually making a difference or is that making me feel like I am making a difference? So we can go on Facebook and we can be, you know, commenting and talking about our business and all that. But are we actually getting clients on Facebook. If not, you might as well talk to a brick wall. And so for me, really make sure that you are thinking about function and how function works.[Coordinating with client’s interdisciplinary providers] Marriott: Hi Joe, my name is Marriott and I am an LPC. I am in the process of beginning to work towards starting a private practice, I was wondering if you could speak to how you coordinate with the client’s interdisciplinary providers such as psychiatrists, primary care doctors, specialists etc. when that need becomes apparent with all of the other demands that are placed upon you. Thanks.
Joe: Marriott, I love this question because a lot of the other questions are more just like kind of business and marketing, but this also has that kind of clinical side. So when it comes to coordinating with people that are involved with your clients, I look at it in two ways. Is this more from a marketing perspective? So you want to get in front of other doctors or is it more a coordination of care perspective, such as this specific individual really needs me to coordinate with your primary care doctor because they are on the heavy psychiatric medication or something like that. So I think first establishing the main goal there – is it really that you just want to update the doctor or is that you have some genuine collaboration there. For me, it really depends on starting with what the client wants. Do they want that? So on our intake, we have a check box if they yes, want us to coordinate with their doctor, or no, they don’t. And so when I first started my practice, that was me. It was kind of calling that doctor, sending a letter, saying I am working with this client, here’s my personal cell phone number. So, that that person knew that I was available. And didn’t always get a ton of reception from it, doctors were really busy, but over time more and more doctors would really jump on the phone and say I only see this person once a quarter and I am prescribing these really heavy medications. I am so glad you are seeing them every single week. So to say there is a lot of value in it for the client that you are seeing, but also from marketing perspective. If you are sending reports to them, obviously with the release of information, everything ethically, and your brandings on it. And it’s a beautiful report whereas other peoples report don’t look as good, that’s going to be in their file, that’s going to be something they see. They are going to then see you as well. Regarding kind of limited time, I think you need to look at, kind of, what’s your role. You are not a case manager. You are not a wraparound coordinator. You are not someone that’s going to be doing community assessments. You are the counselor, and so making sure you are not overstepping that, because that quickly can become, that you become their case manager for things you are not getting paid for. And so I think that’s really important to make sure you understand what your role is at all, even more important than what your role isn’t in regards to your practice and your coordination with your client’s caregivers.[Learning challenge of therapists] John: I see this kind of split between therapists who are pretty ambitious and they are willing to learn new platforms themselves like Google AdWords or Facebook ads or something like that. And other folks just say I want to have nothing to do with that, but I will pay some more and I just want to focus on seeing my clients, right? How do you help therapists make those decisions?
Joe: Yeah, I think first you need to look at what phase of practice you are in. There’s really only three phases. There is your startup phase, when you are kind of bootstrapping it. You are trying to learn everything. You have to wear multiple hats. That usually takes you up to about $50,000 gross. So really during that phase, you want to focus in on your ideal client and you really want to kind of learn as much as you can about things in the practice. Next, you got kind of your growth phase, which is where you are going up to about a$100,000 and you are really looking at, how do I better optimize my time. Is it worth it for me to put time into managing Facebook ads or is it worth it for me to outsource that to someone? Should I add clinicians to the practice so that I can start to grow a little bit more. And then really at that $100,000 mark, that’s when you move into the scaling phase and you are really looking at, how do I remove myself from the practice from all of the non-essentials.[MUSIC] [CONCLUSION] That last question was John Clarke from the private practicing workshop podcast, and next week you are actually going to get to hear that entire interview that he did it with me. It’s a reverse podcast where he is asking the questions, I am giving the answers. We are having discussions about marketing and practices. So make sure you don’t miss that every Tuesday morning. Bright and early this podcast goes live. So we would love for you to be a regular subscriber. Rate and review us in iTunes. So many great reviews. Thank you so much for those. And again, Brighter Vision, thank you so much for being a sponsor on the podcast. If you are looking for an amazing website for $59, that looks like it cost thousands of dollars, head on over to www.brightervision.com/joe and you will get that first month free, and I will talk to you guys next week. Have an awesome week. Bye. [MUSIC]
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