[JOE SANOK]: Is 2021 the year that you want to rock out private practice? If so, I’m so excited that right around the corner, we have our next cohort opening for Next Level Practice. Next Level Practice doors open on February 15th, and you’re going to want to be there. If you aren’t already a member, then you don’t know all the amazing benefits you get. You get over 30 e-courses that will walk you through starting and growing a practice. You’ll get in a small group, you’ll get an accountability partner and we have amazing people coming up like Dr. Julie Schwartz Gottman, that’s going to be one of our experts that you get to pick her brain live in a small group. So, if you want access to experts like Julie, or you want access to 30 plus e-courses, or you just want to get up to that next level in your private practice, head on over to www.practiceofthepractice.com/invite and make sure you get access today.
This is the Practice of the Practice podcast with Joe Sanok session, number 530.
Well, welcome everybody to the Practice of the Practice podcast. I’m Joe Sanok your host. If you have been a listener for a long time, I’m so glad you’re here. Thanks so much for being here and listening and being a part of the Practice of the Practice podcast and the Practice of the Practice community, and especially all of you Next Level Practice people. So glad that you are here today as well. As you know, I’ve been doing this series where I’m interviewing people from Next Level Practice that are part of our community and doing some individual coaching. And today we have Elizabeth Meyer and Elizabeth has been described as a warm, caring and intuitive therapist. She has a growing practice and she’s got some questions. How are you doing today, Elizabeth?
[ELIZABETH MEYE…: I’m good. Thanks for having me on your show.
[JOE]: Yeah, I am so excited. So, why don’t we just start with, tell us a little bit about your practice and then we’ll hear your question.
[ELIZABETH]: so, I work with, I specialize in working with women through all stages of life. I specialize in working with people with anxiety, depression, relationship issues, and people just struggling to find meaning in their life.
[JOE]: Those are really important topics, especially, you know, with 2020 now, behind us, but definitely going to be some carry over of that anxiety, depression. It’s not like it just goes away with a new year. So, tell us how your practice has grown. When did you start it and where are you at now?
[ELIZABETH]: So, I joined Next Level Practice, I think in June of 2019 with the intention of really start working on it in September. I rented office space and opened the doors officially last January. And it’s grown, you know, of all the businesses that opened during a global pandemic, it turns out a therapy business was a good choice.
[JOE]: Yeah. It’s funny how it’s better than opening a restaurant
[ELIZABETH]: For sure. So, I’ve grown really well. I find that I’m full and yeah, I’m doing really well.
[JOE]: And when you say full, I know for each person that’s different, what feels full to you in regards to hours?
[ELIZABETH]: So, I’ve been kind of exploring the leading edge of that. And I think like 17 to 19 is about as full as I can manage.
[JOE]: Okay. So, what’s your question today?
[ELIZABETH]: So, my question, Joe, I feel like I’ve spent so long working to get full and working to take people on. So, now that I’m full, I’m finding that it requires a slightly different mindset to turn people way. Like that just feels really weird. And I find myself maybe taking on more people than I can. I feel like my schedule is a little out of control if that makes sense.
[JOE]: Yeah. And I think, let’s just kind of normalize that first because you know, when you’re hustling and working and trying to just get clients and doing website updates, it feels like there’s just so much to do that’s not clinical. Then you start to get all these clients and you feel appreciation, but then it’s like, “Okay, now I’m full. What do I do now? How do I keep moving forward so that it’s not only based on my time?” So, it’s super normal to experience that shift after you finally have filled up your schedule.
[ELIZABETH]: And if I made Joe, I think it’s also about like managing that, because like one week I got three referrals and I turned everybody away and then two weeks later, two people were like, “Oh, I’m all better. I’m done.” And then two people went to halftime, but like I’d already turned, so, just like how to manage the flow of that as well as the calendar.
[JOE]: Well, and I have some kind of logistical questions. So, do you, are you primarily insurance-based or primarily private pay or a mixture?
[ELIZABETH]: I’m primarily insurance based.
[JOE]: Okay. And then, you don’t have to name names are there other insurances you take, are there insurances that you just don’t like working with?
[ELIZABETH]: Well, I just take one.
[JOE]: Oh, okay. And you stay that full from that one. And do you have any private pay people?
[ELIZABETH]: I have a few here and there.
[JOE]: Okay. And is that something you want to develop or are you pretty happy with the insurance-based approach?
[ELIZABETH]: Well for sure, you know, the private pay field’s easier for sure, but I think in my geographic area, most people do tend to use insurance and that’s fine.
[JOE]: Okay. yeah, so, that’s good to just identify, are you going to stick with private pay or are you going to stick with insurance or are you going to have a mixed model. So, I think as the listeners, you know, they want to think through that. So, you know one of the downsides of taking insurance is that your economic ability to raise rates is very limited. And so, really the only way to make more money is to find other revenue streams, that could be coaching, e-courses, things like that, or it could be having additional clinicians in the practice. Are you interested in growing a group practice at all? Or do you want to keep solo?
[ELIZABETH]: I’m intrigued by the idea of group. I’m not sure I have the bandwidth to take it on at this time.
[JOE]: Okay, and when you say not sure bandwidth, so if it were easy, would you do it or would it be, is it something that you’re, “I just don’t know if that’s even worth my time.”
[ELIZABETH]: Maybe, you know, I feel like I’m interested in learning more because I’ve definitely heard people talk about it and I’m turning away referrals and the idea seems really intriguing. Like, wow, maybe I could have someone work under me and earn more money. That does sound very appealing.
[JOE]: Okay. So, a couple of things that we want to think about at this phase when you’re shifting from kind of just solo, trying to fill up your schedule to, “Okay, I’m full, what do I want to do?” So one thing is to look at raising rates, which is hard to do if you’re on an insurance. We kind of can rule that out for right now, looking at expanding beyond your own time. And so, that looks different in a few different ways where you add clinicians to the practice and that can be super part-time. It can be that you have someone that wants to do five or 10 hours a week, so that when you do get these people that you’re not turning them away. That you can say, “m full, but I’ve hired so-and-so and they’re great. I handpicked them. They also do the same type of work.” And then also examining where you’re spending time outside of your clinical time. So, that could be on billing that could be on sitting on phone calls with insurance companies, dealing with you know, whatever it takes to kind of keep the business going. Where are you spending time right now that’s nonclinical?
[ELIZABETH]: I feel like it’s pretty well managed. I feel like probably 95% of my time is clinical.
[JOE]: Okay. So that remaining 5%, what’s that look like?
[ELIZABETH]: So that’s probably phone calls to insurance you know, verifying eligibility or if there’s an issue and just following up. And you know what, and honestly, intake calls, I feel like not intake calls, but like the, get to know we’re a good fit. I spent almost an hour with someone the other day and I was shocked to realize I had spent that much time with them.
[JOE]: So, I would highly recommend it this level that you start to look at a virtual assistant that can do those phone calls, and then they can say, “Let me look at Elizabeth schedule and see where we can do the get to know you call. These are quick 10 minute calls, and then if that’s a fit, then you come in for the intake.” So, having that buffer between you and your clients, especially on the intake and checking of benefits, that could be a virtual assistant. That could be a billing company. It could be a variety of different things, but I think that making sure that you only do what you do best and then outsource the rest that’s a really kind of, at this phase, it’s totally worth it. If you do one extra session a week, because you’re not spending that hour, for example, on an intake call, that’s a lot of money and, you know, at 15 to 20 bucks an hour, you’re then buying that time for somebody else to kind of build out that system within your business.
[ELIZABETH]: That sounds great. I guess I hadn’t thought that I needed one, but when you put it like that, that makes a lot more sense.
[JOE]: Yeah, I’d say in general, when people are at at least 10 sessions a week, that’s when they want to start looking for a virtual assistant, unless they want to do it earlier than that, but that’s where financially, it really starts to make sense because you’ve got that momentum where people are calling, people are coming in and you’re only doing the work that you’re best at. Also you’re probably going to see an increase in referrals by someone actually answering the phone every time because if you’re the primary person, then you know, people kind of go through the Psychology Today list or they go through their insurance approved list. If someone doesn’t answer the phone, then they just move on to the next one. And so, if you are moving towards a group practice, you can then be able to have a growing list of people that will be referrals to those other clinicians.
[ELIZABETH]: Hmm. Okay.
[JOE]: So, if you had some extra time, things were clicking along with a virtual assistant and we’re thinking about new streams of income, does it feel like a group practice would be the direction you’d want to have kind of the rest of the consulting call or would you want it to go into kind of other streams of income? What have you been feeling in regards to, if you can automate more where you would spend that extra time?
[ELIZABETH]: Well, I’m glad you asked, because I’m also a certified coach and my intention was to grow my therapy practice first. And when that was sufficiently stable to launch a coaching practice, you know, side by side.
[JOE]: And what kind of coaching?
[ELIZABETH]: I’ve been, I think that I’d like to work as a mindset coach with women entrepreneurs. You know, I kind of know what my own struggle was to surmount that imposter syndrome. I’ve been a stay-at-home mom for 14 years and getting my mind back in the game was like a really big deal. And I could see that once I was there, that was a really big shift. So, I’d love to be able to offer that for other women entrepreneurs
[JOE]: And from a licensing and ethics side, have you examined your state laws? Because I know every state’s a little different around people that are licensed that also are coaches. Have you made sure that there’s no conflict there?
[ELIZABETH]: I need to do a little more double-checking. My understanding is that if I have two separate businesses with two separate LLCs you know, separate websites, separate marketing, separate phone numbers, then all of that will be kosher.
[JOE]: Okay. And so, then we would want to look at what’s the return on investment for your time to set all that up. And so you know, if you can charge two or $300 an hour, whereas the insurance is paying you $95 and 12 cents or whatever it is then yeah, that’s going to be worth it if you can scale and take on five clients that are at a much higher rate. We always want to be looking at a few different things. How do we go from one-on-one to one-to-many. So, that can mean one-on-one counseling to going to group counseling because that’s going to be more profitable. It can be going from one-on-one coaching to say mastermind groups or a membership community. And so, there’s a lot of ways to build that, but I would say for most people when they have as many referrals coming in, as you have coming in and you know they’re already pretty close to maxed out at, you know, 18 to 20 sessions per week, the actual energy you can put into that coaching is going to be an hour or two a week.
And you’re going to be exhausted. You’re going to not be as on your game as imagine that you added a couple more clinicians, you had that income that was outside of your own time, you were doing say 10 sessions a week, and then you were doing 10 hours a week working on your coaching business. You’re going to be better positioned to move forward faster with a coaching business or kind of whatever that level up looks like, if you have that passive income coming in through a group practice, assuming you want to do that, which you said you did. Some people just say, “I don’t want a group practice.” So, then this advice wouldn’t be for them. But that to me seems like super low-hanging fruit compared to let’s build an entirely new audience that is going to have an entirely new website, new LLC. Those are all good things. Those are all things that I think you absolutely should do if you want to. But if I just look at those two directions, a group practice, even if it’s a small group practice versus the coaching, I’m seeing that the low-hanging fruit really is bringing in a couple of people because you’re already referring people out. You might as well keep that money in house and keep those clients in-house, assuming they’re a good fit for your clinicians. How does that feel in regards to deciding the direction between the two?
[ELIZABETH]: Again, I hadn’t thought of it that way, but when you say it out loud and put it like that, that does seem kind of easy.
[JOE]: Let’s just run some numbers. I’ll pull up my calculator. So, how many referrals out do you think you’re referring out in any given month at this point?
[ELIZABETH]: Let’s say five.
[JOE]: Five, okay. So, then that would mean that within three months, assuming those people, would you say that they are really warm leads? Like they are ready to start and then they would probably convert? Or would you say they’re 50/50? Like how many of those five do you think would actually convert to another clinician?
[ELIZABETH]: Let’s speak, let’s say four.
[JOE]: So, four per month. And let’s just say over six months. So, within six months, that person is able to see 24 clients. Now let’s just say they lose 20% of those clients. So, 80% of that 24 would be 19.2 sessions a week, you know, within a handful of months there. So, you bring on this hypothetical clinician, they are seeing 19 sessions a week about how much, and you’re supposed to give a range, not the exact amount that you make through insurances, because that usually breaks your contract. What’s around the amount that you would bring in for insurance? Like what’s the range you’d say?
[ELIZABETH]: Let’s say if we said between 60 to 80.
[JOE]: Okay. So, if we do say $70 a session that person’s bringing in, then 1344 a week and say that person works, and this can be split between two people. So, it could be one person that does certain sessions.
[ELIZABETH]: Sorry, a week or a month.
[JOE]: That would be, so if you’re getting four people a month that are saying they want to come, they aren’t usually just coming monthly. They usually come weekly or every other week. So, that would be per week, so 1344 a week. And so, say that person did 48 weeks a year, and say, people did come every other week. But if we think about it, four new clients a month, that’s just one new person a week. So, this is really conservative in regards to our numbers, which I like to do when we’re talking these things. I hate when consultants are like, “You can make millions of dollars off of this.” And you’re like, “Those numbers don’t work.” But this is off of four new clients a month for this person that you’re referring out. So, that would be $64,512 per year.
Now say that you are taking home 40% of that after your costs, after paying them, all of that. That would be an extra $25,804.80 cents per year just off of the clients that you’re already turning away. That’s basically with no new marketing. That’s with just setting up your systems. I would say if you’re as busy as you are, it’s worth it to work with someone like Alison or Whitney. They have mastermind groups that are relatively inexpensive to help you learn how to set up a group practice, just to save yourself the time and do that to make 25 grand a year extra. And that’s one person or that’s two really, really part-time people. And so, if you figure over time, your marketing is going to get better. Your SEO is going to get better. Your networking is going to get better.
Do you think that over the next year, you’ll get more than four new referrals a month? Probably. Yeah. You know, and so then imagine that you are making say $40,000 or $50,000 off of other people in your group practice. That then emotionally lets you say to yourself, “You know what? You doing around 20 sessions a week just feels like a bit much. I really want to do this coaching work.” So, then as people discharge, you can say, “Okay, I’m not taking any new clients,” or maybe you personally move off of the insurance panel and now you’re only private pay or you only take on coaching clients at that point. You can make all those decisions at that point. You don’t have to know that now.
So, then it’s a lot easier to reduce your hours down and say, “I’m going to take a risk on this new LLC, on this new coaching, on reaching out to this new audience.” Maybe you start a podcast, maybe you start being interviewed on podcasts to get a broader audience. At that point then you can put in 10 hours a week, 15 hours a week versus just, you know, an hour here and there were over two months, you’ve put in 10 hours. So, does that make sense why that would typically work better to build out a small group practice to then open that door to the consulting?
[ELIZABETH]: Yeah, that’s, again, I hadn’t thought of it that way, but you make it sound like very easy and very doable. And with that income coming in, that gives me that room to cut down from 20 clients a week to 10. And the other day, instead of seven clients, I saw six clients and I could see what a difference that made in my energy at the end of the day. So, going from 20 a week to 10 a week, I can just see how much that would free up of my emotional energy and my bandwidth.
[JOE]: Yeah. Well, and I think that some people think, “Oh, why would I want to do another group program or mastermind group or e-Course or consulting?” But then in the same way that you’re outsourcing, you know, the phone calls moving forward, then you’re outsourcing those intake calls, in a sense you’re outsourcing the gathering of information to an Alison or a Whitney who already have mega group practices. I mean, Alison, when I first met her and she was doing one-on-one consulting with me, she made $30,000 that first year, which wasn’t that much. And I think it was a year ago or two years ago, just a couple of years after her consulting, she was doing 30K a month. And so, it’s like, when you get that consulting and you get that help, it’s just that shortcut to kind of outsource the knowledge acquisition.
And if you think of it that way rather than, “Oh, I’m just paying a consultant.” It’s no, it’s someone who’s done this before. You can just say, “Here’s exactly how to do it. Here’s the questions to ask your attorney, ask your accountant. Here’s the things to set up. Here’s the systems. We’ve all done it before. And then here’s a community of people like Group Practice Boss that surround you and say, “Hey, you’re doing it. I’m doing it too. We’re all new to this. Let’s learn together.” In the same way, Next Level Practice helped you go from no practice to a thriving practice in less than a year. I mean that investment of a hundred bucks a month, I mean has made you significantly more than that. And so, the same sort of thing, and this isn’t even meant to sell you on like coaching with them, but when you think through your own coaching, this is how I think about it.
I just hired a Facebook Ads specialist. He’s way more expensive than if I paid one of my virtual assistants, but he knows this stuff. And so, I know that the thousand plus that I’m going to pay per month for him to spend minutes on my Facebook Ads, he knows it. He can do it quickly. It’s going to save me time and frustration and you know, potentially wasting a bunch of money on Facebook Ads that are not working or converting. So, hiring those experts is a big shift for most of us because we were never taught business, let alone taught how to invest in other experts that can help us get to that next level.
[ELIZABETH]: Yeah, no, I get it. I’ve been doing a lot of reading and doing a lot of mindset work on my own, so, I totally get it. I totally get the, you know, the value of someone who’s done it for themselves and can teach me how to do it. So, that makes perfect sense.
[JOE]: Yeah. Well, so as you think through kind of this consulting call, as we kind of get to the end of it what are things that this week you’re going to commit to working on to help get to that next level so that you don’t just go back to kind of how things were before this call? So, what are a couple of action items that you want to work on in the next week to take some big action forward?
[ELIZABETH]: Yeah. Well, I guess I need to look into a virtual assistant. Like how does that work? How do you find the right person? How do you set it up? And I guess I need to look at how do I hire a clinician? How do I find someone who would like to be private practice part-time?
[JOE]: Yeah. Awesome. Well, a couple of resources that are people that we trust and you can interview whoever you want, but move forward. Virtual Assistance is a great virtual assistant company. If you just want to accompany to take over that, they only work with therapists. Also Alison Pidgeon started Group Practice podcast. It’s a really good podcast to just listen to when you’re thinking about starting a group practice, to get some of that information.
[ELIZABETH]: That sounds great. I’ll be sure to check those two out.
[JOE]: Awesome. Well, Elizabeth, thank you so much for being on the show today. If you are listening right now and you’re saying to yourself, “I want this kind of advice. I want to know what’s working. I want to be able to have access to experts.” Those are all things that we cover in Next Level Practice. Next Level Practice is a membership community that right now is $99 per month. You lock in that price. So, even if we raise our price later, you lock that in. And we actually have some amazing partnerships that are in the works that I can’t announce yet, but that are going to be huge value adds to our Next Level Practice community where they’re going to get access to just some really amazing resources that usually you have to pay for. And so, when we find these deals, when we find these partnerships, we pass them on to our members so that they can move quickly like Elizabeth did. You know, within less than a year, she went from starting a practice to being as full as she wants to be. Now she’s looking at a group practice.
If you want these kinds of results I want you to sign up for the next cohort. The next cohort is coming up quickly. So, head on over to practiceofthepractice.com/invite. You can read all about Next Level Practice. You can see if it’s a fit for you and see if it might be something that you want to sign up for to join people like Elizabeth in our community. Thanks so much for letting us into your ears and into your brain. Elizabeth, thanks so much for being on the show today.
[ELIZABETH]: Joe, thanks for having me. This was awesome.
[JOE]: Special Thanks to the band Silence is Sexy for your intro music. We really like it. And this podcast is designed to provide accurate and authoritative information in regard to the subject matter covered. It is given with the understanding that neither the host, the publisher or the guests, are rendering legal, accounting, clinical, or other professional information. If you want a professional, you should find one.