How do you keep your mindset well balanced, while getting your solo practice running? Which system is best for payroll: accountants or websites? How can you use LinkedIn to maximize hiring? These are the types of things to consider when you want to grow your private practice.
In this podcast episode, Alison Pidgeon does a live consulting call with Michelle Croyle about mindset, potential clinicians’ skills and practical tips on growing and running your private practice.
Try out TherapyNotes! It makes notes, billing, scheduling, and telehealth a whole lot easier. Check it out and you will quickly see why it’s the highest-rated EHR on TrustPilot with over 1000 verified customer reviews and an average customer rating of 4.9/5 stars.
You’ll notice the difference from the first day you sign up for a trial. They offer live phone support 7 days a week.
So when you have questions, you can quickly reach someone who can help, you are never wasting your time looking for answers.
If you are coming from another EHR, they make the transition really easy. TherapyNotes will import your clients’ demographic data free of charge during your trial so you can get going right away.
To get 3 free months of TherapyNotes, no strings attached including their very reliable telehealth platform click on www.therapynotes.com and enter the promo code: Joe
Michelle Croyle is a licensed professional counselor from Pittsburgh, PA. She specializes in helping women overcome the effects of anxiety and trauma. Michelle also hosts The Free to Be Me podcast where she helps Christian women to overcome the things that hold them back and to become all God has created them to be. She and her husband, Tim, have three young adult children and do marriage mentoring and coaching together, as Marriage Guy and Gal.
In This Podcast
- Mindset to grow your private practice
- Can you require skills from potential clinicians?
- Payroll: Accountants versus websites?
- Using LinkedIn for hiring
Mindset to Grow Your Private Practice
When you find yourself in a difficult place with your group practice or you are not sure where to go, go back to the reason why you wanted to start one in the first place.
Remind yourself of these reasons, whether they were for financial independence, helping the community, or rebuilding your strength and your resolve.
Can You Require Skills From Potential Clinicians to Grow Your Private Practice?
Yes, you can. You can discuss these qualities or skills in the hiring process with this potential clinician:
That is something you can absolutely require and you can talk about that in the hiring and interview process [and explain to them that] this is my vision for the practice and is this something you’d be interested in, would you be excited about getting this training and working with these types of clients or not? (Alison)
By having these kinds of discussions during the hiring process you can weed out the clinicians who may not be a good fit for the future that you see for the group practice. This can also help you to hire the clinicians who are the best fits for the practice because they share your interests and passions.
You would have to pay for their training. If it is expensive, you can sign a form between yourself and the therapist that says that the therapist will remain with the practice for an extended period of time after the training.
If they decide to leave before the agreed upon period of time, then they need to repay you for the training that you invested them into.
Payroll: Accountants Versus Websites
There are pros and cons to using either one of these two options.
I would ask specifically what they are going to do as part of their services and make sure that it includes everything that you need. (Alison)
It is simply important to make sure that whichever option you choose will serve you the best way that you need. Both options have ways of helping you ad ways of needing attention.
It is up to you and the time that you have available to you to figure out which one would serve you and the practice best.
Using LinkedIn For Hiring and to Grow Your Private Practice
- Head onto LinkedIn and see if there are any suggestions for people you can connect with,
- Check if they are perhaps in your state, and
- Check if they are in and have experience in the mental health field,
- Connect with them.
When you are hiring, you can then reach out to those people that you have connected with via a post on your personal LinkedIn.
You can also make a business page on LinkedIn where you can post a job opening through your group practice’s own page and in this way potential clinicians can interact with your business virtually and directly.
Another tip is that you can directly message people without making it feel like spam. Reach out to people who you would want in your practice and see if they would be interested in working for you.
- The Free to Be Me Podcast with Michelle Croyle
- Email Alison: email@example.com
- PoP Group Practice Owners Facebook Group
- Free resources to help you start, grow, and scale
- Work with us
- Consult With Alison
Meet Alison Pidgeon
Alison is a serial entrepreneur with four businesses, one of which is a 15 clinician group practice. She’s also a mom to three boys, wife, coffee drinker, and loves to travel. She started her practice in 2015 and, four years later, has two locations. With a specialization in women’s issues, the practices have made a positive impact on the community by offering different types of specialties not being offered anywhere else in the area.
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.
Thanks For Listening!
Feel free to leave a comment below or share this podcast on social media by clicking on one of the social media links below! Alternatively, leave a review on iTunes and subscribe!
You are listening to the Group a Group Practice podcast. Whether you were thinking about starting a group practice, are in the beginning stages, or want to learn how to scale up your already existing group practice, you are in the right place. I’m Alison Pidgeon, your host, a serial entrepreneur with four businesses, one of which is a large group practice that I started in 2015. Each week, I feature a guest or topic that is relevant to group practice owners. Let’s get started.
Welcome to the Grow a Group Practice podcast. I’m Alison Pidgeon, your host. We are doing a series right now of live consulting sessions with our Group Practice Launch members. So Group Practice Launch is a community where we lead people through the process of starting a group practice over a period of six months. And today I am having a consulting session with Michelle Croyle. She’s a licensed professional counselor from Pittsburgh, Pennsylvania. She specializes in helping women overcome the effects of anxiety and trauma. She also has a podcast called the Free to Be Me podcast, and she does marriage mentoring and coaching with her husband, Tim, and they call themselves the Marriage Guy and Gal. And on top of that, she is starting a group practice. and her practice is called abundantfreedomcounseling.com. And she has a bunch of questions related to how to find clinicians and how to get your mindset right about starting a group practice. So I really enjoyed working with Michelle and I hope you learn something from this live consulting session.
[ALISON] Hi, Michelle. Welcome to the podcast.
[MICHELLE CROYLE] Hi Alison. I love that I get this chance to talk with you.
[ALISON] Oh, thank you so much. So let’s start out by you introducing yourself and your practice.
[MICHELLE] Okay. So I’m a licensed professional counselor in Monroeville, Pennsylvania, which is just outside of Pittsburgh. I specialize in helping Christian women overcome trauma and anxiety. I currently have just completed my EMDR certification and training and I’m working towards certification. I really want to move into a group practice because I want other excellent trauma informed clinicians to work with me so that we can have a greater impact and touch the things that talk therapy can. I’m currently on two insurance panels and the rest is private pay, but in all honesty, it’s mostly insurance and the two or three private pay clients I have is pretty much the standard. That’s the proportion. It’s usually just my two insurance companies that I see.
[ALISON] Okay. Very nice. So I know you have a bunch of questions for me so we can definitely jump right in.
[MICHELLE] Yes. So I guess my first question is regarding mindsets. So I’ve loved the documents and everything in the Group Practice Launch. I found it to be incredibly helpful and worth the investment in this process to have the scripts and the tools and all of those things. There’s some stuff around that that I do have questions on, but before we get into that, I think my biggest question is mindset as far as I keep finding myself, getting stuck with things are great right now because I am making good money for the hours I’m putting in. I love what I’m doing. I love my clients. I also love working on the business and, and things like that. My undergrad was communication, journalism, public relations. So it’s kind of a really perfect fit in all areas. As far as marketing and everything, I love it.
But when I think of expanding to a group practice, my question is how do you get past the mental block of, oh my gosh, there’s so much to work on upfront and all the investments with all of these systems like payroll and benefits and extra people coming on and phone systems and the cost for that and the electronic health record. I mean, the mindset is just, do I even want to bother? I mean, it just seems like so much work for not a whole lot of return. And I know that’s not true, but I was just hoping I could get your kind of answer to how you would approach being at this stage of going, “I’m doing okay. I really want to make the week, but I really don’t.”
[ALISON] Yes. That’s such a great question and I’m really glad that you brought that up. I feel like that’s something that we should talk more about in the group, because I think there is a lot of mindset shifts that need to happen when you’re scaling up your business. It’s one thing to start a practice and you’re the only one in it and it’s a whole another thing and a whole another leap of faith to start hiring people and be depending on other people to provide really excellent services and represent your brand and all of that kind of stuff. So I think a lot of it comes back to your reason why you wanted to start it in the first place. So I know for me, it was about being able to increase my income and also having more freedom of my time because of having little kids at home.
So when, I won’t sugar coat it for you. Definitely the first two years were tough and I wish I had gotten business coaching or consulting sooner because I would have avoided a lot of mistakes. So I think that’s one thing that you’re obviously doing the right way is that you’re reaching out for help as you’re building it and getting started. So you can learn all those shortcuts and you can learn from me and Whitney, like what is worth investing in right now versus not?
[MICHELLE] And I really do appreciate that. I got, I purchased QuickBooks and I just got set up with Spruce and TheraNest. So I greatly appreciate everything, but then as I start to think, okay, so that’s another, every time I bring someone on, that’s another fee to this, that’s another fee to that, another fee to this. How do you approach that?
[ALISON] So I think that’s where you’re putting all of this work and money and time into the beginning piece. It’s like you’re front loading it in order to, at some point down the road, it sort of like grows exponentially. And then those costs that you’re spending every month are, are going to be small compared to the amount of revenue you’re generating. And that’s obviously not happened yet because you haven’t hired anybody.
[MICHELLE] Yes. Well, I did. I did hire somebody as an independent contractor back in November and she had the heart for the trauma and working with Christian women and it was a great fit, wonderful clinician, and she wants to have a baby and she ended up getting an offer with full benefits, which at this point I couldn’t do so she left. So at that point I was thinking, how do I transition this independent contractor into a employee? And, oh my gosh, I’m going to have to lower from the 60/40 split. I’m going to have to lower it but then to be able to do benefits and everything, and right as I was trying to figure out that all of that is when she’s like, “I got this job. It fell in my lap.” I have to, and I’m like, “No, you have to take it. I get it.” And so now I’m back to solo. I mean, she just stopped this week. She gave me like a month of extra work, which I really appreciate it, but that’s the other piece. It’s mindset, but it’s also these costs and the efforts, like, I guess I’m scared. What if that happens again? You know, only I do it with an employee and I’ve put in all these front-loaded costs and it was for nothing.
[ALISON] Right. And this is where, you know the first time all of these things happen to you, it’ll feel like absolutely terrible and like a crisis and then the second time, because it will happen again.
[MICHELLE] I figured.
[ALISON] The second time and the third time it happens you’ll be like, “Okay, this has happened before. I know how to handle it.”
[MICHELLE] “This is how we regroup.”
[ALISON] Yes, and you’ll learn, like I learned along the way that like, I need more therapists than I sort of the break even point for like the overhead, like I need over and above that. So that way, if somebody leaves, it’s not like this big financial hole that I’m in. Does that make sense?
[MICHELLE] Okay. It really does. It really does. So —
[ALISON] Yes, I think the other thing I was going to mention too, just about the initial investment piece is that you’re not really going to see a big chunk of your salary coming from the practice and what the other clinicians are bringing in until you’re grossing between $350,000 and $400,000 a year. So there’s kind of a tipping point at which it’s like, “Oh wow, this is great. I’m finally making money from the group and not just making a salary based on the clients that I’m seeing.”
[MICHELLE] Wow. Okay. And so typically how many, so like if we just use an estimate of like a hundred dollars a client and we say that you know, I have to bring on a certain number of clinicians to see 25 a week or whatever. Do you have an idea of, is that a two year process, is —
[ALISON] I’d say a rough estimate would be like, you probably need five to six clinicians.
[ALISON] So that’s why, like when I talk to people and they’re like, “I just want to build a small group practice, maybe hire one or two people,” I usually tell them that that’s probably a not great idea because they’re not, you’re going to be making all, putting out all this money to bring on these one or two people, but you’re not going to be seeing the return in terms of profit.
[MICHELLE] Okay. Okay. Okay. So then my next concern then goes to people who are specifically the first enough for the majority of the population I serve, which has the added component, not only of trauma focused, but at the faith-based. And knowing that there’s a lot of difficulty as far as hiring right now, people being available and such is this something that you would still advise to start with at this point or is it just not worth it until there are more, there’s less of a demand for therapists being hired so that I can get up to that five or six point?
[ALISON] I wouldn’t necessarily stop trying to hire right now. I think you’ll just have to be a little bit more creative in how you hire. Like, I don’t think it’s going to be as simple as just running an ad on Indeed and you get like 20 great applicants. I think you’re going to have to do a lot of like word of mouth networking messaging people through LinkedIn, things like that in order to get good candidates. But I wouldn’t necessarily like put everything on a hold because I think that this is probably going to be years to come that mental health services are going to be less in demand like everything from the pandemic I think it’s going to be a ripple effect and it’s going to go on for years. So, I don’t think there’s any sense in —
[MICHELLE] It doesn’t help anything. Yes. I guess that was wishful thinking.
[ALISON] I guess another, I guess I would ask you this, not that I’m your therapist, but are you looking for reasons to avoid taking this leap? Because I think that can happen too. We can make it lots of excuses why now is not a good time.
[MICHELLE] Yes. I think that the trouble with me isn’t really, I mean, it’s not really a bad thing. It’s not really trouble, but it’s that if I’m going to do something, I’m going to do it and I’m going to do it really, really well. And I love my private practice where it is right now, I love everything about it and I’m like, why mess with a good thing. But then I look towards the higher, the higher purpose of financial freedom for my family and of freedom from pain and suffering in society in general, or at least the greater Pittsburgh, Pennsylvania area. And I go, yes, it’s worth all the effort and investment. So it’s kind of like I go back and forth between contentment, which isn’t bad, but you know, as far as benefits that I’m getting out of it, there’s altruistic, there’s faith component, there’s financial, but on both sides, I can make good arguments.
[ALISON] Yes. And I think that’s where, like you ultimately have to decide what, they call it you why. What is your why? And as you said, you’ve created a wonderful job for yourself that you love and you make good money for what you’re doing but you know, it sounds like you want something more than that and obviously you being into low practice, isn’t very easily going to get you to that next level.
[MICHELLE] It’s not going to scale.
[MICHELLE] I’m doing it. I know I’m doing it. That was good consulting Alison. That was good.
[ALISON] Thanks. Yes, I also think about like, for me too, it’s about kind of like leaving a legacy for my children. They were very young when I started my practice and it was really hard to have like toddlers at home and trying to grow a practice. And I would just think like when they get older, they’ll realize what I built and I want them to be proud of me and I want to leave a legacy for them. So that also helps like get me in —
[MICHELLE] That’s awesome. I love that. So as far as, my next question is around the desire. So when we looked at our vision statements in the Group Practice Launch, my vision is, I’m not reading this, this is just my vision off the top of my head right now, but is to really impact Christian women who need to overcome, who are just struggling and want those trauma-based skills to overcome the things that hold them back in life. And so I want to be able to be the cutting edge of clinical excellence and have my staff be clinically excellent as well. I personally love the EMDR basics and then from there would love to have everybody trained in other things and branch out, but I’d really like that to be a solid thing that every clinician offers to clients. So I’m just wondering, is that something that I can require of a W2 and then I will obviously have to pay for it, I’m guessing. And then like, how would that go into an offer letter?
[ALISON] Yes, that’s something you can absolutely require. And I would say too, talk about that in the hiring process, the interview process, like this is my vision for the practice and you are, is this something you’re interested in? Would you be excited about getting this training and working with these types of clients or not? Because that’s going to help you to weed out the people who won’t be good fits. And then yes, you can absolutely require it and you would have to pay for it. if it’s quite expensive, we have developed a form and I can certainly share this with you or share it with the group that basically says like we’re paying for this training and so you’re agreeing to stay at the practice for a certain length of time or else if you quit before this time, you have to pay back what we paid for the training.
[MICHELLE] Oh that would make me feel so much more secure. Yes. Okay. Yes, because if I’m hiring five or six clinicians and trying to afford $1,500 training a pop, they need to be able to help me at least recoup that or pay back.
[MICHELLE] But that is something I can do.
[ALISON] Oh, yes.
[MICHELLE] I try to think about, it’s so weird in my kind of perspective how I look at things as it’s almost like the whole confidentiality piece that we learned as therapists and you know, be careful how you market so at this, and all that stuff makes me forget that it’s a business. And I think, well, could McDonald’s do that. Could some other company? Could Walmart do that? Could they require that people have to go through a training? My daughter works at Chick-fil-A. They required training. I mean, so of course I could require training but it’s kind of that almost like, well, business doesn’t apply to counseling and I’m like, no, if I’m going to have a counseling business, it has to.
[ALISON] Right. Exactly.
[MICHELLE] So that’s that mindset too. It’s like, what am I allowed to do and what am I not allowed technically to do? But I think as long as it’s not anti client you know, the best results and privacy for them, you can still run a profitable business and require excellence from your employees, just like Walmart. I mean, is that the right way to think of it? I mean, not Walmart, but you know, something that does require excellence of your employees. You know what I mean.
[ALISON] Yes, but I think that, like, obviously you don’t want to hire somebody who’s not interested in working with trauma clients and you go to the extent of paying for a training and then they say, “Oh, I don’t really want to work with these clients.”
[ALISON] So that’s why I would just make it really clear in the hiring process that like, this is what we’re building and these are the types of clients we’re trying to attract and if this isn’t a fit for you, that’s fine. You know, that’s okay.
[MICHELLE] This is what we’re going to do.
[MICHELLE] Okay. That makes sense. And then I was just also wondering if you have a preference or any insight on an accountant doing payroll versus like Gusto or something like that.
[ALISON] Yes. I don’t, I mean, I think there’s kind of pros and cons to both. I don’t think that there’s one choice that’s better than another. I would just ask specifically what they’re going to do as part of their services and make sure it includes everything that you need, but yes, I don’t think one stands out as better than another.
[MICHELLE] Okay. And can you tell me a little bit more about, maybe it’s in the Group Practice Launch, but I haven’t seen it yet, as far as how you would go or how you have gone about pricing out different medical benefits.
[ALISON] Yes. So what I did was I hired an insurance broker and, oh, I should back up, I didn’t actually hire him. So you don’t pay insurance brokers because they get paid by the insurance companies. So they’re free to use, which is great. and I got kind of a bunch of different plans. I explained to him we have a very small business, at the time it was just like a small handful of people that wanted insurance, what’s available to me and he kind of let me know what I was looking at and gave me a bunch of plans. There was a bazillion plans to pick from, and I was like, “Okay, can you just like narrow down the two or three most popular ones?” And he was like, “Yes, this is what they are.” Then he got us all signed up and ready to go.
So what I ended up with was what they call an age band-aid plan, which means that you pay your premium based on your age. So the younger you are, the cheaper it is or the more expensive it is but I’m legally required to pay 50% of the premium. I could pay more if I want to do, but only have to pay 50% and then the employee pays the other 50% and it comes out over the course of their, like two pay periods per month. So it was actually a much more affordable than I thought it was going to. I realized that it varies quite a bit across the country in terms of cost, but for somebody in their mid thirties, it’s about $500 a month. So they pay $250 and I’m paying $250.
[MICHELLE] Okay. And does that, for you, is that including vision and dental or is that just medical?
[MICHELLE] Okay, that’s everything.
[ALISON] Yes, so vision and dental is another 30 bucks or something.
[MICHELLE] Okay. So many pieces. All right. I’m just trying to assimilate all the different information. So at this point I’m still on systems and documenting everything and getting everything kind of easy flow and such. Would it be reasonable, do you think to have a goal of two clinicians by the end of the year from where we are in this year or what would be like a reasonable …
[ALISON] Yes, absolutely. I would say hiring the first one is always the hardest because you’re doing everything for the first time and I would just really pay attention to what you’re doing in the onboarding process, get feedback from them about how it was for them to be onboarded into the practice and all of that kind of stuff so then you can really tweak it and smooth everything out so then when you hire the second person, it will be much, much easier. So I absolutely think you could hire at least two people. I don’t know how many referrals you’ve been getting, but I imagine if you’re like everybody else you’re like swamped up.
[MICHELLE] Yes, yes. I just took people off the waiting list and because people are, I’ve worked with people for the last year and finally have some really, good discharges happening. So it’s working out really well. So I guess my final question, unless it leads to something else, but it’s just the LinkedIn piece about going after clinicians or letting them know. Can you tell me a little bit more about that kind of framework? Like how you conceptualize LinkedIn? Because I’m not really, I’m on there, but I’ve just kind of been like, I don’t know how it works. I mean, I know you link with people and stuff, but I don’t know how to do it for something like hiring.
[ALISON] Sure. Yes. That’s a great question. So what I do is I periodically go on there and I will look for, you know it basically gives you people, like suggestions of people to connect with. If anybody looks like they’re in Pennsylvania and they have a license or in the mental health field, I will connect with them and then I will actually, when we are hiring, I will put posts in my own personal LinkedIn profile. Like, “Hey, we’re hiring. Here’s the link to our employment page on our website”. And I’ll run a bunch of different posts like that. Sometimes I’ll do it once a day or every other day, just during the time we’re hiring. I don’t do that all the time. So then those people are seeing, if they’re going through their feed, they’re seeing my, “Hey we’re hiring,” post. You can also make a business page on LinkedIn, which I wasn’t aware of until like a year ago. So you could do the same thing there. You can post a job through there as well. And we actually have a lot of followers on there but we also regularly post like valuable content and stuff like that.
[MICHELLE] Okay. Now what’s valuable content in this audience?
[ALISON] Things very similar to other things we put on social media, just like our blog posts or anything related to something our ideal client might appreciate. Like here’s five tips about mindfulness or something like that.
[MICHELLE] Yes. So even though you’re going after the clinicians, you’re giving them helpful information for people they work with.
[ALISON] Yes. I would say the audience is more obviously like other mental health professionals, but they still seem to resonate with the content that we post up.
[MICHELLE] Because we’re in the field because we liked it. Okay, that makes sense.
[ALISON] So the other thing do is I will send private messages to people that are, just in a very simple way to say, “Hey, I’m, I’m the owner of Move Forward Counseling. I’m looking to hire. Are you interested? Do you know anybody else that’s interested?” I find that people who are like sort of content with their jobs aren’t necessarily on LinkedIn looking for a new job, but if somebody better fell in their lap, then they’re open to pursuing it.
[ALISON] So, yes. So that’s where that has been fruitful for me as well.
[MICHELLE] Nice. Nice, okay.
[ALISON] Oh, and the other tip I have about LinkedIn is you can actually search by place of employment. So I know the names of the big agencies where I live and so I’ll go and type those in because those are typically one of the best places to get clinicians because they get trained there. Typically they get licensed and then pretty soon they’re looking for the next opportunity because community mental health is just like unsustainable.
[MICHELLE] Right, right, right.
[ALISON] So I’ll go and type a name of a big agency and I’ll connect with a whole bunch of people. So again, when I publish on my feed, like, “Hey, we’re hiring,” then they’re seeing it.
[MICHELLE] Oh, that’s awesome. Okay. Thank you so much, Alison, this has been really good. I really appreciate it. You and Whitney do a great job in the Group Practice Launch. So it’s really thorough. So I just, you didn’t ask for this, but I want to put a plug in. If anybody is interested, it’s very, very thorough and very worth the investment.
[ALISON] Uh, thank you so much. I appreciate that.
[ALISON] Yes. It was great talking to you, Michelle. I have a question for you? Do you have any big takeaways from today?
[MICHELLE] Oh, I think I need to get on LinkedIn. and just kind of commit to the group process. I think that’s it. It’s just okay, you’ve made your decision, now stop. Stop going back and forth while you’re putting systems into place because you’re already on that trajectory and it’s a matter of getting those five or six clinicians now. So yes, I think that’s my takeaway. So LinkedIn it is.
[MICHELLE] Thank you so much.
[ALISON] Yes, thanks.
Once again, thank you so much to Therapy Notes for sponsoring this show. It makes notes, billing, scheduling, and telehealth a whole lot easier. And if you’re coming from another EHR, they make the transition really easy. Therapy Notes will import your client’s demographic data free of charge during your trial so you can get going right away. Use the promo code [JOE] to get three months free to try out Therapy Notes.
If you love this podcast, will you please rate and review on iTunes or your favorite podcast player?
This podcast is designed to provide accurate and authoritative information in regards to the subject matter covered. This is given with the understanding that neither the host, Practice of the Practice, or the guests are providing legal, mental health, or other professional information. If you need a professional, you should find one.