Start a Group Practice with Alison Pidgeon and Whitney Owens | PoP 439

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Start a Group Practice with Alison Pidgeon and Whitney Owens | PoP 439

Are you wondering whether to start a group practice? What does it entail and does it fit into the vision you have for your business? Should you hire W2’s or contractors?

In this podcast takeover episode, Alison Pidgeon talks with Whitney Owens about all things relating to starting a group practice, hiring people and setting rates.

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Meet Alison Pidgeon and Whitney Owens

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.

She is also a business consultant for Practice of the Practice. What started out as a solo private practice in early 2015 quickly grew into a group practice and has been expanding ever since.

 

Whitney is a licensed professional counselor and owns a growing group practice, Waters Edge Counseling in Savannah, Georgia. She is also a business consultant for Practice of the Practice.

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.

In This Podcast

Summary

Alison and Whitney both answer questions pertaining to group practice:

  • Should you start a group practice?
  • Deciding between W2’s and contractors
  • Do you hire licensed or unlicensed people and what’s your preference?
  • How do you set your rates for paying your clinicians?
  • How do you do an interview and hire someone?

Should I start a group practice? Why or why not?

Whitney: ‘If you’re thinking about starting a group practice you need to ask yourself whether it’s something you really want to do and not something you feel pressured to do. Because if you’re going to start a group practice, you better be all in.

Also, think about whether you want to manage a practice. Do you have the organizational skills? Do you know how to manage money? Do you want to have employees working for you? Does your vision for your practice align with what you’re doing?’

Alison: ‘Enjoy the business side of things because you are going to be doing a lot more of this when starting a group practice.’

Deciding between W2’s and contractors

Alison: ‘I started out with contractors but then switched over to W2’s after realizing that having contractors was stunting growth. As soon as I would hit 12 therapists, somebody would leave because so many people would want benefits and health insurance.’

Whitney: ‘I started with contractors as it just seemed the easier way to start. Having the contractors felt like we were all doing our own thing and ultimately I really didn’t like that. Then I made the transition to having employees, and it was wonderful. I felt like our culture at the practice has come together.’

Do you hire licensed or unlicensed people and what’s your preference?

Whitney: ‘I started with some licensed people and people who had done private practice before and I was finding it difficult for them to align with the way I wanted to run with the practice, it really wasn’t good for the team. So now I’ve started shifting more to unlicensed people or people who are licensed but have been working in hospitals or community agencies first. Then I’m able to bring them on and train them in a way that I want them to do the practice.’

Alison: ‘We’re mostly insurance-based, so if I had unlicensed people I’d have to do a low self-pay rate and then I wouldn’t make as much off of them as I would from the licensed people. I’ve avoided hiring unlicensed people for that reason and I don’t feel really passionate about mentoring or supervising young therapists.’

How do you set your rates for paying your clinicians?

Alison: ‘When they were contractors we were doing a 60/40 split. Now that they are W2 employees we are doing an hourly rate across the board.

A good rule of thumb for paying W2 employees is 45-50% of the average reimbursement rate.’

Whitney: ‘I have a set rate where if they see a client, they make that per hour. The unlicensed people do make less than the licensed people but that’s mostly because we charge less for the clients when they come in. I also do a tiered system where what they make is dependent on how many clients they see.’

How do you do an interview and hire someone?

Alison: When I post an ad I have them submit a cover letter and a resume. And because they are W2 employees I have them fill out a job application because you have to show that you’re treating everyone who applies the same way. I then do a phone screen for 15mins before they come in for a more formal interview.’

Whitney: ‘Very similar in a lot of ways. I know a lot of people don’t like Indeed, but I actually love Indeed because you can share it with somebody else and they can see the applications and you can put them into yes, no and maybe. My assistant really helps me in the hiring process and she reviews everything. When she narrows it down to the yeses, we take them and do phone screenings with 5-6 questions we ask everyone. And then if she likes them we interview 2-3 in person, and if that goes really well then we get references.’

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Meet Joe Sanok

private practice consultant

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.

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Podcast Transcription

[ALISON]: Welcome to the Practice of the Practice podcast, episode number 439.
[JOE]: These days, most people looking for your services are turning to Google. So, you know it’s important that you show up when they do these searches. You’ve heard of Search Engine Optimization, but aren’t sure even where to start. Jessica and her team at Simplified SEO Consulting, make SEO understandable and show you exactly where to start. In addition to their popular Done For You SEO Services, they offer SEO workshops around the country where you can learn to do your own SEO so you can get your site ranking now and then continue to make changes yourself as your business grows. To learn about their upcoming SEO training workshops or begin with $100 off their comprehensive online course, head over to simplifiedSEOconsulting.com/Joe. Again, that’s simplifiedSEOconsulting.com/Joe.
[ALISON]: Today we have two co-host and we’re doing a podcast takeover. I’m Alison Pidgeon.
[WHITNEY]: And I’m Whitney Owens.
[ALISON]: I’m really excited to do this podcast with you today, Whitney.
[WHITNEY]: Yes, it’s going to be lots of fun.
[ALISON]: Yeah. So, let me tell you a little bit about myself. I’m a business consultant with Practice of the Practice and Whitney is my fellow business consultant as well. And I have a group practice in Lancaster County, Pennsylvania. I have 15 clinicians and a full-time admin. We have three locations and I have been working for Practice of the Practice since 2016. Do you want to introduce yourself, Whitney?
[WHITNEY]: Yes. So, I’m also a business consultant with Practice of the Practice. I started working with Practice of the Practice as a consultant in the fall 2019 but have been really active in the community for years. I have a private practice in Savannah, Georgia, which is way down South. So, you hear it in my accent. We are on the coast; I have a cash-only based practice with six clinicians and two part time admins. Yeah, so that’s about our practice.
[ALISON]: Okay, great. So, I thought it would be fun, Whitney, if we maybe talked a little bit about our first impressions of each other. So, we had interacted a few times through like Zoom meetings and stuff. But the first time we met in person was at Killin’ It Camp this past October, and I just thought it would be fun if we shared a little bit about, you know, what you thought of me in person and what I thought of you in person. So, would you like me to go first?
[WHITNEY]: Sure.
[ALISON]: Okay. So, what I thought was really funny, and this stands out to me and you know, I was a little discombobulated, I guess is the word because had I brought my four-month-old along with me. So, it was a bit of a whirlwind, but I remember one of the first things you said to me was, you asked me what my Enneagram number was.
[WHITNEY]: Yes.
[ALISON]: And I was like, “Why are you asking me about my Enneagram number?” And I was like, “I don’t know what it is.” And you texted me like the quiz or whatever it is, so I could figure it out. And then you were like, “Take this quiz, hurry up, tell me what your number is.” So, I did. I did.
[WHITNEY]: Yes. Now everyone wants to know what your Enneagram is.
[ALISON]: Yeah. So, I think now, I even forget what it is. I am, is it.
[WHITNEY]: A three.
[ALISON]: Three? Yeah, yeah. So, you remember. So, I’m the achiever.
[WHITNEY]: Yes. I think the Enneagram is so helpful in working with people and, in your business, but also, I use it in my private practice with my clinician. So yeah, it helps me to understand people. And for all of you that want to know, I’m obviously a one because I’m the perfectionist that has to announce Enneagram numbers. Yeah, yeah, yeah. So, I had known Alison virtually like she was saying. I had been following her. So, I was really excited about meeting her in person and I thought she was so cool in the way that she’s chill and like loving being with her baby and like, it’s not a big deal. She’s not stressed out, but she also takes on so much responsibility and as an awesome business coach and she doesn’t like get in your face about it. She’s really relaxed about it, but she also really gets things done. So really love that about her personality. And that really stuck out to me.
[ALISON]: Oh, thank you for the compliment.
[WHITNEY]: Yeah.
[ALISON]: Yeah. Cool. Okay. Well today on the podcast we are going to talk about group practice. So, I think Whitney you had posted in the Killin’ It Camp group if people had specific questions about group practice, is that right?
[WHITNEY]: Yeah, it was in my Faith in Practice mastermind group where I just kind of asked people, “Hey, what are your questions about private practice? Alison and I are going to put them together and do a podcast.” So, these are questions that they posted, but they’re also questions that we get often as business consultants. So, Alison, you’re going to see some of these and you’re going to know that you get these a lot. So, we’re going to kind of run through those together and hopefully answer a lot of your questions.
[ALISON]: Okay. Awesome. Yeah, so let’s get started. So, the first question was, should I start a group practice? Why or why not? Do you want to answer that?
[WHITNEY]: Yeah. I feel like I hear often people saying they feel a pressure to start a group practice almost because we’re in this community together and we keep hearing about it we think that’s what we need to do. So, it’s really good at, if you’re thinking about starting a group practice to kind of step back and ask yourself, “Is this actually what I want to do, not something I feel pressured into doing?” Because if you’re going to start a group practice, you better be all in because it is a lot of work on the front end, but you do get a lot of benefits of course, in the end. So, thinking about is this something that you want to do? Do you want to manage a practice? Do you have the organizational skills? Do you know how to manage money? Do you want to have employees working for you? Those are all really important questions to be asking.
But the most important thing I think is asking yourself, “Does my vision for my practice align with what I’m doing? Like with growing a group practice?” So, if you feel like you can do things that you want to do in your practice solo, then move on being solo. There’s no reason to start a group. But if you feel like you can’t really meet the needs of your community by being a solo practitioner, that’s a reason to consider going into a group. Or if it doesn’t meet your vision for home. Like if you need to be bringing in more money at home, you might want to consider a group as an option to bring in more money. So, first thing is considering the vision and then considering your personality and if it’s something you really want to do. What do you think, Alison, what do you feel like is important in considering starting a group practice?
[ALISON]: I think what’s really important is that you have to enjoy the business side. I think sometimes people start their own solo practice just because they’re, you know, working in like such toxic work environments that they just like want to get out and be able to sort of be their own boss but they don’t necessarily enjoy the business side. They just do it because it’s like a means to an end. So, I would say you definitely need to enjoy the business side because you’re going to be doing a lot more of that with the group practice.
[WHITNEY]: That’s so true. Yeah, and I think a lot of people when they start a group practice get really sad about seeing less clients. So, it’s got to be something you also want to see less clients because you’re going to have to work on your practice a lot, especially as you grow.
[ALISON]: Right? Definitely. Yeah. I’m to the point now where I don’t see any clients at all, which was by design. Like I wanted to get to that point. So not everybody wants to do it that way, but that was my goal and so I built up the group practice to be able to do that.
[WHITNEY]: Well, I love this next question. I think you could really speak to it in the current moment, is deciding between W2’s and contractors.
[ALISON]: Yes. So, I’m glad that somebody asked that question because I started out with contractors and I think you did too, Whitney, right?
[WHITNEY]: Yes.
[ALISON]: Yeah, so then, you switched over to W2 employees much quicker than I did. I actually just switched over at the beginning of 2020 and, I think if you had asked me a year ago for my advice about what to do, I would say, “Yeah, hire contractors. It’s great.” But as I got bigger, I realized that having contractors was really holding me back from growing past a certain point. It seemed like I would hit 12 therapists and as soon as I would hit 12 somebody would leave and then I was sort of, you know, there was another hole I had to fill and I just was having trouble getting qualified, licensed therapists to fill the spot because so many people want benefits and want health insurance and that kind of thing. So that was my main reason for switching over to W2’s. And even in the short time we have that model now, it’s been great. I can see how it’s just brought so much more stability to the business. I’ve actually had lots more people apply who are great, qualified, licensed clinician. So, I’ve been really happy with the result. And I think you kind of had a similar experience too, right, Whitney?
[WHITNEY]: Yeah. That’s awesome. Allison. Hey, another question people ask a lot, which I didn’t put on the sheet here in front of us, but how do you talk to contractors about that transition because I think a lot of people are fearful they’re going to make a change from contractor to employee and lose therapists because they’re going to have to make less money when you make that transition. How did you convince people to stick with you?
[ALISON]: Yeah, so I did a lot in terms of sort of presenting it to them like way ahead of time to start getting them used to the idea and I made up a whole worksheet that sort of showed how a lot of the expenses were now being shifted over to me and sort of like showing them line by line. This is the justification of why you’re now getting paid less. And you’re not really getting paid less. It’s about the same. It’s just that the costs now are getting shifted around. So, I think because I was really transparent about that and explained that really well, I think the majority of them were like, “Okay, yeah we get it,” and they could see like the positives to it. Like there were definitely quite a few of my staff who really wanted like better health insurance because they were getting health insurance on the exchange. And so, I think that also helped that they were seeing the positive side of that as well.
[WHITNEY]: Oh yeah. That’s great. I started out with contractors, had two of them, and so when I was starting my practice, it just seemed like contractors were the easiest way to start. I was very intimidated about the idea of a W2 employee and honestly, I wasn’t very educated on what it meant to have W2. I guess I thought I was going to have to pay them a salary annually or something regardless of clients. And it really doesn’t have to be that way. But I also felt with my contractors, I’m struggling to keep them and I was struggling to create a culture. I wanted to create in my practice. I know a lot of people have contractors and they have great culture and community, but for some reason having the contractors, for me it felt very divisive. Like we were all doing our own thing and ultimately, I really didn’t like that. So, then I made the transition to employees and it was wonderful. And I just feel like our culture at the practice has really come together. We’re more of a team instead of individuals having our own practices under the same roof.
[ALISON]: Yeah. I think that was one thing too. Like I would get feedback from my staff about how they didn’t really feel like a team because there wasn’t anything, like, I couldn’t tell them like, “Well you have to show up to a staff meeting. It’s mandatory,” you know. Like it was sort of like, “Well it’s optional because you’re a contractor and so now that they’re W2 employees, yeah, it is mandatory and there’s going to be more of that, you know, kind of just times when the whole staff is going to get together. And so, they’re inevitably going to get to know each other and I think feel more of like a cohesive team rather than yeah, like ships passing in the night.
[WHITNEY]: Yeah. So, another with the hiring and employees and contractors was do you hire licensed or unlicensed people and what’s your preference?
[ALISON]: Yeah, so how would you answer that, Whitney?
[WHITNEY]: Yeah, so I started with some licensed people and people who had done private practice before and I was finding that people who have a lot of experience, especially already in private practice, think that they know how they want to do things. I was finding it difficult for them to align with the way I wanted to run the practice, and so we were kind of doing our own things and it really wasn’t good for the team. So now I started shifting a little bit more to more unlicensed people or people who are licensed who maybe were working in hospitals or community agencies first. And then I’m able to bring them on and really train them in the way that I want them to do the practice and the way I want them to follow up with referral sources or do their notes. And that has been really great and that’s actually gone better for me. And actually, from a profit standpoint, I make a greater profit the way I run my numbers on my unlicensed clinicians than the licensed ones. So that also is an advantage to me.
[ALISON]: Ah, okay. That’s interesting because I actually probably have the opposite problem because we’re mostly insurance-based. So, if I had unlicensed people, I’d probably have to like really do a low self-pay rate and then I don’t think I would make as much off of them as I do the licensed people. So, I’ve actually avoided hiring unlicensed people for that reason but also because I don’t really feel passionate about kind of mentoring or supervising young therapists. But I mean I think there’s definitely pros and cons to both and so it also sounds like it has a lot to do with, you know, self-pay versus insurance and how you have your structure set up and all of that kind of thing.
[WHITNEY]: Yeah. And how hands-on you want to be. Like, I love really helping the new clinicians build their practices under me. You know, that’s something that I really found a lot of joy in meeting one on one with them and talking to them about their clients and kind of forming them into good clinicians. So, I like to be really hands-on.
[ALISON]: Well, I’m glad that there are people like you in the world, Whitney. I don’t want to do any of that.
[WHITNEY]: Again, it’s all figuring out what you want to do right. And doing it well.
[ALISON]: Right. Yeah, and what you’re passionate about and what your strengths are and just owning that and just being okay with it.
[WHITNEY]: Yeah. So how do you set your rates for paying your clinicians?
[ALISON]: Excellent question. So, when they were contractors, we were doing a 60, 40 split. They were getting 60%. Now that they are W2 employees, we do like an hourly rate just like across the board. Like you see a client, you get paid this per hour. How do you do it, Whitney?
[WHITNEY]: Yeah, I have a set rate that they see, [cough] excuse me, they see a client and they make that per hour and the unlicensed people do make less than the licensed people, but that’s mostly because we charge less for the clients when they come in. But I also do a tiered system where they make more, depending on how many clients they see. So, I payout every two weeks and so they get a set rate for how much they make per client. But if they see more than 14 clients in a two-week period, so if they say 15 to like 27 then they make five more dollars for every client they saw. And then if they see more than 28, they make five more dollars for every client they saw. So, it really can make a difference of like a $100 – $200 in their paycheck and it gives them that motivation to get more clients on their caseload instead of me only filling them up.
[ALISON]: I’m glad you brought that up because I feel like when I was trying to figure out what to pay my people when they were switching over to W2’s, I remember we talked about this and I actually ended up doing something very similar to you, but they have to see, because we’re mostly, because we’re insurance-based. They have to see 25 people a week if they’re full time and then once they hit number 26 and up, they start making 10 more dollars per session again to motivate them to see more clients because like they’re already, have them on the payroll. Like, you know, it’s just icing on the cake at that point to have them see a few more people for them and for me.
[WHITNEY]: Oh yeah. And I do encourage, this is so, especially when you’re first hiring to be as conservative as you can when you’re doing your pay rates. Because what you don’t want is that you pay your employees so much that you have nothing left over to take care of the practice and then your practice fails. So, it’s best to be conservative and then you can always increase and give raises. I mean, I give all my employees a raise in a year. You want to be able to have that option.
[ALISON]: Sure, sure. And if you start out too high, there’s no wiggle room there.
[WHITNEY]: Oh yeah.
[ALISON]: I actually interviewed an accountant for my podcast just last week and she was saying a good rule of thumb for paying W2 employees is like 45 to 50% of the like average reimbursement rate.
[WHITNEY]: I’ve heard the same thing.
[ALISON]: Yeah. So that just obviously that’s like a generalization, but something really good to do if you’re trying to figure out how to set your rates or what to pay your clinicians would be, you know,, have an accountant or somebody that has a finance background look at your numbers, figure out how much overhead you have. I think the thing people forget is that in that amount that the clinicians are bringing in, that’s coming to the practice that also needs to go to pay your salary as the owner and also have some profit for the business. So, I think clinicians get focused on, “Oh well as long as they cover my overhead, it’s all good.” But then they forget, “Oh no, they also need to be paying me part of my salary because I’m doing all this work being a group practice owner.” And again, that’s where people get themselves into trouble that they don’t think about that when they’re trying to figure out what to pay their people.
[WHITNEY]: For sure. So, the next question here is how do you do an interview and hire somebody? So how do you go from posting the ad to actually hiring the person? Alison, do you have like a process for that?
[ALISON]: Yeah, I definitely have a process that I figured out over the years. So, when I post an ad I have them submit like a cover letter and a resume now because they’re W2 employees. I also have them fill out like a job application because you have to sort of show that you’re like treating everybody the same way who applies? So, then I do a phone screen so I’ll email them and just say, “Hey, can we jump on the phone for 15 minutes just to see if it’s a good fit to see if it would make sense to have you come in for a more formal interview?” So, during that phone call I kind of tell them what all the potential deal breakers are. Like I try to be as transparent as possible about those things as I don’t want like to waste anybody’s time by having them come into an interview and then it’s clearly like not going to be a fit.
So, I really try to make sure like, you know, is your specialty kind of aligned with like our practice and what you’re looking for. When I was hiring contractors, I was really clear about, you know, “This is a contract position, there’s no benefits. Is that going work for you?” That kind of thing. And if it seems like potentially a good fit, then I have them come in for a more formal interview and we could probably talk about this all day, but the thing that I look for is you know, how organized are they, are they going to be on top of managing their schedule, getting their notes done because if they’re not, and I have to chase them down to do those things, that’s going to make my life miserable as their boss. And then I do obviously ask them questions about themselves clinically, but I figure if somebody is licensed, they’re probably pretty decent. Like, you know, their supervisors and you know, past work experiences probably wouldn’t have let them get licensed if they were really terrible. So, I figure they’re pretty solid there. And then I also look for if they have good boundaries and good judgment, like clinical judgment, because I found when I had experiences many, many years ago mentoring young therapists that like you sort of can’t teach good judgment. Like you either have it or you don’t. So, I try to ask questions around those things too. What about you Whitney?
[WHITNEY]: Yeah, very similar in a lot of ways. Posting the job and then we get all the applications. I know a lot of people don’t like Indeed. I actually love Indeed because of the way that you can share it with somebody else and they can see the applications and you can put them into like yes, no’s and maybes. And so, my assistant really helps me in the hiring process and she reviews everything and then she narrows it down to the Yeses and then we take those Yeses and do screenings. But she does those and does like five or six questions that we ask everyone and then if she likes them she lets me know and we try to interview two to three in person and I do those and then if that goes really well we get references and call three references of places they’ve worked. If I’m still like really unsure about the person but I’m not ready to let them go, I’ll do a second in-person interview with another one of my therapists in the rooms. Usually, it’s the one who would do like the supervision of that person, like the clinical supervision. And so that’s gone really well.
[ALISON]: Okay, great. Yeah, that’s the part I do too. I check references as well and then something else that can be really helpful is going by the hungry, humble and smart from the Ideal Team Player book to sort of see in the interview process if they seem like they’re hungry, humble and smart because I think that framework has really helped me hire the right people as well. Do you use that to Whitney?
[WHITNEY]: No, actually. I mean I love the concepts and people talk about it all the time, but I haven’t read the book yet. I’ve got, it’s on my list.
[ALISON]: Yeah, right. Your ever-growing list of books that you should read. Yeah, we’ll definitely do that. So basically, hungry means somebody who’s like motivated, they’re willing to go the extra mile, they see an opening in their schedule and they’re calling another client right away to try to fill it. Humble just means they’re not like arrogant or narcissistic like, they’re humble about themselves, not that they’re not confident, but and then the smart means like interpersonal skills; that they’re smart and you would think most therapists would have great interpersonal skills, but I’m amazed at the number of clinicians I’ve come across that have trouble, like communicating with other coworkers or with their boss, like if there’s a problem. So that’s something else I really try to tease out during the interview process if they’re, going to be able to, you know, things come up and like you need to be able to come like talk to me about it.
[WHITNEY]: Definitely. So how do you encourage clinicians to manage their caseloads? I think the question here was how do you encourage clinicians to keep their caseloads really high and not feel like you’re the one who’s constantly having to get on them and make sure that they’re, how do you know they’re hungry basically?
[ALISON]: Yeah, that’s a great question. Do you want to take a crack at this one first, Whitney?
[WHITNEY]: Yeah, I mean one of the ways I do that is by having the tiered pay system to see that they can, they’ll see that they can make more money per client. So, a lot of times that will give them the motivation that they need but also doing those references on the front end, finding out, “Okay, what were they like at their other jobs? Did they seem like they wanted to do well or were they kind of lazy about what they were doing?” I also think you can tell in an interview their passion level too. Like are they actually excited about it or are they kind of haphazard I guess about the idea of working for you? If they seem really excited about seeing clients, then when they come in, they’re going to want to work really hard to see clients. If they seem like they need to make money because they don’t have another job or they have family that they need to take care of or they have four kids, they’re going to be a lot more motivated to get clients because they’re going to need the money. So those are all factors that I consider.
[ALISON]: One thing that I have done is when they were contractors and now that they are W2 employees basically like they’re not getting paid unless they’re seeing a client. So, when I switched them over to W2 employees, I didn’t do a salary for that very reason because I didn’t want people to be like, “Oh, well if I see 20 clients or I see 30 clients, I’m still going to get paid the same amount.” So, you know, it just sorts of encourages them to not be on top of filling up their schedule. So, the way I have it set up now is like, “You’re not getting paid unless you see a client or you charge your no-show fee. So, they’re still motivated to get in the required number of clients if they’re full time or you know, even if they’re part-time it’s going to affect their pay. So, they’re going to be more motivated to like fill the hole that was left by cancellation or whatever.
[WHITNEY]: Yes. And I even have some therapists, and this is always really amazing. We have the 24-hour cancellation policy and if they’re canceling right before their appointment or maybe a few hours before and then we’re charging them and then the therapist will go down their list and fill that slot with another person. And I’m like, “Wow. Way to be so motivated. You just got double pay.”
[ALISON]: Yeah. Nice.
[WHITNEY]: It’s always nice. So, we all know that running a practice, especially the bigger [inaudible 00:25:29], you have so many systems you’ve got to get in place to do that. There are so many moving parts. And so, Alison, do you have a story maybe you could share about a time you got pretty overwhelmed with the practice and something that you implemented that really helped?
[ALISON]: Yeah, that’s a great question. I think too, like, because now I’m in the, we just had our fifth anniversary of when I started the practice, which is very exciting. So obviously it’s been like an evolution over time and so in the beginning, of course, I was like doing all the things, like answering the phone and you know everything. And I think that just had to figure out through that process, especially as we got bigger, like how to manage those things, because yeah, there were definitely times when things felt overwhelming. I would say a big game-changer for me was when I got a virtual assistant and they started like answering the phones and then I saw that they were awesome and trustworthy and they were doing a great job. And so, I started like giving her more and more tasks to do and I was like getting so excited because I saw all of these things like coming off my plate. It just felt like such a relief to me.
So, you know, I think for a lot of practice owners like answering the phones and emails is like the low hanging fruit, right? Like, “Oh, if I could just get that off my plate, that would be amazing.” And then depending on you know, the type of staff you have working for you, you can then start looking at, “Okay, what else can I start delegating?” So, one of the very first assistants I had who is really excellent, she had like a professional writing background and I was like, “Well, could you write blog posts for me?” And she was like, “Sure.” I was like, “Oh wow, this is amazing,” because I could write blog posts but it took me a while and then I was just, you know, it ends up being one more thing on your to-do list. And so yeah, the more that I was able to pass off to other people the more than I was able to do, what only I could do, which was like hire people, look at expanding, you know, that type of thing. What about you Whitney?
[WHITNEY]: Yeah, real game-changing time for me was related to money. Before that, I had a 24-hour cancellation policy, but it was really hard to make it happen because at the time I was running credit cards in real-time through, I was using Square. And so having to take the time to run the card to the end of every appointment and then having to follow up with people when they didn’t show up to try and get that payment, calling them and getting the card run over the phone, or I was seeing a lot of college students whose parents were paying, so then I’m having to send receipts to parents and then follow up with all those, making sure they were sending payments. It was totally overwhelming. So, I made a transition and got a credit card system that is all HIPAA-compliant and you can save credit cards in there. You get them at the very beginning and it’s there for however long the client is with you. And so that was a huge game-changer for me and not having to make all those follow-ups and send receipts back and forth. And then I was just able to charge the cards after they left. It saved tons of time.
[ALISON]: Oh, nice. As you were saying that, it kind of reminded me of something that was sort of like a rookie mistake that I made in the beginning. It was, you know, we take mostly insurance and so when the year starts over in January, 1, people’s benefits typically start over as well. So, if they have a deductible or something like that, it typically starts over on January 1. And so, I didn’t like the first year that, you know, the new year changed over. I didn’t check, we weren’t like verifying benefits at that time. We were just like leaving it up to the client to do it, which, you know, 95% of them didn’t bother. And so like I’m just, you know, doing the same thing I always did because typically by the end of the year, people have, used up you know, met their deductible and so they’re paying me nothing or very little for their therapy appointment and then January 1 came and I didn’t think like, “Oh, deductible, start over. I need to start collecting more money.”
And then, you know, the EOB has come back and I see like, “Oh, I should have collected like a lot more than I did.” And then I’m like chasing people down for money and you know how that becomes a whole thing. and you may never see that money if you don’t collect it at the time of that session. So, we then learned like, “Oh, okay, every January 1 now we have to go in and like check benefits,” and it’s like super time-consuming. I have my assistant do it now. It takes her like days and days because we have like 400 clients or maybe close to 500 now. But, it’s super important because otherwise the clinicians don’t know what to collect. And then there’s like all this money that went uncollected that first year that, you know, some of it never got collected. So that’s just something that you learn, you know, over time. And like, now that we know that, just like every year, that’s what we have to do on January 1.
[WHITNEY]: Yup. We usually learn things through mistakes.
[ALISON]: That’s right.
[WHITNEY]: We’re always changing our practices to make them molded the way we need them to be. So, yeah. Well it’s been so fun like doing this with you and go through the questions and you know, I always learn something from doing the podcast. I loved getting your input there. So, I wanted to make you all think, are you thinking about starting a group practice? If this recording was really helpful for you and you’re hearing Alison and I talk and you’re thinking, “Gosh, that sounds like something I really want to do,” and it makes you excited. We would love for you to join us for a webinar. We’re going to be doing a webinar on March 10th at two o’clock Eastern time. You’ll find that in the show notes here. So, you’re going to find out more about starting and growing a group practice and we can help private practice owners get started with a mastermind group that we’re going to be launching on March 31st. That group’s going to be called Start and Scale a Group Practice Mastermind. And the bonus is, it’s led by Alison and myself. So, you’re going to get two business consultants instead of just one. So, you’ll get double the goodness in that mastermind group. Like I said, it’ll start March 31st, but come to the webinar on March 10th.
[ALISON]: Yeah, I’m really excited Whitney, because I know I’ve been leading this mastermind for, I can’t even remember how long. I think this is like the seventh or eighth time we’re going to run it and I’ve just been doing it by myself and, it was called Start a Group Practice Mastermind, if anybody’s heard of that before and now we’re going to sort of join forces here and kind of amp it up a little bit and add some more content around sort of your area of expertise. And I think it’s going to be really cool to not only talk about starting a group practice, but also how do you start to scale it up because it seems like, you know, getting started like half the battle and then you sort of get some things established, you get a couple of clinicians hired and then you’re sort of meet with maybe some new challenges. And so that’s going to be part of the group as well to talk about, you know, what are those other challenges that you might encounter and then, you know, possible solutions that can help you continue to grow.
[WHITNEY]: So that group’s going to run for six months, but if you’re interested, the webinar’s free and that’ll be on March 10th. So, join us for that.
[ALISON]: Yeah. Awesome. Yeah, I wanted to say thank you to our sponsor, which is Simplified SEO Consulting. So, Jessica Tappana is the owner of the company. I know her personally, Whitney knows her personally, and she is awesome. I hear lots of great things from her clients about what a great job she’s doing, helping them increase their SEO and getting them moved up in the ranks on Google. So definitely want to give a shout out to Jessica and Simplified SEO Consulting for sponsoring. If you’re interested in the special deal that we have through Practice of the Practice, you can go to simplifiedseo.com/joe and you can see all the details to get, I’m not sure if it’s a discount or a special extra thing, but definitely go there and check it out because I know for me ramping up my SEO for my group practice website has been like a total game-changer as well. We’re on page one of Google and we get a ton of referrals from being on page one.
[WHITNEY]: Same here.
[ALISON]: Yeah. Nice. So, you’re another evangelist for SEO.
[WHITNEY]: Yes, and I love Jessica. She’s wonderful.
[ALISON]: Well it’s been so fun taking over the podcast today.
[WHITNEY]: I know it was so fun and it went fast. We, you know, time flies when you’re having fun.
[ALISON]: That’s right.
[WHITNEY]: Yeah, and hopefully we’ll do this again soon.
[ALISON]: All right. And we’ll see all of you at the webinar.
[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.