[WHITNEY]:
Welcome to the Practice of the Practice podcast. This is a podcast takeover with consultants Alison Pidgeon and Whitney Owens. Good to be with you today, Alison, how are you?

[ALISON]:
I’m pretty good. How are you, Whitney?

[WHITNEY]:
Doing good, excited to take over the podcast today to talk about some of the biggest mistakes that we see group practice owners make.

[ALISON]:
Yes. And we definitely have seen the good and the bad…

[WHITNEY]:
That’s right.

[ALISON]:
…and we’d like to share with you mistakes that other people make so you don’t make the same mistakes.

[WHITNEY]:
Yes, that’d be great. So, Alison’s got five of them right there that she’s going to run through, and then I’ll kind of tag team with her a couple of different ideas on that, and we’ll kind of take it from there. So, Alison, what do we have for the first biggest mistake that group practice owners make?

[ALISON]:
Yeah, I think this is probably deserving of the number one slot, and that is not delegating. I see so many practice owners who want to grow a group practice, and they have hired, you know, therapists to work in their practice, and they haven’t delegated anything, like, they’re still answering the phone, they’re still cleaning, they’re doing all the things and they’re exhausted and they don’t understand why this, you know, whole group practice thing doesn’t seem to be going very well.

[WHITNEY]:
I know, it is really amazing. I’ve had the same thing. That is one of the biggest mistakes I see when consulting people. I’ll even hear, you know, “I have a practice of five or six clinicians, and they’re still taking calls” and I’m just amazed. First of all, I’m amazed that they have that capability to still take the calls, but also that feeling when someone else takes the call for you… It’s the best feeling ever.

[ALISON]:
Yes, for sure. Yeah, when I got an assistant and I was able to stop answering the phone, it was such a, like, weight off my shoulders.

[WHITNEY]:
Yeah. When you think about when you were in the beginning stages of your practice, or maybe even further along, what were some of the things that you struggled to delegate? Or that maybe you wish you delegated earlier?

[ALISON]:
Yeah, I know, this kind of sounds silly, but I waited a long time to find somebody to clean the office, because I really wanted to find somebody trustworthy, you know, who was, like, willing to sign a BAA and understood about confidentiality. And so, yeah, it just sort of took me a long time to finally, like, find somebody that I felt comfortable with, like, obviously, being in the office and cleaning when we are not there and, you know, potentially seeing confidential information, you know, not that we leave it laying around, but just, you know, you could come across it at some point by accident. So, yeah, that was kind of a funny thing that took me a long time to hire out for.

[WHITNEY]:
So you were cleaning the office yourself?

[ALISON]:
I was. Yep.

[WHITNEY]:
Wow. That’s humility, right there.

[ALISON]:
Yep.

[WHITNEY]:
Cleaning the toilets.

[ALISON]:
Yep. What about you?

[WHITNEY]:
Yeah, so, I absolutely hated doing supply runs, and I would go get all the drinks for the practice. At that time, there were three counselors, and so we saw a good number of clients, and having to get sodas, and then just all the cleaning supplies, the paper, all that kind of stuff. So, I was really happy when I hired an assistant, which I should have hired way earlier, I also needed her to answer the phone too, because I was answering the phones for three different counselors. So, anyway, once I hired her, she did the supply runs and did the phones. And I was so happy the very first time there was soda in the fridge and I didn’t have to put it in there, it was fabulous.

[ALISON]:
Nice.

[WHITNEY]:
Yeah. Cool. You have another one there? What’s number two?

[ALISON]:
I do. Yeah, I would say number two is not tracking your numbers. So, there’s so many things as the owner of the practice that you really need to be keeping tabs on. Not that you necessarily need to be, you know, aggregating that data or whatever, but there needs to be some system in place so that somebody is sort of catching small problems before they become big problems, whether it’s, like, insurance claims going through or your, you know, assistant isn’t converting the appropriate number of calls that you’re getting, or whatever the case may be, like, you definitely need to have hard data about that and not just go by, like, your gut feeling about it or an assumption or anecdotal evidence.

[WHITNEY]:
Yeah, a lot of times in the business world, we call those KPIs, key performance indicators, and so, knowing your numbers for your practice are basically KPIs. And I agree, Alison, when I talk to people, sometimes I’ll say, “Okay, well, how many calls do you get a month?” and they have no idea, or, “How many of those calls convert into actual clients?”. Another big one is retention, you know, paying attention to your clinicians. Are they seeing all their clients? And why are they not seeing their clients? Even in my own practice, not too long ago, I realized that our client retention was lower than I wanted it to be, and so I sat with my team and I did a little training on, hey, here’s how much money time and energy we have to put into getting a new client into the practice, and so, if they don’t see you past a handful of sessions, you know, that’s not good. Not only is it not good for them, but it doesn’t fare well on the practice and for you, you know, and us wanting to make money, and so, yeah, I think that’s another number that a lot of group practice owners miss is going back and checking after a client gets scheduled, how many sessions do they actually come for? And are the counselors able to retain clients?

[ALISON]:
Yeah, that’s a big one that I find practice owners, you know, talk about through the process of consulting, like, they usually have at least one clinician in their practice who is having difficulty retaining clients. So, super common problem, it’s just that you might have to have a more concrete discussion or training, like you did with your staff, about kind of little strategies and tips to help retain your clients.

[WHITNEY]:
Definitely. And I love that you brought up with numbers, the insurance piece, because I hear that too. What are common problems that you think people have with knowing those numbers or maybe getting payments or, like, how much money do you think practices lose on something like that?

[ALISON]:
Yeah, what I see happen is that people aren’t looking at what’s typically called, like, an aging report. So, in our EHR, we can generate an aging report, which basically tells us, like, you know, what are the claims or balances that are older than 30 days old, and that’s, you know, usually an indication, like, there’s a problem if they’re older than 30 days. So, every, like, week or two, my admin assistant is going through those and just following up on, oh, this claim got rejected, because we, you know, had a wrong birthdate or whatever it was, and now we need to resubmit and make sure we get paid for that. If you’re not staying on top of that, you could be out tens of thousands of dollars pretty quickly, you know, depending on the size of your practice. I’ve worked with practice owners who were anywhere between $30,000 and $100,000 was owed to them by insurance companies.

[WHITNEY]:
Oh, my gosh, that’s a whole salary right there.

[ALISON]:
Yes.

[WHITNEY]:
That’s crazy.

[ALISON]:
Yes. Because, like, they didn’t have a good system in place to track it.

[WHITNEY]:
Yeah. So, that goes back to delegating out, right? The number one, right? I mean, you really want to make sure you delegate out something like that, cos as a practice owner there’s no way you can keep up with all that for, not only yourself, but all your clinicians.

[ALISON]:
Yeah, for sure. For sure.

[WHITNEY]:
Wow. Okay, after knowing your numbers, what’s number three?

[ALISON]:
Number three is not writing down your mission, vision, and values for your business, and I can kind of give you a brief explanation of what this is. So, lots of people know what a ‘mission’ statement is, it’s sort of, like, what you stand for as a business. A ‘vision’ is actually, like, the vision you have for your practice in the future, like, you know, 5/10 years in the future, what do you want to be known for? And then ‘values’ is very similar to probably your personal values, like, I have a value that, you know, everyone should be treated with respect, so that’s an example of a value. So, I had a business coach who encouraged me to do this for my practice because, when I started, I just didn’t know this was something I was supposed to do, and I was like, “This seems like busy work, why does she want me to do this?” and then once I did it, and it’s, you know, not something you just write down in 20 minutes, and you’re done, it, like, takes a while to formulate and edit and write a few drafts, and that kind of thing. And once you do, I realized it’s such a great filter for helping me make business decisions, because I think, as entrepreneurs, we can get really distracted by different opportunities that come up, and so, if it wasn’t something that was in your original kind of mission/vision/values, then that’s probably a good indication that, like, it’s just a distraction, and you need to get back to what your original intent was. So, I tell people that writing down mission/vision/values is really important for all types of things. Even hiring, making sure you’re hiring the right people who are, you know, resonating with your mission and your vision and your values.

[WHITNEY]:
That’s such good advice, and I do think it gets overlooked so easily. And I’m curious, Alison, do you think that people need to do this, like, every year or every six months? Because our practices are just, I’m thinking, they’re changing all the time and they’re growing and morphing, so what do you think about timing?

[ALISON]:
Yeah, I think it’s meant to be like a living breathing thing, and maybe, like, once a year, you know, you could go back and review and just see, like, “Hey, has anything changed? Would I edit anything or add anything?” and again, not because something, you know, I think a lot of times, things come up or opportunities fall in people’s laps, and then, you know, they’re like, “Oh, well, you know, this counselor just moved to this other town, maybe I should open, you know, like, a part of my practice over there” and it’s like, okay, well, was that your original intent? Or are we just sort of getting distracted because it seems like it would just be an easy thing to do, you know? Like, I think it’s really easy to get off track. So, yeah, definitely, definitely once a year, go back and review.

[WHITNEY]:
Yeah, I really like that. And, you know, you’ve inspired me, maybe I need to do that again, because the practice just grows so fast and so many things happen, that it is really good to go back and redo that.

[ALISON]:
Yeah, I think especially with the pandemic and everything that’s happened with telehealth, like, that’s gonna become a whole nother arm of my practice, and so, now I’m gonna have to incorporate that into my, you know, my business model, essentially.

[WHITNEY]:
For sure, for sure. All right, what do you got for number four?

[ALISON]:
The fourth one is about hiring. So, I see practice owners make a lot of mistakes around hiring because, for several reasons, they aren’t clear about who they want in the practice, they’re not, you know, maybe they’ve never had the experience of hiring before, I think it’s really good to have hiring be, like, a multiple step process to see how committed the person is to working in your practice. And there’s just, like, a lot of different pieces that you have to look at. It’s not just “do you have good clinical skills?” but it’s also, like, “do you get your notes done on time?” “Are you gonna drive me crazy because you’re totally disorganized and scattered, and I have to be chasing you down every minute to make sure you got your job done?” You know what I mean? Like, that has so much to do with, like, your satisfaction as a practice owner, that you need to be asking those things and teasing those things out through the interview process, and I think that’s something that a lot of first-time practice owners don’t realize. They’re just like, “Oh, this person seems nice. I interviewed them once, and they have a license, so I’m gonna hire them”.

[WHITNEY]:
So true. And I love that we hit number three before this because, if we have that vision in our values and it’s all kind of lining up and we got it written down, we’re a lot more likely to hire someone that fits that mold, that culture of our practice. And too often, yes, people just hire the first person or, even experienced practice owners, they’re in a bind and so, they hire someone because they just really need someone to see clients, and they realize, “That person didn’t really fit the culture of my practice”. Well, no wonder it didn’t work out with them.

[ALISON]:
Yeah, for sure. And there’s other red flags, too, that I’ve learned along the way. Like, if you see on a resume, somebody who’s, like, hopped around to a bunch of different jobs, that’s a bit of a red flag to me, and also, I look for people – and this is my style of management – but I look for people that have a lot of experience because I don’t want to be hand holding. I realize not everybody has that perspective, but if you don’t already have outpatient experience then, you know, it’s gonna be hard for you to get the learning curve of the pacing of outpatient and all of that kind of stuff, so that’s probably not a good fit for me as well.

[WHITNEY]:
Yeah, this brings up a really good point about the business owner knowing themselves and knowing what they like and don’t like, and it is okay for any of you that are new to group practice owning, like, not figuring that out, because sometimes it takes some time, but as you grow, you figure out what you do and don’t want, and I’m like totally the opposite. I love investing in my staff and, like, really being able to help them in the process. So, I actually have found that I do best with people who are not as experienced, a little bit more newbie, maybe they’ve only had two or three clinical jobs, I really enjoy those and they kind of fit the mold of my practice a little better, but I love getting super involved.

[ALISON]:
Yeah, and I don’t, so yeah, good point about, you have to know yourself and know what your passions are, and like, my passion is not mentoring young therapists which is fine, and yours is, which is great, because we need it in the world, but just, you know, being honest with yourself about what you want your practice to be and being okay with the fact that you don’t want to mentor young therapists and that’s okay.

[WHITNEY]:
That is okay. Yeah. And I know, at least for me, my first two hires didn’t end up being the best for the practice, and I, oh boy, I mean, I feel like the whole hiring process, it’s almost like dating, you know, it’s like, you’re trying to find someone that you want to date more long-term, and then you go through this interview process, and then you hire them, they work for you, they leave or break up with you, and you’re like, ah, and so… I just remember my first two not working out and just feeling super discouraged and upset, like, what is going on here? And within a Facebook group, I had a couple of people, and actually you might have been one of the ones that commented on this, a couple people who said, “it’s okay, a lot of group practice owners make the wrong hires at the beginning”, and “you can do this”, and it was just this, like, huge encouragement, and people were like, “I’ve had that problem too”, and ever since then – I’m seriously knocking on wood – almost all my hires have been great. And that really, it’s like, that experience helped me so much to find my culture, because I don’t know how much I really had a good grasp on that, and it really improved the overall practice. And so, so much of what we do revolves around that hiring process.

[ALISON]:
Yeah, I mean, I feel like that makes or breaks your whole experience as a group practice owner, because I have awesome clinicians now, who just, like, are independent and do their job and they know that I’m here for them if they need something, but otherwise, they, you know, do an excellent job managing themselves and, like, that makes my job super easy. So, yeah, it definitely is a stark contrast to, you know, knowing you maybe hired a bad fit and, like, waking up in the middle of the night worried, like, are they going to, like, ruin the reputation of my practice?

[WHITNEY]:
Yeah.

[ALISON]:
Are they, you know, like, how many progress notes do they have missing because they’re, like, chronically behind in documentation? Like, it’s just, the stress is just not worth it.

[WHITNEY]:
Absolutely not. Alright, what do you have for number five?

[ALISON]:
So, number five is not having the vision of a CEO, and I’ll explain this a little bit. So, I think a lot of times, you know, people tend to start a solo practice and then they want to grow into a group practice and they sort of just keep on doing the same thing that they were doing at the solo practice, like, they’re seeing a lot of clients, and they’re just, you know, doing the day-to-day, making sure the day-to-day of the practice is being taken care of. And that’s all well and good, but if you’re not setting aside that sort of time to think about, like, long-term future planning, that big-vision, CEO-type perspective, I think you’re really missing out on making your business, you know, really excellent. I know, for me, I’m always thinking, like, three to six months in advance. So, I’m not just focused on “Oh, what do I need to get done today?” It’s like, “No, three to six months from now, where’s the practice going to be? What is the, you know, flow of clients? Am I going to need to hire?”. Because we take insurance, I hire people three months in advance, because we have to get them credentialed, so, right now, you know, it’s September, but I’m thinking about January, because probably, I’ll start interviewing people now knowing that I want to add people in January. So, it’s just, like, that type of thing that you have to be thinking through, and I think, too, like, I’ve come up with some creative ideas for the practice, like, we established our own EAP contract recently. So, instead of kind of contracting with, like, an EAP agency, and then, you know, the EAP agency contracts with the business, we kind of cut out the middleman of the EAP agency, and we contracted directly with the business. So, we’re getting a much better rate than we would contracting with the EAP company and now I’m, you know, establishing relationships with business owners in the area and, you know, we’re getting paid well to do these EAP services. So, it’s just, like, those kinds of things, like, if I didn’t have time to, like, talk to those other business owners, or just have time to myself to, like, think about those types of ideas, like, we wouldn’t ever sort of get better or come up with new things, or, you know, all of that stuff that you need, like, a leader or a visionary to do for you.

[WHITNEY]:
It’s so true. I mean, group practice owners are so stuck in all those details of their practice, it is really hard for them to kind of get past that and look at the big picture, and that is what’s going to take the practice forward. And I love how you came up with that cool idea for the EAPs, what a service that you’re providing for them. And, yeah, you gotta have that time to think through it. I mean, I try at least, you know, end of the year, beginning of the next year is always that perfect time to gameplan, and so, I do my goals, like, every three months, every six months, every nine months, and every year, so that I kind of have those short-term goals, but then also those long-term goals of where I’m going and making sure that those little ones get me to the big one, you know…

[ALISON]:
Right.

[WHITNEY]:
… that I’m going towards, yeah. So, it’s so important that we [be] visionary for our practice.

[ALISON]:
Yeah, definitely. Do you have an example of how you’ve done that, Whitney?

[WHITNEY]:
Yeah. I always have financial goals, that’s for sure. So, I might say, “Hey, I want the practice to make this amount at the end of the year”, and so, then, coming up with ways over that one year period, every three months, having something that helps move the practice forward in a financial sense, and that could be hiring somebody or creating a new product that we want to offer. One of the things that I really have wanted to do is develop better relationships with churches and, specifically cos of telehealth, we can offer services all over the state. And so, I was thinking, “Okay, well, how can I do this?” Well, if we could create really good relationships with pastors, those are the people who refer, right? And so, I actually have someone on my staff who’s a counselor and a local pastor. And so, I said to him, “What can we do?” And we just kind of problem solve, how can we get these referrals? And so, we decided to start offering a monthly webinar where it’s free and it’s on Zoom, and he talks about issues that pastors face within the mental health world. And so, that’s been going on for a few months now, and it’s growing, and it’s actually expanded even beyond our state, like, people in other states are attending this. And so, that’s something that I’m really working on as a practice, to kind of increase those referrals, because, boy, pastors are big people to talk to to get referrals from.

[ALISON]:
Yeah, that’s a great idea. That’s really cool.

[WHITNEY]:
Yeah, cool. Well, those were all super helpful. And then, let’s take some time to kind of talk about this new product we’re launching that I think people are really gonna get a lot of benefit from.

[ALISON]:
Yeah, so Whitney and I are launching a new program called Group Practice Boss and we are wanting to support established group practice owners. We have tended to kind of provide a lot of services for people who want to start a group practice, and we realized that there weren’t a lot of things that we were offering to established group practice owners. And you know, once you get started, you kind of just, you know, you’re presented with a whole new set of challenges. So, we are going to do a Facebook group, and then also, there’s going to be a Teachable platform where there’s going to be all kinds of resources, and every month is going to be a different theme. Do you want to talk about the different themes, Whitney?

[WHITNEY]:
Yeah, yeah, definitely. So, we were thinking, with these topics that we just discussed, that each of these would be able to be identified within this group. So, that’s just a little bit of, kind of, the things we’re going to hit on, but also, some of those deep dives are going to be that first one, the delegating, we’re going to talk about how to delegate out and hiring for that and things like that. We’re also going to talk about how to design your practice in your business to fit your lifestyles, instead of, like, living your life for your business, let your business live so that you can live the life you want. We’ll do a lot on hiring, retention, how to track intake calls, how to keep up with your KPIs, how to manage your staff… Those are just some of the topics. So, each month, instead of just doing, like, one webinar and then you’ll go do the work, we’re going to actually take a month with a theme attached to it and we’ll do that deep dive into that, we’ll have an ‘Ask the Expert’ about that, when we bring somebody in on that topic, we’re gonna offer a free webinar – it’ll be included as part of it – but it’ll be a webinar every week, at least one if not more, specifically surrounding that topic so that you can really get ahead in your practice. And then, also within the Facebook community, it’s just going to be that camaraderie of being able to help one another. As group practice owners, it can get lonely at times, and so, being able to have other people that you can bounce ideas off of and throw questions at. And, you know, Alison, one of the things I have loved about being a part of the Practice of the Practice community is just how authentic everyone is, and really being real about their stuff and about what it’s like to be a group practice owner, so I think that’s going to be something really valuable to this membership community that we’re doing, is having that space for that.

[ALISON]:
Yeah, I agree. I really like, you know, taking the approach of, like, I’m going to tell you as much of the good stuff that I’ve done, as much as the mistakes and the bad stuff that’s happened, so that you don’t repeat those same mistakes. And obviously, we’re not perfect, and we’re all just doing our best, and, especially in the beginning, you know, there’s a lot of trial and error. And so, yeah, so, I mean, I think we can all learn from each other in that way, and support each other too, because it is so lonely being a group practice owner, especially when you’re, you know, in your own local area, like, it almost feels a little bit weird reaching out to other group practice owners, because they’re kind of, like, your competition. I don’t necessarily, you know, feel weird about that, but I could see how other group practice owners might. And so, it’s sort of, like, you’re doing your own thing, and there’s nobody you can really reach out to, which I think is another reason why the Practice of the Practice community is so great because, obviously, you’re with a group of people who are invested in, you know, making their business better and, you know, just really doing things at a high level, which, I always like to surround myself with people who are doing things better than me, or, you know, doing different things from what I’m doing, because that inspires me to consider doing different things in my own practice. So, I think that’s one really cool aspect to it, too.

[WHITNEY]:
Yeah, most definitely. So, if you’re listening to this in the month of September, when it airs, then we would love for you to join our list, our email list, to get more information. And so, you can go to the landing page, and that’s practiceofthepractice.com/grouppracticeboss, and you can learn more about this Facebook community group, and then you can click on the link and join the email list. You can also email Alison or myself, and that’s [email protected] or [email protected], if you just want to chat with us a little bit further about the group. So, as far as the launch, we will be launching this group for two weeks only, and that’s going to be October 6th for two weeks. The cost of the membership community for the first two days is going to be $129 a month, and then after that will be $149 a month, so you will want to lock yourself into the price on October 6th and 7th to get that discount, and that will be a long-term discount for you. So, go on to the lead page, join the mailing list so, that way, when that goes live, you’re going to get that email so you can go ahead and join. But I think this is going to be an awesome opportunity. And we love Next Level Practice through Practice of the Practice, but we were finding that it was so perfect for starting practice owners, and now we’re going to give them somewhere else to go, once you’ve started your practice and it’s grown and you’ve started adding clinicians, this is going to give you a community to be a part of past NLP. So, we’re pretty excited about it.

[ALISON]:
Yeah. And I’m super excited to work with you, Whitney. I think it’s gonna be cool because, you know, you have the perspective of running a faith-based practice, of doing all cash pay, and my practice is secular, I guess, if you want to call it that, and we take insurance. So, like, obviously, we’re doing different things, and so you’ll get both of our perspectives, which I think is super valuable as well.

[WHITNEY]:
For sure. And you know, I always like to talk about the Enneagram. So, Alison is a three and I’m a one, and I have always heard threes and ones work well together, so threes are big-picture, ones are detai-oriented. So, she brings out all the things I’m not good at, so I’m glad to be working with her.

[ALISON]:
Thank you.

[WHITNEY]:
Yeah, yeah. So, anyway, head on over to that page, it’s practiceofthepractice.com/grouppracticeboss, and we thank you for letting us into your hearts and ears and minds today.

[ALISON]:
Yeah, thank you so much.

[JOE]:
Special thanks to the band Silence is Sexy for your intro music; we really like it. This podcast is designed to provide accurate, 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.