[LATOYA SMITH] The Grow A Group Practice Podcast is part of the Practice of the Practice Network, a network of podcast seeking to help you market and grow your business and yourself. To hear other podcasts like the Practice of the Practice Podcast, go to www.practiceofthepractice.com/network. You are listening to the Grow A Group Practice Podcast, a podcast focused on helping people start, grow, and scale a group practice. Each week you’ll hear topics that are relevant to group practice owners. I’m LaToya Smith, a practice owner, and I love hearing about people’s stories and real-life experiences. So let’s get started. Welcome back to the Grow A Group Practice Podcast. I’m your host, LaToya Smith. You know that on this podcast we talk about all things relating to group practice, so basically how to start, how to grow, how to scale. We talk about what you should implement, what’s going to help you be successful as a group practice owner, sometimes just the common topics and sometimes the ones that we don’t often think about, but we know we need as we’re growing our practice. But today is a little bit different. I have the pleasure of interviewing the newest consultant with the Practice of the Practice team, Mr. Larry Beer. So I’m really excited to have him on. He has had a successful group practice and I want him to tell us all about it and then I also want him to share how he can be of help to all of you when you’re looking for a consultant, when you’re looking to grow your practice, when you’re looking to scale and expand. I know Larry is the go-to person for that. So Larry, welcome to the podcast. [DR. LARRY BEER] Thank you, thank you. It’s good to be here. It’s nice to join you. [LATOYA] I’m excited to have you. Welcome to the pop team, the Practice of the Practice consultant team. [DR. LARRY] Yeah, it seems like a great team to be a part of. [LATOYA] Yeah, I think so. I’m a little biased, but I think so. First things first let’s tell the podcast audience a little bit about who you are. [DR. LARRY] Well, I’m a Licensed Psychologist and a Licensed Professional Counselor. I got my doctorate from Western Michigan University in 1986 and I started practicing in a group practice immediately afterwards, opened up my own practice in 1989 called Child and Family Psychological Services, I waited until I got my full license to be able to open it. Then my plan was to have me or three or four other associates because it’s nice to have people just to make sense out of things with and talk to with me in the practice but it just, the practice had a life for zone and kept growing and growing. So until I sold it in 2020 it had probably close to 50 therapists, mid-forties. At one point if you include interns, it reached actually having 50 therapists, which was like way beyond what I would’ve imagined but it worked. [LATOYA] Yeah, I want to hear about, I want to hear about this work. That’s a lot. [DR. LARRY] No, that’s, tell me about it. [LATOYA] I know you’re from New York originally because I can still hear the accent. I know you said you’ve been in Michigan for years, but that New York accent still very, very strong. Okay, so when you started the practice, did you even think like, okay, I’m going to start myself, then I’m going to have a group, or did it just evolve into that? [DR. LARRY] No, I mean I started with, I knew I wanted to have a small group and so I started with two part-time therapists. I was teaching adjunctively in the graduate school at Western Michigan University and I liked one of my students, so I invited her to join me and then I put an ad in the paper and someone, a master’s level psychologist said that he would like to join too. So we were off. I had a small suite. I knew I wanted this specific suite so I started paying rent a couple of months before I even opened it because I felt it was fair for me to give my other practice a lot of notice because me leaving would’ve hurt their volume and their productivity. So I gave six months’ notice to my other practice before I actually started seeing clients at Child and Family Psychological Services. [LATOYA] Okay, so you focused just on young people and families, you saw adults or was it a certain niche? Like what do you think helped you grow your group practice? [DR. LARRY] Well, yes. Couple questions. A couple of answers for you. So, yes, I started working a lot with kids when I was younger and as I grew, as I got older, it seemed like my caseload got older. One of the things that really helped me get going in practice was to, I found a niche and that niche was working with young, working with teenagers because a lot of people can’t work with like, especially like male teenagers. In my case, we matched maturity levels that helped me get my foot in the door and then once I had like that niche then I started getting involved in other areas, doing other types of therapy, doing couples counseling. I really like working with men’s issues and relationship issues and of course anxiety and mood disorders, anxiety and anxiety disorders and mood disorders, depression. [LATOYA] When you, and I love that you, that’s what’s something that in consulting we say to people, make sure you have a niche. Make sure you have an area that you “specialize” in so that way people know why they’re coming to you. What makes you, I always say what makes you stand out from other people, even if it’s the tiniest thing, make it right because now we want to make sure that people know that you’re there and yours was working with — [DR. LARRY] With some male teenagers. And at first it took a little while to like find like what that niche was and then for other people to find out about me [LATOYA] So what did you do in that space? Like what did you do to make sure that, hey, I started my practice. How’d you get people to know that you were there and that you had a team available? [DR. LARRY] Well, I would give talks if a place needed to talk and I wouldn’t charge just to get my name out there. I was just involved in general with the community through, when I became a parent and getting to know other parents of other kids seemed like that was like really nice connection for me. But basically, I would give talks, I would always, I would reach out to the, a lot of the physicians in town and if I ever did get a referral, make sure they gave them, send a note back just letting them know what about the status of their client, which sometimes is really hard. When you get really busy it’s really hard to fill that stuff in, but that’s really important to do that. [LATOYA] Absolutely, absolutely. So you did like the, you did the basic steps, found the niche, was intentional about building relationships in your community, showing people you’re there and standing out. It came time to grow, did you bring on therapists that were, had the same niche, like work with teens just like you or did you bring on therapists that maybe did some of the things you didn’t do so that you could help more people? [DR. LARRY] I focused more on the person than they did upon their particular niche at first. I would tell myself how would it feel to me to go to therapy with this person? The other part too is I had to be ready for them. I mean I had to be able to provide office space. [LATOYA] Okay. That’s another question that we get a lot, so did you get the space first or you got the people and maxed out the space you had? [DR. LARRY] I got the people first. First, I had like, there was, I was really fortunate that somehow people liked what I was doing and people reached out to me to join [LATOYA] Oh wow. [DR. LARRY] What I was doing. At first, sometimes I would get some from my older associates. They weren’t really excited about me bringing on new people because from their point of view, that felt like competition for referrals but what I told them is that when you bring our board a person, if they’re a really good therapist and a good person, you don’t just get that therapist, but you get that therapist and their network. [LATOYA] Okay, I got you. That’s a great point. That’s a great point. So that therapist with the idea of I’m bringing on a therapist who’s a great person, they’re going to bring their own following and they’re not going to take away from yours. [DR. LARRY] Right, exactly, all their friends just outside of therapy. Yeah, it’s going to you got to be careful who you bring a board because it’s going to affect the reputation of the whole practice. [LATOYA] Yeah, that’s a good point. You know what, like, I never thought about that. I never thought about if you have such a big team, is there, how do you keep that culture right and that teamwork and not like every man for himself mentality. [DR. LARRY] Right. I mean, and that’s a good question. so what I looked for was community oriented people. Because some people are great therapists, but they’re just like, they just really like operate in their own universe and they don’t really fit this community. I wanted people who, if we had a marketing event that they would want to go and join and be part of it. I wanted people who were collaborative in nature, because sometimes I thought that really helped me a lot was brainstorming with some of the associates who joined me. Like they brought up things that I might not have thought about and I really tried to use their ideas when I happened to agree with them. I didn’t always agree. [LATOYA] So you wanted forward thinkers and team players? [DR. LARRY] Yeah, team, definitely team players. People, team players, forward thinkers, two more things, one is that people who just like flowed with other people. The second thing which is really important is people I can count on. if they, if someone says something, I want to be able to take it in the bank, to the bank that they’re going to do that. I just think that’s a really important quality that someone has. [LATOYA] I love that. I love that you knew what worked for you. And I’m with you on that one. I love a team player. I love community-oriented people. You want to get out there. Like, I just love that. So you knew, listen, if you just about coming in, checking off two hours a day and going home, you’re probably not the therapist for this practice and — [DR. LARRY] Right. I mean, you could be a really good therapist could work with you somewhere else, but it really wasn’t what I was looking for. [LATOYA] What, but then how was that, when you were looking at, okay, I’m growing, I’m bringing people on, like, it sounds like there had to be some people you had to weed out or tell them, hey, this may not be the best fit. [DR. LARRY] Yeah, that’s true. I mean, I want to think I had a pretty good batting average in terms of selecting people, but I didn’t always get it right. So one of the burdens of being a group practice is that you get the benefits of being the owner, but when something goes wrong, it goes, it falls into your lap and you have to deal with it. [LATOYA] Right. [DR. LARRY] It’s not necessarily fun to deal with it. [LATOYA] It’s not fun but — [DR. LARRY] But you have to. I mean, I had a complaint once about a therapist falling asleep in therapy and that person was going through their own stuff. You try and help them out, but it’s much more fun to like, tell people, yes, to bring a board, but if somebody’s going to, one person can impact the reputation of the whole place. So when that happens, like of course you’d rather not deal with it, but you have to deal with it. There was a couple of times where I let someone go and I said, hey, look I don’t think this is the right fit for you. Let’s try and help you find the right fit for yourself and they didn’t necessarily like me for that decision, but I had a choice. I could either support my practice or let something go on that could possibly bring us down. [LATOYA] Yeah. I mean, when you say it like that, obviously we want to make the right decision, but you’re right, being the owner, it’s great when things are great, but it falls on us, when it’s not, we have to make those tough decisions. For you, if you have a team at some point of 50 people who helped you to manage it all? Like what structures did you set up? How did you elevate people to supervise? Like what does that look like? [DR. LARRY] Well, you have to, I mean, you have to be patient. I remember when I first started, so we’re talking here like 1989, early 90’s. It was a big deal when I could afford to get a fax machine because you don’t have that much money coming in. You have to manage what you have. But eventually when my practice became large enough and consistent enough, I was able to hire an administrative person who would take care of a lot of the things that I was doing or I was doing out of the practice. I was paying for services out of the practice. As I grew, then I had to pay for more administrative help. So one of the nice things about having a large enough practice is it gives you you have the volume that you can afford to pay for a high-quality administrative assistance. [LATOYA] As a therapist, I can tell you from experience that having the right EHR is an absolute lifeline. I recommend using Therapy Notes. They make billing, scheduling, note-taking, telehealth and e-prescribe incredibly easy. Best of all, they offer live telephone support that’s available seven days a week. You don’t have to take my word for it. Do your own research and see for yourself. Therapy Notes is the number one highest rated EHR system available today with a 4.9 out of 5 stars on trustpilot.com and on Google. All you have to do is click the link below or type promo code [JOE] on their website over at therapynotes.com and receive a special two-month trial absolutely free. Again, that’s therapynotes.com and use promo code [JOE] on the website. If you’re coming from another EHR, Therapy Notes will also import your demographic data quick and easy at no cost so you can get started right away. Trust me, don’t waste any more of your time and try Therapy Notes. [LATOYA SMITH] So basically, as you grew, you kind of, you used the money to to go back into the admin and support teams. What about with the therapist? Did you elevate some to clinical director or? [DR. LARRY] I did at one point. When it got really large, I had someone assume the director’s position. I was able to give him a better split and he took on the role of being the clinical director. [LATOYA] Ok, all right. Well, that’s good. Listen, if I’m going to build, I’m going to build a certain way, I’m going to set the structure up a certain way so that it’s stable. And I know like, just for people that are listening and therapists, I don’t know if anybody sets out to say, I want to grow to 50 people as much as it happens organically. [DR. LARRY] It really did. It really did in my case. And 50 people can be a little, LaToya, could be a little deceptive because not all 50 people had their own office. Like two biggest sources of overhead when you’re a practice owner are administrative assistants and rent. I mean, we didn’t, not very many people did virtual sessions way back when. But so, I had to be careful not to overextend myself because all of us were going to do this. If we’re going to go and take this risk of having a group practice, we want to become profitable but we have to do it intelligently when we’re ready for things when opportunities present themselves and hopefully, we’re going to make mistakes hopefully you want to make like the $10 mistakes as opposed to the $10,000 mistakes. [LATOYA] How do you, because I know you’re going to be doing some one-to-one consulting with those, with practice owners, especially those I know you can help with, like who want to grow, who have big practices, what type of advice would you give them for those that when you hear like, wait, that’s not a smart money decision or why are you going to buy a building when you’re not using up all the offices that you’re renting? So what’s the best way to lay out expenses, take a look at everything, like making the smart money move so you’re not top heavy trying to grow? [DR. LARRY] Well, I mean, I can give my own opinions, but the bottom line is that as an owner, it’s their decision. If they want to take the risks, I’ve seen some people I thought were going to be making some really dumb decisions and then they turned out to be great and then I saw people making some seemingly great decisions and they turned out to be not so much? I mean, as a consultant, all I’m going to do, like you, LaToya we give the best suggestions we can based upon the knowledge we have and it’s for the owner to consider what we’re suggesting to them and they’ll make that decision. Sometimes even if you make a decision and it doesn’t turn out well, it can still have other benefits. I can give you two examples if you want me to [LATOYA] Sure. [DR. LARRY] Okay, one time you try and get, I try and build a community in my practice. One way I thought we could do that and market the practice was to do a conference and we even connected with another practice so that my practice and other practice were going to do this like whole day conference for the community. We marketed it and we talked in the radio shows and everyone had their various presentations they were going to do and I think like a dozen people showed up. [LATOYA] Oh, wow. [DR. LARRY] So, I mean, from that point of view, in some ways we weren’t successful, but in other ways, I mean, think of all like the benefits I got from having my therapist interact with each other and building community that way. Think about from all the advertising we did, how many people heard about our practice. So that’s an example of when something didn’t go just as planned, but you can still get benefits. Another time I would say is when I opened another office inside of a medical center and really, I just thought it was a slam dunk, open office inside a medical center. But for whatever reasons it just, it wasn’t working and then I had to make the decision because it’s like takes a lot of energy to do another practice to close it up. So I did. So on one hand that idea didn’t turn out like I hoped it would, but then the therapist who were in that practice moved to my other prac, moved to my main office. So that benefited the practice in a way maybe I hadn’t expected it would. Does that make sense? [LATOYA] Yeah, it does. So it’s like goes back to the statement that you made of, hey, you got to do what’s best for you, the group owner, what “risk” you want to take or step out there. But you also, what’s that quote, I never lose, I either win or I learn. So there’s always something. I love it. [DR. LARRY] Great quote. [LATOYA] Definitely a quote, not mine. It was great. It would’ve been great if I thought of that, but I did not. So it’s the idea that you want to make wise, this is what I hear you saying, you want to make wise decisions, but don’t, everything’s not failure. You can look and say, okay, what did we gain from this? I love the part that you said like, listen, we may not have had a great turnout, but man we built, we were working on team culture and I mean we put our myths together and we saw what we can do. [DR. LARRY] Right, exactly. So yes, there’s some real, and there’s a lot to be said for team culture. I mean, I think like it’s so important for a group practice owner to develop a really strong team culture because that’s what’s going to attract other people to want to be part of what you’re doing. [LATOYA] I love that. So really, it’s the culture that, it’s the culture and the consistency and integrity that drives people to want to be a part of the team, right? I know back in, like you said, you started in the 80’s, wasn’t a social media presence, so it really had to be, it wasn’t like I could look and scan and see what you guys are doing. Like it really had to be coming to see you or seeing you in the community that other therapists want to join on board. [DR. LARRY] Yeah, I mean it was the reputation we were developing. I mean, things were different back then, that people really needed to practice under the supervision of a licensed psychologist too. So there was some advantages back then that I don’t think exist anymore in present. Now a licensed social worker, licensed professional counselor, marriage family therapist, I mean, they can open up their own shops pretty easily. [LATOYA] What, for those that will be working with you in the future, for those listening to this podcast and maybe they have a supersized practice now, what are some best ways that you enjoy helping other practice owners grow? What are some things that you’re like, man, this is really what I just love and how I can best help people? [DR. LARRY] Well, let me first say that I’m just getting into it. [LATOYA] You have a good resume. [DR. LARRY] I do. I mean, yeah, I mean, I feel pretty good about my career so far. [LATOYA] You’re doing, you did, you’re doing great. [DR. LARRY] And I learned a lot along the way from like some of the things, the successes and some of the, there’s no, would you say no failure is just the things you learned from? [LATOYA] Uh-uh [DR. LARRY] So, yeah, I mean, so I’ve learned a lot from my experiences. I’m at a stage in life right now where I’ve sold my practice to a national company and I don’t have to work, I don’t have to, I don’t want to work as hard as I once did when I was a practice owner. So yeah, to me it would be great to be able to help somebody, coach them and help them, just help their practice become larger and not even just larger, but even like more enjoyable for them. [LATOYA] Gotcha. I like that part because you can make it, you can check the boxes and it can be large, but it’s a fun, do you still enjoy the work? That goes back to culture, what we make of it, like what values we put into it and what we want to see happen. Like that. I like that. So this is good. I think, I know that you’re going to help a lot of people especially those that, because sometimes we don’t know, we set out to have big, next thing we know it’s a bunch of people we moving, moving and shaking. Or I know some people with multiple locations or desire to open multiple locations. [DR. LARRY] And I’ll be able to share like what my experiences were in terms of opening other locations and the things that worked for me and things that didn’t just to people to put into their mix and just consider. [LATOYA] Absolutely. Well, I thank you so much. Is there any last words that you want to leave with the audience? It may be a group practice owner that’s listening that wants to scale up, wants to go big, just doesn’t know first steps. [DR. LARRY] Two things. One is just always keep in mind, like, it’s got to be fair to all parties because if something doesn’t feel fair to the people who are contracting with you, they’re going to resent you and that’s going to, instinctly going to resent and that’s going to hurt your culture. So try and keep it fair. Sometimes the most fair thing is for somebody just to like, move forward, like take what they learn from you and do their own thing. That’s hard when you really care about people and you develop them and seeing them leave, but, but I really don’t think, like I’m personally, I’m not a big believer in non-compete clauses. You don’t want people there who don’t want to be there. It’s just not good for the practice. [LATOYA] Right. [DR. LARRY] So how’s that? [LATOYA] That’s great. I love it, I love it. [DR. LARRY] All right. Latoya, such a pleasure. Thank you for inviting me to do a podcast with you. [LATOYA] You know what, I appreciate you being a guest. I have this feeling, Larry, that you’re going to be a guest again in the future. I just feel it. Thank you so much. Wow, that was such an informative interview with the newest consultant, Larry. I just feel like he’s just a wealth of knowledge, somebody to definitely learn from when it comes to starting, growing, scaling your practice. If you know you’re listening to that, you’re like, man, I have a large practice now and I’m trying to figure out how to grow it, stabilize it, go over to the Practice of the Practice website, check out the consultants, and just reach out and message, email and see sign up for a pre-con consulting call with Larry to see how you can start working with them. All right, thank you so much for listening to the podcast. I hope it has helped you, gave you some great tips and I’ll check you all in the next episode. Thanks once again to Therapy Notes for sponsoring this episode. Use the promo code [JOE] to get three free months to try out Therapy Notes for free, no strings attached, and remember, telehealth is included with every subscription for free. If you love this podcast, please be sure to rate and review. This podcast is designed to provide accurate and authoritative information in regards 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 any other professional information. If you want a professional, you should find one.