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Are you thinking about moving away but still keeping your practice? What are the logistics for managing a practice remotely? How has COVID-19 influenced managing a group practice from afar?
In this podcast episode, Alison Pidgeon speaks with Dr. Megan Warner about how she transitioned to managing her Connecticut group practice while living in Boston.
Meet Dr. Megan Warner
Megan Warner, PhD is a clinical psychologist who has a group practice in Guilford, CT. The majority of the time that she was living in CT, she was an assistant clinical professor in the dept of psychiatry at Yale School of Medicine. She moved to the Boston area last summer with her husband and children and transitioned her group practice to one that is primarily managed from a distance.
In addition to her practice, Megan has built a Facebook group to support people through COVID-19 (Flattening the Anxiety Curve) and soon hopes to return to her big idea, Practibytes, a space that connects researchers and clinicians.
Visit her website and email Dr. Warner at firstname.lastname@example.org
In This Podcast
- Megan’s motivation for starting the group practice
- Moving away from the group practice
- Logistics of managing your practice from afar
- Things that Megan didn’t anticipate after the initial move
- How COVID-19 has affected the managing of the practice
- The number one tip for anyone considering managing their practice from afar
- Megan’s online communities
Megan’s motivation for starting the group practice
Megan first started a solo practice in Connecticut with the goal of serving the community while maintaining a lifestyle that worked for her and her family at that time. With two young kids, she soon found herself overwhelmed with too many clients and needing to refer prospective clients elsewhere.
However, she only had a small number of referral options and was not comfortable sending people to other practices/clinicians that she didn’t really know. While many people think that group practices get started for financial reasons, Megan grew hers so that she could have more control over the situation and calm the anxiety that arose when she was fully booked but still getting clients calling in for referrals.
So, she decided to start looking at some of those referral sources to bring into her practice and began to transform her solo practice into a group practice, Guilford Psychological Services, in 2015. After searching meticulously for about a year, she brought two people on board at the same time, both of whom fit the community-orientated mission she had set for her practice.
Moving away from the group practice
At the time when Megan and her family were potentially moving from Connecticut to Boston, there were 4 clinicians, including Megan, and a few admin staff. She felt extremely conflicted with many questions floating around in her mind:
- What do people typically do?
- Does it make sense to manage the practice from afar?
- Do I keep the practice?
- Do I try to sell it?
Megan got stuck on that last question because she felt like she was not yet done with her mission. They hadn’t done everything they wanted to do in and for the community. She also considered heaving someone else to direct the practice, but she still felt anxious and conflicted about leaving behind a practice with so much potential. Ultimately, she decided to run it remotely and keep building it until it gets to the point where she can hand it over to someone else.
Logistics of managing your practice from afar
- Megan made sure to delegate those tasks that must be done at the practice so that she can focus on the work that can be done from afar.
- The initial plan involved a shift of all Megan’s clients, tasks, and responsibilities to Mondays and Tuesday mornings. She would come in early on Monday, stay overnight, and then leave on Tuesday to be back in time to fetch her kids from school. Sometimes, she even slept in the office with blankets and toiletries kept in one of the cupboards.
- Megan made sure to prepare her staff well in advance. She took each of them out to lunch and explained how much she was going to be relying on them, and they all were and still are very supportive. Once the move was done, she made sure to keep in contact with everyone and check-in every now and then regarding how each of them was coping with the transition. Megan explains that a large part of why the transition was so smooth was that she was very specific about the people being hired, so she knew she could count on them.
Things that Megan didn’t anticipate after the initial move
- The impact of not getting mail regularly on clients (checks, statements, etc.)
- Handling the collection and placement of water jugs – Megan is now considering a water delivery service instead.
- Issues regarding the scheduling of team meetings and making set times to check-in at the end of each day.
- Getting notarized documents, such as those regarding tax and appreciation of the practice furniture, from Megan in Boston to the respective places in Connecticut.
How COVID-19 has affected the managing of the practice
- Juggling the different state expectations
- Handling issues related to insurance and telehealth
- Preparing for physical therapy sessions
- Going from weekly visits to months without
Megan hasn’t been to the practice since March when lockdowns were first implemented, and quarantining was first encouraged. This is a stark contrast to her visits once a week to check-in with her staff and to handle many responsibilities and tasks. She has the weekly team meetings online, makes sure they know the channel of communication is always open, and even sends things like care packages to them in the mail.
The number one tip for anyone considering managing their practice from afar
Megan emphasizes the importance of being flexible and reachable, especially now with COVID-19. Issues will inevitably arise, and you need to be able to adapt what you’re doing and be available to your team members.
Megan’s online communities
Flattening the Anxiety Curve’ Facebook group
When COVID-19 began, Megan was feeling really helpless and wanted to create a space where she could write and let people know that it’s okay to be worried and stressed in these strange times. She started the group ‘Flattening the Anxiety Curve’ on Facebook, where she put up some blog posts about what is to be expected when going through something like this.
The group has also become a space for people to share important articles and resources relating to mental health, both related to COVID-19 and otherwise. Creating and running the group has also become a sort of self-care for Megan, as she now has a way to aid her own helplessness and she has created a special community where people aren’t necessarily seeking therapy but still appreciate and benefit from the advice and resources that get shared.
Megan founded this online platform as a way to connect researchers and therapists. Thereby creating a means of exchanging clinically relevant and practical research, as well as space where researchers can offer guidance to and get direct, valuable feedback from practicing clinicians and therapists.
- John Clarke Sold His Group Practice and is Starting a New One | GP 27
- Guilford Psychological Services website
- Email Alison: email@example.com
- PoP Group Practice Owners Facebook Group
- Free resources to help you start, grow and scale
- Work with us
- Consult With Alison
Meet Alison Pidgeon
Alison is a serial entrepreneur with four businesses, one of which is a 15 clinician group practice. She’s also a mom to three boys, wife, coffee drinker, and loves to travel. She started her practice in 2015 and, four years later, has two locations. With a specialization in women’s issues, the practices have made a positive impact on the community by offering different types of specialties not being offered anywhere else in the area.
Alison has been working with Practice of the Practice since 2016 and has helped over 70 therapist entrepreneurs start and grow their businesses, through mastermind groups and individual consulting.
Thanks For Listening!
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Hi there and welcome to the Grow a Group Practice podcast. I’m Alison Pidgeon, your host. Today, I am interviewing Dr. Megan Warner and she actually is running her group practice from another state. I became aware that this was actually a kind of a common phenomenon among group practice owners that, you know, if they had to move for some reason, or, you know, just. whatever their life circumstance was that they couldn’t be physically close to their group practice, they could still run it from wherever they were. And I wanted her to come on in particular, because I knew of Megan just through the Practice of the Practice community, and I saw her at Killin’ It camp this past fall and fall of 2019, and she was telling me about how it was going with managing her group practice from afar and I just thought, Oh, yeah, you have to come on the podcast and talk about that because I think there’s just so many pieces to it that you have to think through when you’re getting ready to make that transition that, you know, if you’re in a similar situation you may not have thought of. So, Megan shares a lot of great tips with you and I’m excited to share this episode with you.
Welcome to the Grow a Group Practice podcast. I’m Alison Pidgeon, your host. Today I have with me Dr. Megan Warner. She’s a clinical psychologist who has a group practice in Guilford, Connecticut. The majority of the time that she was living in Connecticut, she was an assistant clinical professor in the Department of Psychiatry at the Yale School of Medicine. She moved to the Boston area last summer with her husband and children and transitioned her group practice to one that is primarily managed from a distance. In addition to her practice, Megan has built a Facebook group to support people through COVID, called Flattening the Anxiety Curve, and soon hopes to return to her big idea, Practibytes, a space that connects researchers and clinicians. And you can find the Facebook link to that in our show notes. So, Megan Warner, thank you so much for coming on the podcast today.[MEGAN]:
Y’all, thank you so much for having me. I’m so happy to be here. [ALISON]:
Yeah. I think it’s great that we were able to connect about your kind of managing your group practice from afar. And so that’s kind of the majority of what I want to talk about today, because I didn’t realize until I had gotten into business consulting that this is actually pretty common that people may start a practice or move or maybe they just see an opportunity to start a practice in a different area from where they live, and so then they have to figure out how do I manage it when I don’t actually live close by? [MEGAN]:
That’s actually reassuring to hear that it’s not that uncommon, because that speaks to, like, it was such a crisis of indecision. So that’s actually very reassuring. [ALISON]:
Yeah, yeah. So, maybe we can just start off by hearing about what was your motivation to start the group practice to begin with? [MEGAN]:
Yeah, so I kind of love this story. It’s sort of like, you know, people like to tell their love stories, I like to tell the group practice story. Because when I started on my own, like I think as many of us do, I had no idea what I was doing, and I would never have thought about doing a group practice. In fact, I still frequently kind of look over my shoulder going, really? Like, what? Cuz I kind of tend to be, you know, kind of disorganized, and I just can’t believe, you know, this is happening, right. So, I started the practice in a mission to serve the community and wanting to have a lifestyle that, you know, worked for myself, my family – at the time I started my solo practice, I had a two year old and a five year old. But what happened is, and I think this happens to a lot of us, is I pretty rapidly got full, you know, like three months after starting, you know, I was pretty much booked, and I found it very stressful when people would call and say, “Yeah, but I want to work with you, who else should I work with?” And I did everything I could to like learn about the referral sources, and certainly I had referral sources, but it made me uncomfortable to send people places where I really didn’t know, you know, kind of the story of where I was sending them. And again, I had connected with these referral sources, but why I like telling the story is I think a lot of people think people start group practices for financial reasons, and that couldn’t be farther from the truth. I started this group practice for controlling reasons, like I wanted to have control over the anxiety that I felt when people called, and I could not serve them myself. So, I started looking, you know, I think, so I started the group practice in early 2015 and by 2017, I had been looking for, you know, 9 to 12 months for someone. And I think that’s another important part of the story, is that I was very fussy in terms of who I would consider bringing on board. And serendipitously, two people arrived at the same time and they were both fantastic, you know, they fit the mission and they had the website ready. And that’s the group practice story. I just wanted to have people on my team that I felt good about when people called me, and I couldn’t help. [ALISON]:
Yeah, and I think that is actually somewhat common that, you know, you feel passionate about the type of work that you do, or just passionate about you want people to receive really excellent services. And so, I think that’s a big motivator for me as well. Like, you know what good therapy is and you want to bring more of that to your community. [MEGAN]:
Absolutely, exactly. That community mindedness piece, I think, is huge and sort of, not always understood. So, yes. Exactly. [ALISON]:
Yeah. So, you obviously started the group practice, and then you were kind of building it up, and so, by the time you knew that there was a possibility that you were going to have to move, that you and your family were gonna have to move, like, how big was the practice at that point? [MEGAN]:
The practice at that point, I think there were… at the point of the move, there were four people total. I’ve just hired a few more people, but there were there were four of us and, in addition, some administrative support. And so, at the point I knew that we were going to move, it was a conflict. That’s sort of why I’m glad you’re talking about this because I didn’t know what people typically do. I didn’t know if it made any sense to manage it from afar, and I had, it was sort of a crisis of meaning in a way of do I keep this practice? Do I try to sell it? Like, what do you do? You know, when you move? [ALISON]:
Yeah, that’s what I was gonna ask you like, what were all the options in your mind about what you could, like, what you could have picked to do at that point? [MEGAN]:
I mean, I certainly thought about selling it, and that always induced a lot of pain, you know, because I feel like we’re not done with our mission. You know, like, I have things I still want to do in the practice. And so, one thing I considered a lot was, you know, the Boston area is pretty well-established with great therapists and also really well-established with dialectical behavior therapy which is something that I offer, I also offer a lot of trauma support, and our team is known for DBT and empirically validated treatments. And the Boston area, you know, there’s a million internship sites, they’re cranking out psychologists constantly that are very well-trained and, the shoreline of Connecticut, though it’s not far from Yale, still has a bit of, like, an insular quality about it. And so, when I thought about closing the practice or selling it or having someone else – another thing I thought about was having someone direct it, you know, and fully take over the role as director which, as an aside, I still toy with – when I thought about that, I just felt like a lot of anxiety because I don’t feel done. So, there were a number of possibilities that were entertained, but that was the conflict. [ALISON]:
And so, maybe we should back up a second. So, you were obviously living In Connecticut, and then I believe it was your husband got an opportunity for a new job in Boston, is that right? [MEGAN]:
No, he’s a scientist who really, you know, does his best work in biotech startups. And so, we had actually moved to Connecticut for a biotech startup job, and Cambridge is a haven for many biotech startups. And so, there’s always been a sense that Connecticut might be something that was impermanent. So, I’d always held that possibility. At the same time, I’m someone who really likes to plant deep roots, so even though I knew that was a possibility, I didn’t prefer that possibility when I would consider it. So yeah, he had an opportunity in Cambridge. And again, Cambridge is kind of where it’s always been, like, we’re probably going to land here, and it was such a good opportunity, and he was so drawn to it that it was just like a no-brainer that it was time to make the move. [ALISON]:
So how far apart is where your practice is in Connecticut and where you are in Boston? [MEGAN]:
it’s probably two and a half hours, you know, by car, and about the same by train. Pre-COVID, I was taking the train down to check in on the practice into work, and I was able to leave and catch a 06h30 train, you know, about 30 minutes out of town and be in the office at 08h30. So, it’s not unmanageable. [ALISON]:
Okay, so, yeah, so doable in one day, although that’s a long day. [MEGAN]:
Could it be doable in one day? I did not do that. I definitely did it in two days when I was making that run. But yeah, not so far. I think, when I was trying to make the decision to kind of continue or not continue, the distance was a factor in the in the ‘keep it’ column, because it’s not a hard drive. It’s kind of a nice drive, actually, once you’re out of Boston. And you know, it felt manageable. [ALISON]:
Yeah. So, what helped you to make the decision to ultimately run it from afar, essentially? [MEGAN]:
Yeah. I mean, you know, ultimately, I think it was a values decision. I really feel a need to say, like, there was a lot of soul-searching in this time, you know. There were many tears shed over what to do. I talked to my team after I made the decision and it was, you know, very affirming, but it was a hard decision at the time because there’s something that felt very clean about letting go and moving on and leaving this town that I love so much. I was attracted to, like, the cleanliness of “let’s just be done and, kind of, take this next chapter”. But I kept coming back to this value of, like, there’s more to do here and, kind of, going to your point also, like, the community doesn’t feel as served as I want it to, you know. There’s groups that we haven’t started yet. We didn’t have a kid or adolescent person that fit, you know, our mission which, as an aside, we just hired, you know, last week, and so I just didn’t feel done and so, it was a values-driven decision, for sure. [ALISON]:
Yeah, I think so much of starting a business feels like another child, at least for me that’s how it feels. And so it’s like, you want to, like, see that child grow up, and you want to keep nurturing it, and like, you don’t want to just, like, give it to somebody else, here, like, “take care of my baby for me, and I’ll like, talk to you once in a while”, you know what I mean? [MEGAN]:
Exactly. This baby doesn’t feel launched yet. You know, like, maybe when the baby’s 18, or maybe, like, in practice years, that’s, you know, 7 or 10, I don’t know. You know, but I want it to be at a place where I feel like I could hand it to someone and feel like it’s ready. Right? All the systems are in place, and all the groups are being run. We’ve hit a number of those checkboxes. You know, we have a reputation, we have a great team, but I’m just, yeah, this baby isn’t ready to move out of the house yet. [ALISON]:
Yeah, that’s how I feel about my practice too. [MEGAN]:
Yeah, exactly. [ALISON]:
Yeah, yeah. So, when you finally did make the decision to keep the practice and run it when you were living in Boston, what were some of the initial thoughts that you had in terms of, like, logistics? Like, how is this actually going to work? [MEGAN]:
This is where I think, you know, this topic I know comes up a lot in our communities, you know, of delegation was really important. Like, we have someone who cleans the offices every other week, and they have a key and, you know, that that stuff is done. So, I didn’t feel the pressure of that. But there definitely was a sense of paralysis of catching all of the loose ends. How is this going to work? And my primary issue was maintaining connection with my team, you know, in terms of actually seeing my team, and you know, having that opportunity to take people out to lunch and see how people are doing, to conduct interviews, and also to see my own clients. So that was the main stress, can I maintain some balance? And so, initially – and this is the pre-COVID conversation – the initial plan was to shift everybody to Mondays and Tuesday mornings, all of my clients, whatever staff meetings I could do, and then I would come in early Monday and just kind of crank it out, stay over on Monday night, and then be home to pick up my children from school Tuesday afternoon. And I was able to balance that, and that was great. That let me kind of take the trash out, and make sure the plants were all still alive and, you know, there was nothing that needed to be purchased, and that people were doing fine. So, that that was the initial plan after I considered what the hiccups would be. [ALISON]:
Yeah, and I think, too, you were telling me before we started recording about how you actually, like slept overnight in the office. [MEGAN]:
How does that work? [MEGAN]:
Now, I’m not sure I would recommend it, and I would definitely not recommend, you know, sharing it with, you know, like, people in your community, because clients will hear, you know, and bring you breakfast. And there are a couple of clients that do, and they would show up, you know, before I’d open the office. So how it worked, it was exactly as you would imagine. The office is designed in a way that the waiting room is behind, like, a double-bolted door. So I would, you know, shut the office down, I would see people till 8pm, close the office down, you know, we have a refrigerator, a microwave, you know, infinite amount of things to, you know, drank water, tea, etc. And so, I would pick up, you know, Thai food or Indian food or whatever, and enjoy a very peaceful and, I know for the parents out there… So, it was a lovely Monday night alone in my office, the couch I used was actually the Coddle, and that’s a couch that flips down into a bed, and so I would just flip the couch into a bed, and I would just crash and I would start the next morning at 06h30 or 07h00 with my next client. So, it was heavenly. [ALISON]:
Yeah, and I remember you saying, like, you kept, like, a pillow and a blanket like stored in a cabinet so nobody could see it. [MEGAN]:
Exactly. Pillow and blanket are in the cabinet and I had a, you know, toothbrush, toothpaste, the whole, you know, dry shampoo, the whole thing. [ALISON]:
You were all prepared. [MEGAN]:
I was all prepared, and I reflect on those times as those were the good old days when I could crash in the office. [ALISON]:
Oh, that’s funny. So, because you were essentially, before COVID, coming into the office once a week, was there not as much of a push to delegate absolutely everything to other people? [MEGAN]:
I wouldn’t say the list of delegations has changed at all, except for details like who gets the mail, and who gets the water, you know, so, other than that, I had delegated most of it already. But yes, it was easier. You know, really, I miss kind of walking through the offices, you know, because there’s things you don’t anticipate. I mean, I’m not, like, obsessively orderly but, you know, this book is out of place, or this tea needs to be restored or, “oh, I should order more lemon ginger tea.” I don’t think there’s anybody that’s going to do that in the way that I’m going to do that, you know, in the way that a practice owner is going to do that. [ALISON]:
yeah, I come in and I fluff the pillows on the couch. Which I like don’t ever do at my own house. But I’m like, Oh, yeah, we this needs to be… [MEGAN]:
Yeah, exactly. I used to vacuum the couches, sometimes when I had nothing to do on Monday nights. I would just stay up and vacuum all the couches like, no one’s gonna vacuum the couch. [ALISON]:
Yes. I’m laughing because I’ve done that before. [MEGAN]:
Hopefully, they’re okay. Right? Like, hopefully they’re okay, but they’re okay because no one’s been sitting up. I’m like, I’m thinking, “How do I get there to vacuum the couches? Oh, my God”, but they’re fine. No one’s been sitting on them. They’re absolutely fine. They were vacuumed in March, it’s all good. [ALISON]:
So, when you made the move to Boston and now, you kind of have your new schedule, were there any shifts in terms of your staff, or how you were managing the staff? Or even just, sort of, their perception of how the practice was being run? [MEGAN]:
Do you mean like post COVID? Like in this current window or pre-COVID? [ALISON]:
No, like, right when you first made the transition, like you’d just first moved, and you were just getting the hang of running things remotely. Like, was your staff just like, smoothly transitioned to that setup? Or was that difficult? [MEGAN]:
That’s such a good question, and that goes to this point that I wanted to make sure to share today, which is, I think it matters so much who you hire, like, in terms of how smooth working from a distance can be. My staff was fine. You know, I had been preparing them all along the way, so there had been no shock, you know. As soon as I made the decision, I took each of them out to lunch, I kind of shared it in a way where I explained to them that they’re, you know, foundational members of this team, and I’m relying on them. And also, I want to hear from them how it’s feeling, and I only got support. And I think also, importantly, after the move was done, I made a point to check in with each of them, have a meal with each of them and say, how are you doing with this? Is this feeling okay to you? And across the board, people were feeling absolutely fine. They weren’t feeling like they saw that much less of me, and even still, I think they would say that because, the way of, you know, group practices, I think all of us like working with a team. But the truth is, you know, it’s really hard to spend much time with each other and prolonged amounts of time because everybody’s busy, you know, shuffling among clients, so I think, you know, the key there is that I checked in with them and also that they are all autonomous, you know, kind of, personalities where they didn’t have a need to have me, you know, down the hall from them. [ALISON]:
Yeah, I think those are some really good points, like you said, you prepared them well ahead of time, and I’m sure you also probably went through, like, the logistics of, you know, how’s this going to work now that I’m not here all the time? But also, yeah, having people who are a good fit and who can work independently is so important. Because, yeah, I could see how, if you had really green therapists, that might have really rattled them. [MEGAN]:
Exactly. And there was a hire I almost made kind of around the same time. And this is where, I know this is a bigger conversation about, kind of, making hires reactively versus wisely, and I almost hired this person. And just, in the discussions and the interview discussions, and she wasn’t an agent, she was just sort of a, someone who had more need to, you know, check in. She asked so many questions with such urgency, you know, that it made me very stressed. And I was like, I can’t. This isn’t a good fit if I’m going to be far. And so, that was an important takeaway for me, like, I need to hire carefully going forward, I just hired three people. And they’re all very, you know, independent, capable, etc. Yeah, that’s a good point. [ALISON]:
The other thing I’m wondering too, I’m sure you prepared for as much as you could before you actually made the move. But I’m wondering, were there things that you didn’t realize or think about until you actually started managing the practice from afar? [MEGAN]:
I definitely didn’t think about things like how not getting the mail regularly would impact clients, you know, so this issue of getting the mail to me has become a real issue because I’ve heard a couple times from clients, like “Well, do you not have my check? I see that, you know, it hasn’t been put on my, you know, on the statement.” That’s because you know, it’s sitting in a mailbox or in the mail pile that one of my team has been collecting for us. So, issues like mail, certainly, who’s going to carry the water jugs up the stairs, and who is going to pick them up, you know, I may have to shift to a water delivery service at some point… You know, things like that. And then issues of, you know, scheduling, making sure to block on the schedule team meeting times, because there aren’t those opportunities to peek in and chat at the end of the day, you know, so really holding, you know, making sure that those times are available. So, there’s a number of things like that that have been, kind of, you know, you take them as they come. Yeah. [ALISON]:
Yeah. And I think about, too, your experience with managing your practice from afar was a little bit like my experience last summer being on maternity leave. You know, I had a C-section so I couldn’t drive, so I was kind of stuck at home for a while. And I think the biggest issue that we ran into was me signing the checks, because I’m the only check signer on the account, and so my assistant actually had to bring the checks over to my house so I could sign them and then she would take them to the bank. [MEGAN]:
Exactly, things like that. Yes, exactly. You know, another thing that’s coming up now is, you know, each town has, you know, tax, like here in Connecticut they tax your furnishings, like, one way the town gets tax money is they tax the things you buy for the practice each year, as well as appreciation of things you’ve bought in the past, and so that has to be notarized and delivered to, like, the town, you know, the main town building, and like, how do you deliver a notarized, you know, they’ll notarize it for you and the building, but that doesn’t help me, I’m, you know, two and a half hours away, so I have to get it notarized up here and mail it. Yes, there’s definitely a yes. It’s an adventure. [ALISON]:
Yeah, for sure. So obviously, things have probably changed a little bit or maybe quite a bit because of COVID. So, what happened when COVID started, in terms of how your staff was delivering services, but then also how you were managing the practice? [MEGAN]:
I think the most dramatic shift in COVID is juggling the different state expectations, you know, like, wanting to make sure I’m respecting the Connecticut recommendations from the governor, and when can businesses be opened, and the requirements for mask-wearing because, of course, up here I’m hearing about the Massachusetts requirements. So, I’m sort of always opening both, you know, state of Connecticut pages, state of Massachusetts pages, as well as the insurance, you know, hiccups. We’re not in network with any insurance companies, we’re definitely an out of, you know, network practice. However, you know, there are implications if clients submit for their telehealth practices. So that’s been an additional piece to try to make sense of that, and I’ve brought in a billing person to help make sense of that and help advocate for our clients, it’s certainly been an issue for some of our clients where the insurance company’s like “Well, you didn’t get an authorization in advance.” We had no idea we needed to get an authorization in advance, you know, for out of network, so that’s been a post-COVID challenge. And definitely, yeah, the navigation of when do we go back? Certain people only want to see their therapist in person, how do you navigate that? Do we have any offices that have six feet of distance, etc.? So, in my garage right now, for example, I have a ton of masks, sanitizing wipes, and cleansers that I haven’t had to bring down yet because, generally, as a practice, we’re not working yet in person. But there have certainly been accommodations that have needed to be made. [ALISON]:
So, you haven’t been traveling down to the office since COVID started? [MEGAN]:
I haven’t. I’ve been contemplating taking a trip. I had one that I intended to take in July and then something came up, but I want to do that this summer before the fall picks up and, you know, set up the cabinet with masks, etc. So, I haven’t actually gone down at all since March, which has been pretty weird. [ALISON]:
Yeah, and so, how has that been? In terms of, like, you have that connection where you were going down once per week, at least, and now you don’t have that. So, has there been differences in how you’re, like, interacting with the staff or just other things you’ve had to change or think about, because you’re not actually physically there on a regular basis? [MEGAN]:
I think the main thing with the staff is like, you know, we have a really lovely team, and I keep our team meetings happening. So, we have a weekly team meeting where we can all check in. And that’s a way to both check their morale, which I think it’s, you know, taken a hit a couple times since this started, and also to check in with, you know, sort of administrative hiccups that are definitely coming up. So, we have these weekly staff meetings. So, I feel like the staff is feeling, you know, I think the team, I hope, is feeling supported. And then also in that spirit, you know, I can’t, there are certain ways that you can offer support when you’re there and that is typically, like, I’m going to pick up a coffee for you, or I’m going to check in, or like, I used to leave, you know, stroopwafels for one of my team members. When I would leave on Monday nights, I would leave, like, little treats, you know, I can’t do that now. So, you know, I sent a care package, I’m thinking about sending them, you know, something in the mail coming up here. So those sort of gestures, I think that’s where I feel at the most is our community and collaboration. We’re known for being collaborative and compassionate, and that’s where I feel the impact of COVID the greatest, is not being able to support you know, our team. [ALISON]:
Yeah, I’m glad that you brought that up because I think that, for a practice owner who has been really intentional about, like, those little kind gestures for staff and wanting them to feel supported, like, I know I have had to think through like, okay, I still want to demonstrate that to them, but obviously, we’re not all in the office and can’t physically be with them right now. And so, how do I still demonstrate that with, you know, the limitations that we have now, which is like, Oh, we can only have staff meetings on Zoom and that kind of thing. And so, I actually did something similar where I sent them each a note just to say, “Hey, I’m thinking about you.” And I had these, like, packets of flower seeds that I stuck in there, just to say, like, you know, I know, things are kind of rough with, you know, going through COVID, and your clients are all going through it at the same time, and just, I hope this brightens your day, kind of thing. And they all loved it. Yeah. [MEGAN]:
They were just, like, so thankful and just appreciative that I did that, which is so funny, because it’s like, you know, it’s not something that really costs, you know, maybe it cost $1 between the stamp and the card and the seeds, you know what I mean? It’s like, but they were so pleased that I would just be, you know, thinking about them and drop that note in the mail. [MEGAN]:
Exactly. I’m so glad you’re sharing that story. That’s a great idea, and I might copy it, if you don’t mind, or something like it. But I was thinking, as you were saying that, I think, with everybody working, you know, or many of us working virtually, we have to really be clear to our teams about what the, kind of, added value of working in a team is, you know, because I know that, if I was working, you know, alone doing telehealth, I’d be like, “why am I working for a practice? Like, what am I getting out of this? I could do this on my own.” And so, I have to kind of keep reminding them, right. Like, here’s why you’re part of a team, you know, you’re cared about and we’re like a, you know, a space for you to do this work and the space is waiting for you, and I’m here to support you. So, I think we have to kind of remind our team, what they’re why they’re with us. [ALISON]:
Right? Exactly. [MEGAN]:
So, if someone had, kind of, a similar idea in mind, maybe they want to move to another state but they want to keep their practice and manage it from afar, are there any tips or strategies that you would recommend to them that maybe we haven’t talked about yet? [MEGAN]:
No, I mean, I think the main thing that we, you know, as we’ve talked about, is to kind of be flexible and be ready to, you know, and be available, I guess, to be reachable, so that the team does feel like they can get ahold of you, as things inevitably do come up, and they do come up whether we’re down the road or, you know, two hours away. So, I don’t think I can, I mean… I think the logistic issues as we’ve talked about; mail, payroll, you know, who’s in charge of fluffing pillows, etc. I think, also come with time, you know, they come when you see the dust on the couch, like, you know, you got to kind of roll with it. So, I think that’s it. [ALISON]:
Okay, great. And I know you made a cute little PDF for our audience about just, sort of, some tips about that, managing a practice from afar. So, we will have that link in the show notes. So, thank you very much for doing that for us. [MEGAN]:
Yeah, yeah. [ALISON]:
And then, just switching gears a little bit – I know you mentioned you started a Facebook group to help support people through COVID called Flattening the Anxiety Curve. So, can you tell us a little bit about that? [MEGAN]:
Yeah, Flattening the Anxiety Curve. I started it when COVID began because I was feeling so helpless. So, sort of like a way to sublimate, you know, the powerless feeling, and I wanted to write and let people know that it was okay to be worried, and okay to be stressed. And so, I didn’t quite know where to put it. So, I built this, you know, group, Flattening the Anxiety Curve, and put some blog posts up about what is understandable and expected when you’re going through something like this. And mostly it’s become, you know, in addition to some blog posts, it’s become a space for, you know, important articles in terms of how to take care of your mental health. I have a wish that it would be a space, you know, if people wanted to write additional COVID, kind of, articles, it would be a good space for that. But I think everybody’s very busy. But people have been grateful for just, kind of, it’s like, cool, you know, cultivating kind of quality resources. And yeah, it’s been nice. [ALISON]:
Cool. So, you found that was sort of, like, almost like a self-care thing for you? [MEGAN]:
It was a space to put kind of, like, a little bit of, like, a restless agitation I had. I think, what’s interesting about Flattening the Anxiety Curve is it appeals to a different community than, you know, our clients. Like, I would say, the majority of people aren’t, you know, a clinical community. You know, I have the sense that these aren’t therapy-seeking. You know, like, there’s a large community that came through a friend of mine, and I, you know, who knows, you never know who’s in therapy and who’s not. But there seems to be a lot of novel ideas and content that I think many of us would not find novel, right? Like how to self-care. So, I really kind of wanted to reach the people that that don’t have access to therapists and don’t have a therapeutic history in their background where they don’t have that, you know, skill set. [ALISON]:
Yeah, that’s great. [MEGAN]:
So, community health and community health via Facebook. Yeah. [ALISON]:
Yeah. That’s awesome. Yeah. And the other thing I wanted to ask you too, about, is Practibytes. And I know that is kind of a big idea that you’ve had and, obviously, with moving, you may not have had a ton of time to work on that, but can you tell us a little bit about, kind of, the concept behind it? [MEGAN]:
Oh, my gosh, I love Practibytes and I can’t wait to get back to it. And, you know, hopefully this will kind of help light that fire. You know, Practibytes has been, like, a long time that I’ve had this dream of connecting researchers and therapists in terms of getting access to research that’s both clinically relevant and practical, and also to create a space where we researchers can hear from clinicians. Because one thing I have struggled with having a background in, you know, academia is you write these papers, you write these amazing things, and you know, you go to conferences, and everybody’s so excited and talking about the data. But when you leave the conference, you have the sense that like, no one’s doing anything with what you’ve found. And there’s a real reality to that, right. Research is such a silo. And so, I want to create a space where researchers can talk to us as therapists and quick, you know, very quick, like, 2 to 5 minute bursts of, here’s what my research has found that is relevant to you, specifically, and to your practice. Like, for example, there was this one, you know, I did host somebody who I know from my, you know, university history about personality disorders. So, for example, there’s a lot of literature that personality disorders actually change over time. And that in aging, you see a different pattern. So, the first person that I interviewed we talked about how, you know, they do actually shift their course over time, and that’s not what most of us have been taught, and it completely affects, you know, how you interact with individuals with those diagnoses when you know that you know age and presentation shift, so I want those kind of juicy, you know, morsels in our hands so we can give them to clients. [ALISON]:
Yeah, I think that, yeah, that’s so important and I think especially too, we, you know, we might go to trainings and do our required (inaudible) or whatever, but it would be nice to have, like you said, those, like, quick little bursts of information, maybe on a more regular basis so that we can just be continually like doing better therapy. [MEGAN]:
Exactly. And the clients love it. You know, clients love when you mention like, actually, the research says this about circadian rhythm are actually the research says that about, you know, ways to get increased dopamine in your system. They love that stuff, and you’ll find that they will quote it. So, the hope is that, you know, you create the space where, you know… The next person I’m going to host, and we’re in talking about when that’s going to happen, is going to talk about, you know, the neuro psychology of trauma. Feels like a relevant topic. You know, what’s actually going on in the brain when trauma is happening. And she’s, you know, a researcher at the National Center for PTSD. So that’s hopefully coming up. [ALISON]:
Megan, I think you cut out there for a minute. Could you just repeat what you just said? That’s okay. That’s okay. [MEGAN]:
Oh, where did I cut off? Did I cut off with who will be hosting? [ALISON]:
A little bit before that. [MEGAN]:
Did you hear my rambling about personality disorders? [ALISON]:
I think you were saying something about PTSD when you cut out. [MEGAN]:
Oh, yeah. So, the next person we’re gonna bring on board is someone who works at Yale in the National Center for PTSD, and she’s going to talk about the neuropsychology of trauma, and what do we know about what’s happening in the brain? And how can this, you know, what can we tell our clients about this that might help. [ALISON]:
Awesome. Yeah. Okay, good. Yeah, we I wanted to make sure we heard that because it sounded awesome. [MEGAN]:
Yeah. It’ll be great. I’m excited. [ALISON]:
Yeah. Very cool. Well, if the audience wants to reach out to you if they’re interested in either of the Facebook groups, or just want to make a connection with you, what would be the best way for them to get ahold of you? [MEGAN]:
Well, Practibytes has a Facebook group which I’ll send to you and you can put in the show notes, and Flattening the Anxiety Curve is there. And then, if anybody has any need to email me for any reason, they can reach me at my email address which is on my website, the meganwarnerphd.com website, but I’ll say it here really quick and it’s firstname.lastname@example.org. I also want to say our practice website if anybody wants to, you know, I know that I used to look at a lot of private practice websites, group practice websites, when I was getting that started. That is guilfordpsych.com if anybody’s interested in checking it out. [ALISON]:
Awesome. Well, thank you so much. It’s been such a pleasure speaking with you and thank you so much for sharing your experience. I hope it’s valuable for other folks. Like I said, I think there are more people than you know who were managing practices from afar. So, thank you so much. [MEGAN]:
Likewise, thanks for having me. [ALISON]:
So I love how Megan shared that story about how she actually was sleeping overnight in her office one night a week and nobody was any wiser to it, because she had a couch that folded into a bed, and she kept all of the blankets and things in a cabinet, I just thought that was hysterical, but very practical, and very smart because then she didn’t have the added expense of, like, renting a hotel or whatever, once a week. So, hope you enjoyed that episode, and I will see you next time.
Grow a Group Practice is part of the Practice of the Practice Podcast Network, a network of podcasts seeking to help you grow your group practice. To hear other podcasts like the Imperfect Thriving podcast, Bomb Mom podcast, Beta Male Revolution, or Empowered and Unapologetic, go to practiceofthepractice.com/network.
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