[JOE SANOK] You’re someone with a vision for your practice, for your side hustle, and for your personal journey, but when it comes to establishing your path on how to get to where you want to be with your practice, things get a little messy. You’re also someone who’d prefer to go in person instead of to groups and listening to everyone else’s story. To me, it sounds like you could benefit from one-on-one consulting with our experienced Practice of the Practice consultants. From $595 a month and up, you can work with a consultant that will give you more direction and practical tried and tested tips matched to you and your goals. For more information, visit practiceofthepractice.com/apply. Again, that’s practiceofthepractice.com/apply. This is the Practice of the Practice Podcast with Joe Sanok, session number 852. [JOE] I am Joe Sanok, your host, and welcome to the Practice of the Practice Podcast. For the last month, we have been just digging into private practice issues things all around starting a solo practice. That’s what most of February was and now in March, we are kicking off all sorts of group practice, teachings, trainings, just telling you things that we’re noticing and talking to people that have launched all sorts of group practices. In fact, next week, in seven days on the 14th, I’m going to be doing a reverse podcast interview where I talk with Latoya Smith and she interviews me about trends that I’m seeing in group practice. So it’s five big trends that we’ve been noticing with our consulting clients, with our membership communities, and just as we really pay attention to what’s happening in group practice, some significant shifts in 2023. So that’s coming up in just a week. [JOE] But today we’re hanging out with Matt Fowler, who is a group practice owner, and he’s going to be sharing with us just what his journey’s been like. Matt, welcome to the Practice of the Practice Podcast. [MATT FOWLER] Hey, Joe. Thank you for having me. [JOE] Yeah, absolutely. Well, tell us a little bit about your private practice, your group practice, and a little bit about just you outside of your work. [MATT] Yeah, so I own a small little group practice out here in Portsmouth, New Hampshire. My personal practice, I specialize in treating children in family struggling with depression and anxiety and anger and my group practice specializes a little bit in helping kids with a wide variety of issues too. Each clinician specializes in our own little thing but we also see some adults and couples and families along those lines too. So being out here in New Hampshire, it’s a really great place. We really get all four seasons. We’re just coming off of a pretty intense snowstorm out here but really enjoy being outdoors. I live in a great area that’s right by the water, so get a good mix of mountains and water and all that good stuff. [JOE] Oh, that’s awesome. Yeah, Northern Michigan, we have quite the snowstorms in the winter as well. We don’t have the mountains even though some of the ski resorts call themselves that. We don’t have the mountains here. We got to fly out somewhere to see that. Well, that’s awesome. Well, tell me about the transition from solo practice to a group practice. What were you thinking about? What made you think I’m going to go from just a solo practice, want to grow a group practice? What were some things that you considered or thought through in that process of going from solo to group? [MATT] So, I started my private practice just going out in solo in about 2019. Right around that period of time, I didn’t have, I had this idea that one day I wanted to have a group practice, but just really wanted to get myself established. Then once the pandemic came along, I was in like a small little three person suite and the two other people that I was sharing the office with, they ended up leaving and going on to still do therapy but they just sort of went the telehealth route. So that was really at the period of time where I was like, okay, this is not, this was not part of my journey that I had thought was going to come at the time and s eventually decided at that point that if I didn’t take on those other two offices, I was going to lose access to the waiting room. So it was well, this is something I wanted to do in the future, and here it is a little bit sooner so started the sort of the process of getting involved and thinking a little bit more seriously about a group practice at that time. [JOE] What timeline did you have when you realized, oh, I’m going to lose this waiting room? How long did you have to make that decision? [MATT] That was probably about a six month decision when I had to make that. So it was about, all right, I need to figure this out pretty quickly for myself, along with everything else that needed to transition and change during the pandemic. [JOE] Wow, that’s a lot to take on in the middle of a big question mark of a year. So what was helpful, like as you made that decision, were there numbers that you ran? Was there, were there people you talked to or programs you looked at to really figure out what all it would take to run a group practice or are you more of a like, just jump full force in and figure it out as you go? [MATT] Once I sort of made the decision I was, I’m actually, in a fortunate position where I know a couple of other people who own group practices so it was really at that time I started to talk to them about how they set up and structured their group practices and how did they get started because there’s no rule book and guidebook, at least I felt at the time anyway that I to set that up. So I started just sort of researching a little bit, and then as time went, I really wasn’t sure what I wanted to do and actually came across your Group Practice Launch program and joined that in March of last year, putting that all together and decided that like there’s a structure, I don’t need to reinvent the wheel myself. I had all these ideas in my mind of how I wanted to structure things, but wasn’t necessarily sure which way I wanted to go with it. So joining that and doing your Group Practice Launch really just started an outline and a process for me of starting to put all the pieces together. [JOE] So how, where did you land with say, 1099s W2s? What infrastructure did you build at the beginning? Where did you say I know I need to do this, but I’m going to wait for a little bit? Take us through some of those maybe operational decisions. [MATT] So I eventually landed on 1099s. I felt like that was the best structure for me at least getting started. I think finances played a little bit of a key role. I think also company culture and what I wanted to be able to build sort of played a key role in that. Yeah, I had to weigh things back and forth. I think there are positives and negatives to each and so I really just decided that, all right, 1099s is the way to go. It sort of gives the clinician a little bit of that freedom of working for themselves but also still in that sort of collaborative group practice model that I was looking to build and get started with. [JOE] Take us through some of those pros and cons that you saw in making that decision, because that’s one of the most common questions we get, and I always love to hear how other people sorted through W2 versus 1099. [MATT] So I think there were pros and cons to each obviously. I think I landed on the 1099 because it felt a little bit, at least at getting started, like there’s so much to figure out with a group practice and which way you wanted to go. It felt like the 1099 route was a little bit more of the, of the simpler process and least the way that I felt going forward so it felt like, okay, I’m going to go this way and just go with a little bit more of the simpler process. But I really felt like I could have gone either way, depending upon how I wanted to structure it. So that’s not, I feel like it’s a little bit of a simplistic view, but in some ways I was a little bit overwhelmed with the process of just decided I need to pick one and go with it. [JOE] Yeah. Now that you look at where you’re at now and you’re, you have three or four clinicians working with you, I think? [MATT] Yep, so I have two other clinicians working with me. [JOE] Okay. So what would you say was helpful in onboarding those first two people to really learn to go from solo to group? [MATT] So one of the things that I felt like was a really good thing was to start to think of, I worked backwards and started thinking to myself of what did I need to do in solo practice to be able to get myself up and running, and then what am I going to anticipate that I’m going to need a clinician to be able to do, to get up and running and started to just put a list together and to be able to be as prepared as I could be. Then as I was walking through the steps, other things would start to pop up into my mind, things that I wasn’t necessarily doing before. So I guess some examples of that of how do you solve the steps and I need to make sure that I’m covering those things? How do they use the email? How do they access their our EHR program? how do they do all that? So just sort of taking notes as I went along. Then as I started onboarding clinicians in the beginning too, it’s sort of you don’t think about things until you think about things, so I’d be sitting there talking with some of my new clinicians and thinking to myself, oh no, I need to make sure to cover this with them, but at the same time writing it down so that with the next clinician that gets onboarded, I’ve already got that process ready to go to step forward with them, to get them on onboard a little bit more quickly. [JOE] Yeah, like today I was onboarding an executive assistant because mine left. The previous person had a list of all their roles and we started this Trello board for the executive assistant and just the amount of times I’m like in mid-sentence, I’m like, oh wait, I got to put this in there too, we got to cover this. You would hope you’d have all these standard operating procedures, but then over time sometimes people just start doing really great stuff for the business and they don’t document it and then it becomes part of the business, but no one’s holding that person accountable or saying here’s exactly how to do it. I feel like there’s just this constant push and pull between documenting and making sure your training is solid and just running full tilt in the business and be like, we got to hold on and just like, move forward and not just document everything. That can be such a push and pull for so many business owners. Do you feel like there’s things that you did during that onboarding with your first two clinicians that’s going to set you up for success in the future to make it easier to hire future people? [MATT] I mean, really just writing things down. I mean, you don’t know what you don’t know until you know it. So I was very honest and open with them in the beginning that there are things that I don’t know. So I was working very collaboratively with them to get things up and running so really just trying to document the process as much as possible so that the next time you get a clinician onboarded, you’re just that much further ahead in that onboarding process. But I also am very open with understanding that I’m still learning things and there are things that I might still need to add to the list as we go. I feel like it’s an ever-evolving process. [JOE] Yeah, I mean, I remember, I think it was my third or fourth clinician with Mental Wellness Counseling that I was onboarding and I hadn’t put on my onboarding document, give them a key to the office. It was like, they’re there for their first session and they’re like, how do I get into the office? I wasn’t there and luckily one of the other clinicians was there, but the door was locked and it was just like, oh my gosh. Like, just something so simple like that, like the door to the office, like how do you, how do I get in? I just assumed it would be unlocked for me. Oh no, everyone needs a key. It’s just those things. Then keeping track of the keys because the building didn’t want to have a bunch of keys just floating out there. So things like that can just, those of us that are more visionaries, those little details fall through the cracks sometime. What were things that maybe were more difficult than you thought in launching a group practice? [MATT] Being comfortable with not having everything figured out. I’m the person who likes to have a, like a plan for things. So I think going into this I had to realize and just get comfortable with myself that I wasn’t going to know that process. That’s still an evolving process as I’m going through this that I don’t know everything. So just trying to get comfortable with you don’t know it, but you’ll figure it out and you’ll put all those pieces together as you go. So yeah, I definitely think that is still something that I’m learning [THERAPY NOTES] Is managing your practice stressing you out? Try Therapy Notes. It makes notes, billing, scheduling, and tele-health a whole lot easier. Check it out and you will quickly see why it’s the highest rated EHR on Trustpilot with over 1000 verified customer views and an average customer rating of 4.9 out of 5 stars. You’ll notice the difference from the first day you sign up for a trial. They offer live phone support seven days a week so when you have questions, you can quickly reach out to someone who can help. You are never wasting your time looking for answers. If you’re coming from another EHR, they make the transition really easy. Therapy Notes will import your clients’ demographic data free of charge during your trial so you can get going right away. Use the promo code [JOE], J-O-E to get the first three free months totally free to try it out, no strings attached. Remember telehealth is included with every subscription free. Make 2023, the best year yet with Therapy Notes. Again, use promo code [JOE] to get three months totally free. [JOE SANOK] Now, how do you think through where you’re headed? Like do you have specific goals of what you want to do next or is it just let’s just ride this out for a while, or how are you thinking through that? [MATT] So I’m really, so I guess being here in January now, I’ve been thinking about goals and things like that. I know this is going to air a little bit later, but thinking about where I want to go with the business setting goals for myself. So this year I’m really looking at adding on a couple of more offices because it’s been great to have these two clinicians and there’s a little bit more space in the suite that I’m in. So I’m in the position of trying to set that up so that I can secure the lease to get those couple of other offices to really build a bigger community here of therapists. So I think having those goals as guideposts so that when you’re feeling that sort of discomfort of I don’t know what I’m doing, but I’m figuring it out and things are going well to be able to look up sometimes in those moments of like uncertainty of like, okay, this is where I’m heading and I just need to keep putting one foot in front of the other in order to get there. [JOE] Were there resources or other resources that have been really helpful in speeding that process up for you or books or mindsets? [MATT] So the Group Practice Launch was definitely good. Being involved in the community that you have set up on Circle is a really great resource. Talking with other group practice owners or even other people in solo practice of like what are they looking for if they were to join a group and if they’re an individual, why an individual practitioner just out by themselves, like why don’t they join a group just so that I can be aware of like what’s, what’s the climate, what are people looking for out there? I really liked the book, The EMyth, which talks about of how you’re working in your business and eventually how to transition to working on your business. I think that’s also going back to your previous question of where am I going? I feel like right now I’m in, I’m still in that space of working in my business and trying to eventually work towards how do I work more on my business. [JOE] For you, what would that look like to work on the business? Have you sorted through that? [MATT] My idea right now is to eventually, so even thinking further out to adding these other two opposite would be to start to see less clients on the clinical side so that I can be able to free up more of my time to steering the ship essentially, so where is the business going, how do I best use my time to operate the practice on top of doing the clinical work that I love and hanging out with kids and helping them overcome any of the challenges that they have. So really working towards getting to that point, which I hope to be in 2024, a little bit closer to that, but at least I know I’m heading in that direction. [JOE] Are there apps or systems or things like that that you find really helpful in just staying organized and keeping things top of mind that you need to work on? [MATT] I really like, so my ecosystem before was in Google Workspace and I really liked the different, when exploring the different things about what I’m looking for in my group practice, I really liked what they offered. So I use a lot of Google’s stuff as far as Google tasks to be able to keep me organized and what I need to do on a daily basis. My clinicians also use Google Workspace so that we can have a chat space back and forth on top of email to be able to communicate back and forth. So I really like their ecosystem as far as being able to set up a group practice has been great. [JOE] What are some of the things within there, like you mentioned chat, but what other functions that maybe people aren’t aware of are you using within the Google workspace? [MATT] I also use Google Meet, so I’ll use that for my telehealth. Then I give my clinicians access to that too, for their telehealth, which has been great. But it really just, it allows us to be both in person and if they decide, if the clinicians decide to do any work from home, to be also still able to communicate and operate both on an in-person and a virtual basis. Google Voice, I also use that too, which really integrates nicely into everything. I just, I really appreciate how Google works so well together and it seems to have everything, at least I need, as I need for the basics to get this started. [JOE] Are there trainings or things like that that you went through that helped you learn all those features or was it just figuring out as you went? [MATT] I’ve always been a little bit of a technology person so it’s been to sort of natural for me to tinker around the things. Really it was just playing around with, for my solo practice prior to this, I used just Google Workspace for my own email with clients and it really, I was impressed when looking through it and searching through what my other options were that just about how scalable the Google system was at that point. So it was really just sort of playing around and doing some research online that I felt like, okay, this is everything that I need in order to be able to create the at least digital climate that I wanted to be able to. [JOE] Ah, that’s awesome. So Matt the last question I always ask is, if every private practitioner in the world were listening right now, what would you want them to know? [MATT] I guess don’t be afraid to just start. I got stuck in that place of too much information, paralysis of the analysis and what I really just needed to do was start and to go forward and to start putting the pieces together and to yeah, really, really just to start. [JOE] That’s so awesome. Well, if people want to connect with you, if they want to look at your website and just learn more about your team what’s the best way for them to connect with you? [MATT] Best way to connect with me is through email, and they can do that at [email protected] and my website is www.oldportcounseling.com. [JOE] Awesome. Well, thank you so much for being on the Practice of the Practice Podcast. [MATT] Thank you. [JOE] I love just interviewing people to hear their process and the little tips that they had along the way and different ways that, ah, they just make things come together. Sometimes it’s going to be that they are coming up with things on their own, sometimes it’s resources, sometimes it’s books. So it’s just great to hear all these folks that have started group practices, have leveled up in a new way and are continuing to look at growing and addressing the mental health crisis in America and across the world through thriving practices. It’s just awesome to have these conversations. Matt did mention Group Practice Launch, which if you’re looking at going from a solo practice to a group practice, you can read more about that program over at practiceofthepractice.com/grouppracticelunch. Our next cohort is actually opening up next week and the early bird is going to be $650. You pay that twice and then that covers the cost of that six-month program. So you pay it, when you sign up $650 and then I think three or four months later you pay another $650, which is just all automated through PayPal. But that early bird is going to be on sale next week over at practiceofthepractice.com/grouppracticelaunch. And we couldn’t do this show without our amazing sponsors. Therapy Notes is the best electronic health records out there. It makes it so easy if you’re moving from a different EHR, maybe you’re frustrated with your other EHR and you want to switch to a new one, Therapy Notes will actually help with that transition. They’ve got 24/7 staff that can help you out, that you can actually talk to. Head on over to therapynotes.com, use promo code [JOE] at checkout to get two months for free and you’re going to just have the best EHR out there, and it’s going to be streamlined with all the rest of your systems. Thank you so much for letting me into your ears and into your brain. Have a great day. I’ll talk to you soon. Special thanks to the band Silence is Sexy for your intro music. . This podcast is designed to provide accurate and authoritative information in regard to the subject matter covered. It is given with the understanding that neither the host, the producers, the publishers, or the guests are rendering legal, accounting, clinical, or other professional information. If you want a professional, you should find one.