Level Up Series: Leveling Up at Every Phase of Practice | POP 827

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Level Up Series: Leveling Up at Every Phase of Practice | POP 827

Which phase of practice are you currently in? Do you need some helpful steps to easily take you from one phase to the next? What are your goals for your private practice?

In this podcast episode, Joe Sanok speaks about leveling up at every phase of practice.

Podcast Sponsor: Heard

An image of the Practice of the Practice podcast sponsor, Heard, is captured. Heard offers affordable bookkeeping services, personalized financial reporting, and tax assistance.

It’s never too early to start thinking about tax season.

Heard is the financial back-office built specifically for therapists in private practice. They combine smart software with real humans to help you manage your bookkeeping, taxes, and payroll.

Regardless of whether you’re a seasoned clinician or are in the first year of your practice, Heard will identify areas for growth and streamline best financial practices for your business.

When you sign up with Heard, you’ll connect your bank accounts so your transactions will be automatically pulled in and categorized. My favorite thing about Heard is their “allocation guide,” which helps you decide how much to pay yourself each month and how much to set aside for taxes.

You’ll also receive financial insights, such as profit and loss statements and personalized monthly reports.

You can say goodbye to poring over spreadsheets and guessing your tax deductions or quarterly payments. Focus on your clients, and Heard will take care of the rest.

Heard always has transparent pricing with no hidden fees. Sign up for a free, 15-min consult call today at joinheard.com/partners/joe

The deadline to sign up for 2022 tax services is December 31, 2022

In This Podcast

  • Let’s talk about solo practice
  • Let’s talk about solo-to-group practice
  • Growing beyond group practice
  • How to stress-test your group practice

Let’s talk about solo practice

The main goal of a solo practice is to create systems to scale a reliable referral network and an optimized hourly rate.

Joe Sanok

What are you spending your time on that cannot be scaled up? That’s an activity that may have little to no return on your energy investment.

So, change your focus and your energy input. What can you work on that will increase and grow on its own?

For your systems:

  • Think through, “Why am I doing this? Why am I starting a counseling practice? Why do I care about this niche?”
  • Ask yourself, “Do I want to learn this?”
  • Can you outsource the rest?

For your reliable referral network:

[A reliable referral network is when] people are routinely referring to you and they are routinely making sure that your practice stays full.

Joe Sanok
  • As a goal for solo practice, you want to have five to seven ongoing partnership referrals.

If each partnership refers one client to you that you can convert, you can easily start to project the direction that you want to plot the course of your goals for the practice.  

  • Do research: see how and with what people need help throughout the year, and build your referral connections accordingly.
  • Become an authority figure: position yourself as an expert in your field and your area.

You’re probably the only mental health provider in a room of 100 average Americans that have a master’s degree. So just the day [that] you graduate, you are an expert.

Joe Sanok

For your optimized hourly rate:

  • If you’re turning down sessions or losing sessions because you are doing basic admin, you are losing a significant amount of money.
  • In your solo practice, or if you don’t have the financial bandwidth to hire an assistant yet, you can look into automated booking systems.
  • Raising your rates: don’t wait until you are full to raise your rates.

The only time I see a waitlist as being appropriate is if you have decided for your community that you have to take insurance and there’s no private pay option, so you can’t raise your rates, and you’re maybe optimizing into a group practice and this is the only amount of time you want to work.

Joe Sanok

Joe’s advice: when you are 60% full, you know that you are going to continue to grow. Every year, raise your rates and realign.

Let’s talk about solo-to-group practice

The goal with this is to maximize your internal referrals … to better serve clients with your values, your culture, and your approach.

Joe Sanok
  • You have now built a reputation around yourself and your practice, and you can expand that, otherwise, you are limiting the amount of service that you can provide to the people who want to see you, and who you want to work with!
  • Hand-pick your superheroes to hire.
  • Then, replicate yourself. Find a therapist that is great and works in your niche so that you can continue to serve the same clients while you start to extricate yourself from so many clinical hours to focus on tending to and growing the business.

You are the brand ambassador. That switch on the website saying, “I do this, I do that”, to “We do this, we do that”, is a really important switch.

Joe Sanok
  • 1099s or W2s?
  • Create systems that are easy to understand that show you exactly what’s going on in your practice at a glance without having to talk to somebody each time you need to assess the process.
  • Aggressively remove the hats you have been wearing: when you do something, ask, “Why am I doing this? Can someone else do it, or is it only for me as the owner to do?”

Growing beyond group practice

In a group practice, you are working to create income that is not based on your clinical work. You want to grow and earn an income beyond your clinical work.

  • Automate your processes

How do you say things, how do you do things, and how do you approach things? Because we want to really capture your method which oftentimes is just about keeping track of it.

Joe Sanok
  • Move into a CEO mentality
  • Cut your supervision time and have your team meetings be functional
  • Keep track of your numbers
  • What will free up time for you to think big?

At this point, you really want to make sure that you have clear boundaries around your time … having those clear boundaries around your personal life is something that at this phase [is] a trap that people fall into because they’re working too hard [or too much].

Joe Sanok
  • Hire for growth, not to fill the role

Every year, ask yourself these three questions:

1 – What do you love doing that you want to keep doing?

2 – What is it that you dislike and you wish we could remove?

3 – What is something that you would like to grow into and learn?

Build your audience first because you want followers that know, like, and trust you and will purchase the products that you design specifically for them and their needs. This is how you build great passive income.

How to stress-test your group practice

Do you want to test your systems and see if your team is working well together? Take a month off!

What do you need to prep to do this? How can you prep your clients?

Try to not be available, even for two weeks. Then, have a debrief with your team afterward to see where things fell apart and where they need to be strengthened.

Then you [and your business] will get stronger [because] you’ll realize, “Okay, here are the things that were based on me that really shouldn’t be based on me”.

Joe Sanok

Books mentioned in this episode:

Sponsors mentioned in this episode:

  • Heard always has transparent pricing with no hidden fees. Sign up for a free, 15-min consult call today at joinheard.com/partners/joe
  • Use promo code ‘JOE’ to get three free months to try out TherapyNotes, no strings attached

Check out these additional resources:

Meet Joe Sanok

A photo of Joe Sanok is displayed. Joe, private practice consultant, offers helpful advice for group practice owners to grow their private practice. His therapist podcast, Practice of the Practice, offers this advice.

Joe Sanok helps counselors to create thriving practices that are the envy of other counselors. He has helped counselors to grow their businesses by 50-500% and is proud of all the private practice owners that are growing their income, influence, and impact on the world. Click here to explore consulting with Joe.

Thanks For Listening!

Podcast Transcription

[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 2022, the best year yet with Therapy Notes. Again, use promo code [JOE] to get three months totally free. [JOE SANOK] This is the Practice of the Practice Podcast with Joe Sanok, session number 827. What’s up everybody? So you’re here on time, so we are going to just dive right in. Speaker 2: We even already have some people who have leveled up here. [JOE SANOK] What, what? Who’s already leveled up? Speaker 2: Ashley already leveled up to Group Practice Launch. [JOE SANOK] Yes, we were just talking about that yesterday in the Q&A and we ran the numbers and it was like six months ago you should have done this, but hey, better late than never, Ashley. I’m so glad for you. Congratulations. That’s huge. Yes, we are going to be talking all about leveling up today at every phase of practice. I’m going to be going through some of the basics of each phase, so what we’re going to be covering today is all sorts of different things in regards to leveling up. Oftentimes, we only know what we know, so if you’re starting a group practice and that’s brand new for you, like it is for Ashley who just leveled up into Group Practice Launch, starting a practice, she probably could talk about that all day long and be like, here’s what I learned, here’s what I did wrong, here’s what I changed. But then there’s this unknown. In the same way that someone’s like, Joe, we want you to start a 20 million company. I would like to think I could do that, but I haven’t done that and so it’s like I would need some coaching, I would need some help, I would need some guidance, and I’d probably be a touch nervous if someone came to me and said, you need to do that. So maybe you’re starting a solo practice and you’re not sure where to start. We’re going to talk about that. Maybe you’re ready to hire your first clinician or grow a group practice, or maybe even ready to explore podcasting, e-courses, public speaking. I’m going to be walking through exactly what you need to do over the next six to 12 months. So let’s talk solo practice. This is, even if you’ve already done your solo practice, you’re leveling up into like Group Practice Launch, it’s good to think through these things again and just make sure you hit everything. The main goal of a solo practice is to create systems to scale a reliable referral network and an optimized hourly rate. All right, so create systems to scale. Maybe at the beginning you’re doing some things that aren’t really worth scaling, like I couldn’t replicate this, I don’t have a reliable referral network and I haven’t optimized my hourly rate, so what do you need to do? So we’re on systems to scale. You want to think through, why am I doing this? In a lot of ways we want to think about like just why am I even starting a counseling practice? Why do I care about this niche? Why do I want to help these people? So even looking at Ashley, one of our consultants, so her father, and she’s talked about this publicly on the podcast, her father had a severe drug addiction and eventually committed suicide. It was the death of her father was really the thing that made her say in my province in Canada, there are not enough therapists. There are not, there’s not enough support. The system in her area was not what she wanted it to be and she didn’t want to just have it be her this trying to address this. She wanted to have a mega group practice that could just have this compassionate heart for families that had people struggling. For her, why am I doing this because of the death of her father because her dad died from this. No one wants to have to start a business because of that but for me it’s like when I had cancer in 2012 and my daughter had heart surgery and one of my best friends Jen had breast cancer, like, the reality of the shortness of life really hit me. So to say, do I want to keep working at a community college for the rest of my life? Is that what my personal calling is? That’s great for a lot of people. It’s needed. My best friend Paul, I met him through that process. He took over my position at the community college. It’s great fit for him. It wasn’t for me. So saying, why am I doing this personally, why am I doing this for my family and my friends, why am I doing this for my community, for my clients? Just starting there and saying like, what’s behind all of this? Do I want to learn? This is a question when you’re just getting started. So for example, just yesterday in our Q&A we had someone that was just getting started, wasn’t sure where to spend her time and she didn’t have a website. So to say, okay, there’s some options here. Do you want to learn how to make a website? Is that even something you care to learn? Some people say, yes, I want to learn the hosting. I want to learn how to have my WordPress theme installed. I want to go through that process so I know it, so then I can teach someone else. Awesome. That’s what I did with Practice of the Practice. I made a really, really ugly website that after a couple years of blogging and podcasting, I finally put like $500 into upgrade and that helped me learn the basics of it. Now did that slow me down immensely? When we updated that website and it didn’t look like crap, the numbers went through the roof because it looked professional finally and didn’t look like it had been hodgepodged and just put together by me. So do I want to learn this? Do I want to learn bookkeeping? Do I want to learn all of the different things that it takes to run a private practice? Or do I want to find someone that’s better than me at this? So it may be with your systems that you start to think, okay, these are a few things that I really want to learn. I want to learn the website, I want to learn SEO, so eventually I can hand that off to an assistant because then that assistant is going to be a little bit cheaper whereas having a company do it might be more expensive. So you’re building those systems to scale. Next, we want to look at having a reliable referral network. What do I mean by reliable? It means that people are routinely referring to you and they’re routinely making sure that your practice stays full. As a goal, when you’re in solo practice, you want to have five to seven ongoing partnership referrals and so having five to seven people that probably monthly will send you one person that’s enough to keep you full. You figure if you know the lifetime value and length of counseling with someone to know that number, okay, the average person stays with me six months, or the average person stays with me 12 months, then you can run those numbers and say, okay, if I have five people that are sending me one person a month, then I know that those people are going to stay an average of six months. You’ve got to actually know your numbers. Okay, so those five people, then that means in month two I’m going to have 10 people, in month three I’m going to have 15 people. If you’re getting five a month, then month four, oh wow, we’re getting okay, 20 people, 25, 30, now we start to lose some of those people. Now we’re back down. So figuring out those numbers of, okay, maybe I don’t need five to seven, maybe I do really long-term therapy and when you run your numbers for a while, you realize the average person stays 18 months of weekly counseling, Well then you don’t need quite as many whereas if you do short-term counseling, you’re done in eight weeks you might need more referrals. So growing those referrals, building that networking and realizing that networking is really just meeting new people. I think it was Brian that said in one of our last what’s working, it was Brian Cooper who said I realized that networking wasn’t networking. It’s just like creating new friendships, new partnerships, people that I just enjoy hanging out with. When you start realizing that makes it so much easier to network. For me in the podcasting world, I love to go to podcast conferences because I just meet people who like get it and then the amount of partnerships that have come out of that. A lot of the people that are speakers for us have come out of those networking relationships and so being able to build those and just see where that goes. Also building a reliable referral network of just blind searches on Google. That’s where SEO is really important. So making sure that you have Search Engine Optimization, which means that when someone puts in your town plus counseling or plus couples counseling or a variety of different terms that you’re ranking high for that. You can use things like Google Trends to just see, okay, do people search counseling or therapy more often in my area? So to just know, okay three times more people use the term counseling than therapy, well then you’d want to optimize for counseling instead of therapy. Do people use the term couples counseling or marriage counseling? Well, let’s compare those. To be able to go into Google Trends and just put it in, you don’t even need to have like a Google Ads account to do that. You can just compare different search terms. And it’s pretty amazing to see where certain trends are during certain months. You can look back and see, okay, in July, it seems like every July for the last three Julys counseling has outranked therapy, whereas all the other months therapies outranked counseling. So you may release a bunch of blog posts in July that use the term counseling and so then being able to do that over time with some data. Then the third part of a reliable referral network is really that authority building. Authority building is positioning yourself as an expert. When you are an expert, a lot of you may not believe you’re experts yet, but just the fact that you have a master’s degree. We know that 8% of the US gets master’s degrees or higher so that means if they had a room of a hundred people, there’s eight of you that have a master’s degree or higher. Then of those eight, let’s think about master’s level attorneys, people that are doctors, nurse practitioners, you’re probably the only mental health provider in a room of a hundred average Americans that has a master’s degree. So just the day you graduate, you are an expert. Then we look at your own individual life situations, your own individual expertise, things that you’re interested in just reading for fun and certifications. So you are an expert. Then it’s how do we make sure that your potential clients know that you’re an expert? All of this is bedrock, so if you have a group practice or you’re doing other things and haven’t done these things, you want to make sure and you go back and you do these things to just optimize the solo practice. There’s a number of ways that you can do this locally or even nationally because that looks good for any website if you get national recognition. The first is look at your local news outlets, so in newspapers, local radio, local magazines. Being the go-to person around your specialty can be really helpful. For example, we have the Traverse City Women’s Magazine here that comes out every month. If I had a therapist that worked for me and she helped women in transition, I would want to make sure that we’re paying for her to go to the Women’s Magazine luncheon. They launch, they do these luncheons every time they launch a new magazine. It brings like female speakers together and all sorts of folks. I would want that person to be deeply involved there so that they could get quoted by Traverse City Women’s Magazine. But then you can also use things like Help A Reporter Out. Help A Reporter Out, national news organizations reach out three times a day through Help A Reporter Out in an email saying, we need someone to give us quotes on these. For example, it was probably five or six years ago, it was Reader’s Digest wanted some parenting tips. I replied to it and just said here’s five parenting tips. Joe Sanok is the owner of Mental Wellness Counseling in Traverse City, Michigan, blah, blah, blah. Then I got quoted in Reader’s Digest. Now, from that one thing, I could do a news release to local newspapers saying Joe Sanok was just quoted in Reader’s Digest for this, so then there’s these little snippets in the Record Eagle, which is our small newspaper, little snippets in the Traverse City Business News, Grand Traverse Women. Then people see that and they say, whoa, you were quoted in Readers Digest. They may not have caught the original Readers Digest thing, but now the local news connections I have are then promoting that and saying, wow, look, Joe was in Reader’s Digest in Small Traverse City. Not very many people are in Readers Digest. They’re looking for that local news. So you’re then building that authority. Then on your website you can have as seen in the Record Eagle, Traverse City Business News, Readers Digest. Then that Readers Digest article, the same article was just picked up by Red Book on their online. So then I could say as featured in Red Book. Sometimes you do one media appearance and then you get four or five other things that expand to build that authority for you. Next, we want to look at optimizing your hourly rate. So thinking through how much time are you putting into calls? Are you returning those phone calls? Are you doing that in a timely manner within a couple hours of someone leaving a message? Most people will just go through Psychology Today and they’ll just call person after person, like whoever within that basic they take my insurance, they take my niche or what I’m looking for who’s open first? Do you have someone checking your emails or are you the one doing it? Who’s doing the scheduling? Are there automated ways to schedule an intake or even just a like pre-intake phone call with you through your website. So making sure that you’re not spending all that time on calls once you start to get busy because if you’re turning down sessions or losing sessions, that’s a significant amount of money. So if you know, say you charge $150 a session and the average person comes 10 sessions, the lifetime value is $1,500. If you had hired someone at $25 an hour, how many hours do they have to work to make up that $1,500? So thinking through, okay, like it’s not just me saving money by answering my own calls, but I’m actually losing clients because someone’s not answering the phone, someone’s not checking the emails, someone’s not scheduling. So making sure that you’re optimizing your hourly. And you can do that in a variety of ways. You can have systems to do it, so you can have automated scheduling systems, you can have automated booking systems, you all want. You want to make sure it’s HIPAA compliant. You have a business associates’ agreement with the organizations or a software to make sure, make sure they’re not using that data inappropriately. It could be people answering the phones or emails and scheduling. If you have a virtual assistant that’s checking your emails, you want them to have a business associates’ agreement with you, confidentiality training, things like that so that they know how to follow those things or just cutting some things out. There may be things that you, at the very beginning of your solo practice got going and then you realize later on that’s not really the best practice anymore. In that solo practice in the first six to 12 months, you really want to focus in on systems to scale reliable referral networks and optimizing your hourly rate. [HEARD] It’s never too early to start thinking about tax season. Heard is the financial back office built specifically for therapists in private practice. They combine smart software with real humans to help you manage your bookkeeping, taxes and payroll. Regardless of whether you’re a seasoned clinician or are in the first year of private practice, Heard will identify areas of growth and streamline best financial practices for your business. When you sign up with Heard, you’ll connect your bank accounts so your transactions will automatically be pulled in and categorized. My favorite thing about Heard is their allocation guide, what helps you decide how much to pay yourself each month and how much to set aside for taxes. You’ll also receive financial insights such as profit and loss statements and personalized monthly reports. You can say goodbye to pouring over spreadsheets and guessing your tax deductions or quarterly payments. Focus on your clients and Heard will take care of the rest. Heard always has transparent pricing with no hidden fees. Sign up for a free 15-minute consult call today at joinheard.com/partners/joe. Again, that’s joinheard, like I heard it, not like a herd of cattle, joinheard.com/partners/joe. [JOE SANOK] Now I want to spend a little bit of time on raising your rates when you’re 60% full because this is something that, whether it’s in the Q&A yesterday or in our what’s working over and over every few months we have someone that’s like, I’m full, I have a wait list. When should I raise my rates and I answer it the same way. So I’m going to just tell you right now what to do. You don’t want to wait until you’re full and I don’t want you to have a wait list. The only time that I see a wait list as being appropriate is if you have decided for your community you have to take insurance and there’s no private pay options so you can’t raise your rates and you maybe are optimizing into a group practice and you say, this is the only amount of time that I want to work. Now that’s a trap you’ve pushed yourself into the corner with where you’re not able to raise your rates but that’s the situation when I would say, okay, having a wait list. If you know you’re only going to take insurance and you only want to work a certain number of hours a week, you don’t really have the option to raise your rates. With that said, you may want to consider getting off of some insurance panels to be an out-of-network provider. All right, so with that said, how do you raise your rates and why? 60%? If you’re 60% full you’re going to continue to grow. I looked at that five to seven partnerships that are sending you maybe one referral every single month. If we do the math where every six months, we lose someone, some of those five, but then we get five, you’re very quickly going to be at 30, 40, 50 clients a week if you end up doing that. You don’t want that, I don’t want that. Nobody wants to burn out like that. When you’re 60% full, this is a great time to start to say, okay, I need to slow down the referral rates. The way this works is throughout the year you’re raising your rates and then once a year you realign. So how do you raise your rates with people that are new? Look at your current rate. Say it’s $125, I want you to jump up by $25 to $35, so it’s a big jump, not $5, because the emotional impact of it is different. If you jump from $25 to $30 and a bunch of people say yes, you’re going to be like, no big deal but if you go from $125 to $50 or $165 and that first person says yes, you’re going to be like, I was leaving $35 an hour on the table. I can’t believe this. Also you’re getting closer to just saying no to taking clients anyway and so if you are full and you say no or wait list, then you know people you’re saying no to them in essence anyway, so if they say no to you because of your rate, then that’s going to give you some data. Then you’re going to test this out over a few weeks with the next phone calls and then every October or November you’re going to reach out to your current clients and say, “This is my current rate. This time of year, people are looking at their flexible spending and HSAs, wanted to make sure you were prepared for January 1st when my rates are going up. Right now, my rates for new people is $165, you came in at $125, in an effort to align everybody on January 1st, your new rate will be $150.” So you’re trying to get closer to that rate. Some people say, I want all the rates to be the same, so maybe you realign everybody to your rate but then if you keep following this model, you’re going to raise your rates throughout the year. I always have a couple sentences at the end of it that say if this affects your ability to do counseling, I went into counseling to help people, and so please just let me know if this rate increase will change the frequency or the duration of counseling that you want to have. Then over time you can continue to grow. I had a family that I started at $70 a session and at the end of my therapy with them they were at $225 per session. So over time, you just grow every single year. [JOE SANOK] All right, so going from solo to a group practice, the goal with this is to maximize your internal referrals. I’m going to say internal referrals because there may be people you’re referring out to other clinicians, and we want to always do this ethically. Anything that I’m saying we’re saying it falls within your code of ethics. You want to follow that. if there’s someone that’s not a good fit, you’re not going to refer them internally just to make the money. That’s stupid. Sometimes people get all worked up over that. I’m like, of course not. If they’re not, if you don’t do EMDR, you’re not going to refer internal for an EMDR client. So you’re maximizing your internal referrals to better serve clients with your values, your culture and your approach. People come to you for a reason, you have a reputation as a solo practitioner. Now we want to be able to expand that because otherwise you’re just limiting the amount that people can work with you or that can get help. So scaling beyond you. You want to handpick superheroes and so finding people that you can say this person’s a superhero in this area, this person’s a superhero in this area. When I had Mental Wellness Counseling, I could say when a client came through, if our intake coordinator wasn’t sure exactly who would go where, Steve was amazing with substance abuse and toxic family situations. Tara was amazing with women in transition. Sarah was awesome with teen boys and girls that were just a pain in the ass. Like, here’s what each person’s good at. She was like this snowboarding, skateboarding, cool lady that could connect with like the toughest teenagers. So just knowing each clinician has certain superpowers, but it all was under the Mental Wellness Counseling umbrella, which was, we help angry kids, frustrated parents and distant couples. So you may have an umbrella. It may be an umbrella that you specifically want to help women. It may be that you want to help stay-at-home parents. So then you find people that have unique niches within that niche. And you’re looking at, do I want to replicate myself or do I want to compliment myself? And so replicating yourself is finding someone that can take the referrals that are overflow for you, so all these people want to work with Dana and Dana’s full, and then Dana says, okay, like, we’re going to have to find another Dana. So over time we want to be able to say like how do I replicate myself? Or is it compliment? Maybe Veronica is helping women in transition and she’s getting all these referrals of men in transition. She doesn’t want to work with men in transition, but she sees that need there and maybe hires another therapist that can help men in transition. So really deciding, am I replicating myself or complimenting? Now, if you build the complimenting pretty soon you’re going to have to replicate yourself. I would say typically it’s going to be you. Then we’re going to have a couple people that we’re going to have compliment the niche that you have. Then usually your fourth hire or fifth hire, you’re going to want to definitely replicate yourself because you need to be moving up into more of the group practice, running it, which we’ll talk about in a second. Also, you are the brand ambassador and so that switch from the website saying, I do this, I do that to we do this is a really important switch. You are growing the brand to the public on radio stations, you’re writing articles, you’re doing things for the brand of, for me it was Mental Wellness Counseling, and then the individuals, they need to also be out there and making sure that people know that they work at your practice and so making sure that that is understood with your clinicians. Next, we want to look at the logistical side. So are you hiring 1099s or W2s? That’s US language. If you’re from Canada, there’s different language. You got to look at your electronic health records, how do you create systems that make it so that you easily can understand what’s going on in your practice without having to talk to everybody? You’re going to want to start to look at how do you outsource your website If you haven’t done that yet if the website breaks and is down, you want to make sure that that’s up rather quickly instead of being down for days. You’ll want to start to look at hiring an accountant and a bookkeeper. Those are usually two separate roles. One person is looking at the numbers every single month, categorizing them and that would be the bookkeeper. The accountant usually is looking at big picture tax strategy, maybe giving a little bit of advice as to where to allocate money but, especially this time of year between now and December, you’re going to want to talk with your accountant and say I’m up by 20%. Do we need to put a little more money into my quarterlies? Do I need to spend down in some areas? Is this a time to upgrade technology for writeoffs instead of paying taxes? Your accountant can advise you in those areas. Your attorney is going to be able to look at contracts with your 1099s or W2s, attorneys are going to look at say if you have a speaking contract, so Simon Sinek just brought me on as a speaker with Team Simon. I had my attorney look at the contract to make sure that when I do work with them, I’m not giving away my intellectual property. I don’t want Team Simon to own my next big book idea that I create with them whereas in that Team Simon doesn’t steal my information, so I signed to the contract. We want to look at marketing. Is that something you want to be doing or is it time to start to maybe bring someone on super part-time? So there’s organizations that will do all your social media. There’s ones that will do more as needed, like Practice of the Practice. We have a whole team of 10 people in South Africa that can help with the images, the videos, posting it. Do you want to do those things or do you need someone else to do it? [JOE SANOK] Then the next step as you’re going from solo to group and this is such a huge jump to go from just you and maybe an assistant to now you’ve got some people you’re hiring, is aggressively moving, removing hats. Ask yourself with everything, why am I doing this? So even down to taking out your own trash, sure, there’s something to be said for a leader that takes out their own trash, but there’s also something to be said for not having to think about the trash or vacuuming the office or those sorts of things. You want to look at what’s repeatable in your schedule. So to say, okay, every Monday I’m going to look at the numbers for the previous week, I’m going to put that in my calendar. No one is going to be able to schedule counseling with me from 9:00 AM to 11:00 AM every Monday. It’s just in there, it’s blacked out. Thursdays I feel more creative. I’m going to be doing some reaching out to people and networking for the practice. I’m going to try to do some sort of social media that includes me on Wednesdays for half an hour. So putting things in your calendar that repeats over and over that you know you need to do. You also want to have a handful of numbers that you’re going to watch. Lots of people will go in one way or the other. They’ll be ostrich with their head in the sand and just say, I’m not a numbers person. Or they’ll know every single number, but it won’t have any meaning. With any number you want to say, what decisions will I make based on these numbers? So a couple numbers you might want to have is, how many new intake phone calls did we have last week? How many of those intake phone calls converted into an intake? How much just money came in last week? How much have we billed out to an insurance and how much is in the aging report? What was last month’s profit and our loss? How much money is coming in and out? We might want to know on average which clinician is having the most people discharge and how fast. So if one person sees people on average of three weeks and then they stop coming and another person sees someone eight weeks, there’s a difference there. What’s going on? It could be a positive thing. That person could be really good at therapy and good at short-term, and that’s just how it is. It could be that they’re forgetting to reschedule at the end of sessions and then their therapy clients just aren’t coming back. So having a handful of three to five numbers that are just on your dashboard that you’re getting from other people, your bookkeeper, your accountant, your front desk coordinator, bringing those numbers together for you is really important. And starting to really be able to articulate why people shouldn’t see you. So does the front desk person know Ashley’s pretty busy right now. She can get you in two weeks from Thursday, but Ashley handpicked this person, Colin, who exactly fits what you’re asking. Colin’s superpower is helping teen boys and Colin’s superpower is doing these things. That’s exactly what you need. If you ever feel like that’s not a fit with Colin, you can reach out to me or Ashley and you can always see Ashley but really I think Colin’s going to be the best fit for you. Getting that script down of why people shouldn’t see you is really important. So how do you attract unique talent that matches your vibe when you’re going from solo to group? Well, first you have to know your own vibe. Like what is the vibe that you’re going for in your practice? Are you, even just yesterday in the Q&A we were talking about how one clinician wanted to have practice clinicians that were like high energy and ready to work with kids. Okay, so we want to know your energy and then articulate that. We don’t want to sound like every single other practice. We want to say like what makes Ashley unique? What is it about her practice that is interesting? If we asked her favorite clients why have you worked with Ashley for so long, what were the outcomes, they’d have a certain set of things that say this is what makes her different from every other practice in the area. So making sure you know your own vibe. Then as you’re advertising, when you’re putting out Facebook job posts or LinkedIn job posts, or Indeed or wherever you’re doing it, saying here is the type of person. We’re hiring for the personality and the growth. Sure, we need to have the licensure, but really here’s the person that we really want to hire. Then I’m not a big person that feels too much intuition. I’m learning to like see that more but every time I’ve gone against my intuition to hire someone because I “needed” them, like I needed a play therapist because we kept getting play therapy referrals that person has been a total pain. So listen to your intuition. If they don’t feel like a good fit give it some time to think about, do some extra interviews and make sure that that’s a big part of it as well. Then I always recommend having some sort of probationary period or onboarding period where for a few months, maybe there’s a different percentage split. Maybe there’s weekly meetings to make sure that they’re a good fit over time. So group practice, in group practice, you’re creating income that’s not based on your clinical work, so you’re wanting to grow beyond your own clinical work. When you’re going from solo to group you’re adding some in, it might be 50% of what you bring in, but most of it, like if you just quit, like wouldn’t usually be enough to really to really grow whereas group practice, the goal is that if you need to step back for a month, that that thing just keeps running. We want to automate your processes first. So how do you say how do you do things, how do you approach things? We want to really capture your method which oftentimes is just keeping track of it. So when I first brought on my director of details, I would bcc her on any email that I thought she could have answered just to start capturing how I speak about things. Over time, hopefully she can answer questions or respond in a way that would be very similar to how I respond to things. We want to start to move away from as many individual meetings so when you first get going, you might be meeting with some people to just check in on them. You want to be moving towards more team meetings within as-needed individual meetings so that you really are moving into a CEO mentality instead of that coworker or supervisor type mentality. And you want to continue to cut your supervision time and have the team meetings be very functional. So like, what are we doing looking forward? What are the things we’re working on? What are the projects? What are some of our numbers that we all care about? Those are all the things that in the automation of processes we want to do. For time, we want to aggressively think about what will free up time for you to think big. When you’re a group practice owner, you can easily get sucked back into the clinical work, which you may like, you may feel like you’re good at but really making sure that you’re thinking big. You want to slow down, there’s a tendency to just do everything to keep filling up your plate. At this point you really want to make sure that you have clear boundaries around your time. Like, are you taking every Friday off? Are you making sure you are going to your kids’ sports games? Are you taking time for you alone or for you and your partner? Having those very clear boundaries on your own personal life is something that at this phase oftentimes is the trap people fall into where they just are working too hard. You’re going to be hiring for growth, not the role. You want someone that can grow into different roles, so looking at, okay, who could be a good clinical director, who might be good at overseeing our assistant staff, who could start to move up in leadership here. Every year you want to be asking three questions. These three questions are for your intake staff, for your clinical staff, anyone that’s in your organization and at a minimum annually. I would say for us it’s just a part of our culture now with Practice of the Practice where first, like, what do you love doing that you want to keep doing? I love answering the phones. I love the intake calls. You love scheduling. Second, what is it that you hate that you wish we could remove? Honestly doing like the social media posts and the blog posts and coordinating with clinicians to get those, like, I hate doing it. They don’t respond. They don’t do it. Okay, so then that person’s going to help. Hire someone that can help with those things because they’re best positioned to train and to keep it going because if they train, well, they don’t have to do it. If they train poorly, they will have to do it. Then last, what is something that you would love to grow into? Is there something that you would love to learn to do? Do you want to learn video editing? Do you want to learn Gottman Level II? What is it that you want to move into? So then you know your staff and you teach your staff that they can level up within the organization. Again, taking time away and breaks away from the organization, away from the group practice will allow you to do some stress tests that we’ll talk about in just a second. Third oversight and accountability. So what dashboards do you need to make good decisions for your group practice? At this point, data management is really important to have the right people giving you data so that you can understand what’s going on. Something I’m continuing to grow in is then communicating that with your team, making sure that people are on the same page, making sure that if you can’t do that well, bringing people into positions that can. Recently in August we upgraded Sam R to be our chief operations officer. So she and I have been reading books together on the operations of a business looking at more effective ways to communicate things, looking at having a Trello board that our entire team is on that we can look at and know where everyone’s at with different things instead of it just being rely on me who’s more of a creative innovator, dreamer. I’m not good at this stuff. So putting people in those roles to really keep me on track and to keep me focused and to keep the team focused. What numbers matter for each role? As you grow knowing, okay, I need every therapist to see a minimum of 10 people a week. When they don’t, I need to know that. I’m not going to look at that every single week, but I need my intake coordinator to say, hey Tom is down to 12 people. He was at 15. It looks like he’s going to be moving towards 10 or nine. Okay, I want to know that. I don’t want to wait until it’s too late. Then who is overseeing each of these things and who’s reporting to who? So starting to create some more organization. Now how do you do a stress test on your group practice? One of the single best things you can do is to take a month off. Things will fall apart like you never believed but to prep and just say, okay right now at the time of this recording it’s September for January from the 23rd of December until the 23rd of January, I’m going to take a month off. Then say, what do we need to prep to do this? Maybe even you go somewhere where you don’t have internet access, so your team is on their own prepping your clients. Maybe four weeks is too much. Maybe you do two weeks but you genuinely try to not be available and then have a debrief on the other side of it and say, okay, what fell apart? What was tough here? In most situations, you’re not going to sink your business in two or four weeks, and if you do, you have a really shaky business. So being able to have that business run like clockwork as much as possible, Mike Michalowicz’s book Clockwork is a great book around this topic that can help you do some of these stress tests. Then you’ll get stronger. You’ll realize, okay, here’s the things that were based on me that really shouldn’t be based on me. Wow, Ashley was the only one with a password to this and then she went on vacation for two weeks and we were totally screwed over. Okay, maybe we should think through some of these things of like, what are people doing and going to Ashley with between now and when she leaves for a month and say, okay, she doesn’t have passwords. We need something like LastPass to be able to share passwords securely amongst each other. All right, now lastly, we’re going to talk about going from a solo or group practice into passive income building, those big ideas. The goal for this is to create income that is not based on your clinical work and expand your audience. In this, what we’re doing first is we are building an audience. Too often people will build a product first, like an e-course and then try to squeeze people into it instead of saying let’s build an audience first. You want to have followers that know, like, and trust you. You want to understand their pain and transformation and expand that content. So if you were in the previous session about Instagram, this is what we’re talking about, growing that audience so that you have people that will tell you, here’s what we want help with. Then you want to walk through the three P process. This process is one that we use for any new product. When we launched Audience Building Academy back in December I went through this exact process. I interviewed over 20 individuals that were ready to level up. I asked them what’s the pain of leveling up beyond your practice? Oh, I have all these, these ideas and I want to be able to do e-courses and I want to not work so many clinical hours and it’s just a pain in the butt. I don’t even know what to do. So you’re capturing how people talk about that pain. Next, if there were a product that I offered you that would help with that pain, what would that look like? With Audience Building Academy, people were like, I would love to have a milestone-based program where it’s like every month I know what to do. Okay, how long would that be? Some people said three months. Some people said nine months. A lot of people said six months. So you’re getting all this data to say, okay, so it sounds like a six-month milestone-based program. What would be covered in there? Okay, I would want to know my niche and I’d want to have a good opt-in and I don’t even know how to get on podcasts or how to do live events. Okay, you’d want that product to have all of that. Then how much would you pay for that? So then talking through that with these 20 people, some people said I’d pay $10,000 for that. Other people said I wouldn’t pay more than $97 a month for that. So then over time saying, okay, well of these 20 people the price that we landed on was between $700 and $900 a month. Then we do a initial report back to everyone that was invited for these interviews. I interviewed 20 people, here’s the summary, if you want to be invited into the very first Audience Building Academy click here and let me know, and then I’m going to jump on a phone call with each of you and then walk you through Audience Building Academy. Then do people buy? So you go through this process with people from your audience. Now, if you don’t have enough people to even jump on 20 phone calls with you, then you have an engagement problem with your audience. You may have 5,000 people on your email list, and if you can’t get 20 people that will just talk to you, you’re ruling out that you should make a product at this point, you need to work on getting to know your audience better and do some live events to get them engaged. Now, what happens if you interview 20 people, you sketch out the exact product they told you, and then it’s time to buy and nobody buys or one person buys? Well, that tells you that in some way you missed the mark to what these people wanted. I mean, they jumped on calls with you, they said they want this, but then they didn’t buy. So you’re ruling out and saving yourself time before you go and spend all this time and money building a product. Then after you go through that three P process, you’re going to continue to grow your support so that you can invest more of your time into that creativity, ideas and audience, and not the emails, the logistics and all of that. You may want to file a new LLC at this point to separate the business as well from your counseling practice. Now, how do you get to a hundred people on a mailing list really, really quickly? The single best thing you can do is to have an email course to think through, okay, what in nine emails could I help people go from this pain to this transformation? The first three emails in this course are often the problem. Say someone is helping women post-divorce to have the self-confidence to jump into the dating world. Well, what’s the problem here in society? Well, women are taught these messages. Society set you up for failure in these ways. Dating is so much different than it was when we were in our twenties and here’s the problem in society. So basically, it’s not your fault, it’s society’s fault. The next three emails are then quick wins; here’s some two- to five-minute things you can do that will just help you get in the right direction. Maybe it’s something in that situation, physical, I want you to just do a two-minute plank every day just to remind yourself of what your body can do. Or I want you to just talk to your friends about what the dating world is like. So finding what those quick wins are. Then the last three emails are long-term habits. So what are the long-term habits that someone needs to enact if you are divorced and getting back in the dating world? You as a therapist then are saying here’s what I’m teaching and now you have a great opt-in if you’re on a podcast, if you’re on Instagram, in any way that people can go to that’s more robust than just some quick sheet that someone can go look at. Well, let’s see if we got some questions. I just covered it all. That’s awesome. Or a lot of these people have already been to some of the other webinars, so I want to thank you for coming. I just love hanging out with all of you. Thanks for hanging out and I’ll talk to y’all soon. Bye everybody. [HEARD] We couldn’t do this show without our sponsors and it’s amazing to just see how many people are signing up for Heard. As a therapist the last thing you probably want to think about is doing your own bookkeeping and taxes. Regardless of whether you’re seasoned or in your first year, you can say goodbye to spreadsheets and guessing your tax deductions or quarterly payments. You can just focus on your clients and maybe doing some more sales. Heard can take care of the rest. Prices begin at $149 per month for solo practices and can be tailored to your business’ financial needs. You can sign up for free for a 15-minute consult today over at www.joinheard.com. That’s spelled like I heard it, not like a herd of elk, so H-E-A-R-D, so joinheard.com/partners/joe. Thank you so much for letting me into your ears and into your brain. Have an amazing 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. This 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.

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