[JOE]:
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[MICHELLE]:
Thanks, Joe. How fun.

[JOE]:
Yeah, you’ve been such an active member of Next Level Practice and Podcast Launch School. And we’d just love to kind of hear your question today and we’ll dive right in.

[MICHELLE]:
Yeah, so I’m kind of in a place, especially with the new year coming, of trying to envision what to put my efforts and energy towards. I’ve started, you know, a fledgling podcast, I’ve gotten some direction from you on where to go next with that so I’m solid in my next steps there but I’m also solid in my group practice, I’m sorry, my independent private practice right now is really great, and I’m moving into a group practice. I just hired my first independent contractor. So, my question is really where do I focus for the most efficiency? Like, I don’t know where to focus first, because there are so many cool things that I have my hands in but I want to make sure I have that solid foundation. And I’m just kind of feeling like there are too many things I’m trying to do at once.

[JOE]:
Yeah, no, I think that’s such a common thing that people deal with. And I’m so glad you’re asking this question because, you know, a lot of us who are entrepreneurs who are practice owners wanting to do podcasts that the new thing is often very exciting, you know, a podcast and asking those questions and getting guests, and often it’s the most scalable too beyond a group practice. But when we look at kind of where the revenue is coming right now, usually the private practice is more of a no brainer of where to put your efforts. So, we’d love to hear what are you doing to grow the practice? And then maybe we’ll talk about your use of time.

[MICHELLE]:
Okay, so currently, I’m not really doing anything to grow the private practice, other than keeping the referrals coming from the sources that are bringing in the calls. So, the phone has been ringing off the hook with COVID and such, and getting, you know, four or five new inquiries a week. And I was already at max capacity, I really only want to do 15 to 20 hours a week. And I’m doing 24 this week. So I thought, okay, it’s past time to bring on someone to help me. And as soon as I hired her, the phone stopped ringing the last two weeks. So I’m guessing that’s with the holiday and such. But I have really good referral sources, it’s kind of flowing pretty effortlessly. I just get a lot of word-of-mouth referrals from current clients, and then have, I’m on a couple of church lists. And I’m on quartet so they refer, I have a local business referral network on Facebook. So, I feel like all of those referral sources are pretty solid right now and I am primarily insurance, I do do some independent, you know, out-of-pocket pay, but primarily the two biggest insurers in Pittsburgh are keeping me going really well. So, it’s kind of on autopilot but I’m not necessarily sure once the independent contractor is up and running exactly kind of what’s going to be needed there. I have some systems in place. I put everything on paper as far as how she uses the electronic health record and all of those kinds of things, the nitty-gritty, but I want to make sure that I can support her so that she, you know, can really make this worth her while too, and also, of course benefit me and the group practice itself.

[JOE]:
Yeah. And is she applying to be on insurance panels as well?

[MICHELLE]:
Yeah. So she’s on one of the two that I take and the second one will be coming this month, hopefully.

[JOE]:
Okay. And so I think it’s really smart to be onboarding someone, I would actually look at maybe even a second or third person sometime in the next couple quarters, just because, to have people that can offer kind of a diversity of services, but to still stay within your direction. So I know you primarily help Christian women, and then looking at who are you referring out? And so is it, you know, couples? Is it kids? Who is it that you don’t want to work with? Maybe it’s really draining for you to work with teenagers. And so to really figure out where those gaps that you’re referring out, and with this first person, you’re spot on that you’re looking at your systems, because you really want to take your time with that first person, keep track of the onboarding process, keep track of everything from you know, you’re getting them on to the panels, you’re getting them on to all your electronic health records, all of that. Just make yourself a checklist of all of it so that for person two, and three, it’s a lot more seamless. So I’d say that, I’d say also, just make sure that you’re setting up a dedicated page for that person, make sure you’re switching your website over from “me” to “us” instead so it sounds like a group practice, because it is a group practice. And then, especially because you’re full, you want to kind of de-emphasize “Michelle”. And so that means that this new person is kind of at the top of the page when you have your staff page. And that, you know, when you list it as a drop down of people that you work with, you know that this person is that new person’s first. Also, a lot of people miss that on their website, they don’t have the option to search for the specific issues that you work on. And so sometimes even having a drop down of like issues we work with, or types of people we help, where it drops down into anxiety, and then it, you know, it has another subcategory of who helps people with anxiety, maybe that’s just this new person. So you want to also be able to do it not just by clinician, but by subject of what people are working on.

[MICHELLE]:
Oh, so we tie the clinician to the subject of her population?

[JOE]:
Exactly. Yeah, so there may be 12 different things that the two of you do. And there may be some that both of you do. And there may be ones that only you do, and ones that only they do, you want that user to be able to say, I’m dealing with marriage issues, which counselor or counselors can help me with this. And so you kind of want that under the “About Us” section of your website. So I say all these things, they’re not the fun kind of really cool things to do. But they’re so essential when you’re kind of putting some time into really just positioning yourself to grow into a larger group of practice.

[MICHELLE]:
So would that be SEO stuff as well?

[JOE]:
Yeah, I mean, I think also doing SEO, I would go back and look at any past blog posts. So, say you have blog posts that are about anxiety and this new person also serves anxiety, you’re gonna want to link to those pages, so that you have, you’re making her individual page about her, her “about us” or “about me”, that that’s gonna start to rank for anxiety, or depression or things like that. So you really kind of want to replicate as much of what you did for yourself, for this new person. I’d also say doing some warm introductions with the churches and the strongest referral sources to say to them, you have been amazing in referring people to us, I want to do a zoom call with you to introduce you to this new contractor, I’m planning to hire a couple more as well, in 2021 so if you notice, any great counselors that go to your church, feel free to refer them to me as well, but wanted to give you a chance to meet this individual. I know that when I did my practice, the people that worked with churches, that often didn’t translate to they would refer to other people, it was very kind of connection centric, where it’s, I’m referring to Michelle, I’m not referring to her practice, I want this person to see Michelle. And so, there’s a little bit more kind of fostering of that relationship, because you know, a pastor, they’re going to think differently about the referrals that they send, because they want to make sure that that person represents why they’re referring. And so, there may be a little bit of that connection, with the churches in particular, and the other referral sources that would be helpful to help grow that individual within your practice.

[MICHELLE]:
So that is another question that’s come up. Since I get a lot of referrals from word of mouth from current clients, they’ll call and they’ll say, “No, I really want to work with Michelle,” and my office manager will say, you know, my virtual assistant will say, “Well, Michelle’s, you know, at full capacity right now, but she’s bringing on a wonderful clinician who has the same you know, same faith-base, same skill set and would love to put you in with them.” And that’s pretty much how we’ve been handling it, is that is that the right way?

[JOE]:
I mean, I would do that. You can also say she has a waiting list. I don’t love waiting lists but when someone personally if… when I was looking for a marriage counselor for my wife and I for us to go work with someone, there was a particular counselor that people said, “Oh my gosh, you have to go work with Carrie.” And I didn’t want somebody else, I would have waited three or six months and just kind of figured out stuff in our marriage for that three to six months. And so, you on your side, want to make sure it’s worth it for you. And so that’s where if you’re looking at the insurances you take, are they paying enough to make it worth it for you? And maybe they are, and maybe in your area, you’re like, I have to be on insurance. But for your private pay, you may want to look at raising your rates, if you’re this full, and someone says, “You know, I don’t care, I want to work with Michelle,” it may be time to raise your rates if you’re this full. Because ideally, if you don’t take their insurance, you want to take them. And so do you mind me asking what your private pay rate is right now?

[MICHELLE]:
Sure. It’s 150 for an intake and 125 per session.

[JOE]:
Okay, and so I mean, you said you’re at 24 people when you preferably want to be like 15 people, right? Okay, so for you to see that 26th person is 125 an hour. Does that feel like, “Ooh, yeah, I definitely do that”?

[MICHELLE]:
No, not at this point.

[JOE]:
Right. So your time is more valuable than that money. Now, if someone was paying you 195 per session, would that feel like you’d take that 26th person?

[MICHELLE]:
Yeah, that’d be a little more worth it.

[JOE]:
Okay, then I would say moving forward, have your intake be 225 and then have your private pay be 195. So, when you start to build that private pay caseload, even if it’s just a handful of people, and you realize, wow, there’s these people that are paying 195 per session, and these insurance companies pay me $79.12, it then makes it a lot easier to start to switch into more of that private pay mindset, while you kind of keep the insurance going with with everyone else in your practice. Now, there are some states where you have to stay on insurance in order to have your whole group stay on the insurance. So you’ll want to look at your contract and make sure that you can limit Okay, you know, 15% of my caseload I’m going to give to this insurance company and 20% to this other insurance company. You’ll want to make sure that you follow that contract and follow those ethics with it as well.

[MICHELLE]:
Okay. Okay. So would the goal be, if I were allowed, to keep my contractors or if I move into w2, if the goal would be to try to get off of insurance panels for myself, but let them stay on it if that’s a possibility?

[JOE]:
Yeah, I mean, ideally, you would want to have, in general, we want your hourly to keep going up. And so, if we can go from your hourly rate now being 125 to 195, well, that means you can see fewer clients and put more time into the podcast and more time into the practice. And so, if you know, you know, I could cut my caseload down to 12 people, and I’m still gonna make the same amount of money. Now I have an extra, you know, 10 or 20 hours of, of time that I can put into these things that are big level ups, because right now, you’ve got so many plates spinning, rightfully so like, I remember when you join Next Level Practice, and you were struggling to get going, you know, you just were like, “I just want a couple clients.” And you know, now you’re at 25 and it’s awesome to see but now, it’s like, you don’t want to lose that momentum and you also need to optimize your time.

[MICHELLE]:
Yeah, I don’t want to burn out.

[JOE]:
Cuz the problem a lot of people at your phase get into is you’ve given yourself a high paying job, but you still have to show up to make money. We want to move away from that where you don’t have to do as many hours and you’re still making that money. And that’s where having the group practice, having that thriving, having, you know, two or three people or more, and then also growing that podcast, which is going to be more scalable also, those are then more of a business than giving yourself a job.

[MICHELLE]:
Okay. I like that. It’s normal to be a little bit scared about that though I’m sure.

[JOE]:
Oh, totally Michelle. I mean, I think that’s one of those things that we never learned. I mean, just to hit six figures, most practice owners are like, I can’t believe that I’m making twice what I used to make at CMH and I’m enjoying it so much more, or whatever, you know, our stories. And so the idea of, wow, I want to get to 200,000 or half a million, we’ve been told that that is selfish, and especially in the faith based community, we often hear that message a lot too. But I mean, think about the jobs that you’re giving, if you’re able to employ three counselors that they just want to do counseling, they don’t want to start a business or to offer a podcast and give yourself to that and to do consulting or a membership community or whatever, you end up deciding. You can serve way more people. And so, when we’re not stressed out, when we’re not back into the corner financially, I believe we can actually do better work. Now of course, there’s people who make money and they’re scumbags. Like, okay, but that’s not you me, that’s not me, we want to help people you know, and so, so even when you raise it to 195, you can always say to yourself, you know what, I’m gonna still have a sliding scale. For me, it was always kids in foster care. I always hated how they got these crappy counselors that were like just not doing good work. And so for me, kids in foster care, no matter what I always had room on my caseload for them, even though the state paid $53 a session. But I was charging 225 and 250 for my counseling practice for my individual private pay.

[MICHELLE]:
Gotcha.

[JOE]:
What other mindsets are gonna get in the way of kind of getting to this next level for you?

[MICHELLE]:
Well, so, the money mindset, I’m pretty good on getting past that. I did that work and I like being paid what I’m worth or aspiring to get paid what I’m, you know what I bring to the table, I’m good with that. It’s more, I think, I guess what it is, if I stop and think about it, I think it’s, I want to make sure that whatever I do, I’m doing it well enough for the people that I bring on and the people I serve. I don’t want to just grow for the sake of growing and I want to make sure that I can trust the clinicians. The one that I brought on, I really do feel that she’s got really good alignment with kind of my core beliefs and the way I run things, and she’s responsive and caring, and all these good traits. I guess, to replicate and bring in other people, you know, other independent contractors or employees is a little bit scary because I’m probably going to make a wrong hire at some point.

[JOE]:
You will make a wrong hire so I would just, I would prepare yourself that you will hire someone and realize that they weren’t a good fit, and you may have to fire him, you may have to coach him, like, that’s part of becoming a business owner. So, if you just stop fearing it and say, “Yep, it’s gonna hit the fan at some point, okay, I’m prepared. And I’m gonna make a bad hire, I’m gonna choose someone that I thought was great, I’m gonna have to apologize to a church because of what they said or whatever, like, it’s gonna happen.” But don’t let that fear or that worry, get in the way of all the great work that you could do with all the other team members.

[MICHELLE]:
Yeah, and that’s, that’s the other part of it, too, is, you know, making sure that I have a solid base for all the other team members. I guess there’s a little bit of fear around the fact that, you know, like I said, the phone was ringing off the hook, I hired her and it’s been silent for two weeks. Now, I know that there are factors around that, I know that they just put more COVID restrictions in Pennsylvania, Thanksgiving was coming up, you know, I know, there’s, there’s a lot of just, it’s an ebb and flow sometimes, um, with what’s going on in, you know, in life in general. And I fully expect that it’s gonna, you know, pick right back up and such, but I would, I think there’s fear that someone’s livelihood would depend on the fact that my systems were a certain direction, and then what happens if my systems fail them.

[JOE]:
And I think that’s a very common mindset that people say, I have to be full enough to keep people full to bring them on. And there’s a couple of things I would challenge on that. The first thing is, especially if they’re a contractor, they’re a business within your business. And so they have some responsibility and onus of control also. And so making sure from the very beginning, even with W2s I recommend this to say, my main goal is to make sure this practice is known in the community, that it’s respected in the community that we have a strong website that we get phone calls, but your responsibility is to make sure that the world knows you work here, that you’re putting out content, that you’re making those networking connections, that you’re using your own network that I don’t have to let them know that you’re now working here. That’s important for both of us together to be promoting you. So I put a lot of kind of that on the individual clinician, when they come on, even from the interview, saying, you know, this isn’t just me handing you clients, this is us working together, and you brainstorming how you can use your own network as well. So I look for people that have a different network. So, that could be that they go to a different church, or it could be that they are connected in different ways. So for example, one of my hires that, back in Mental Wellness Counseling, she was so well connected in the community in ways that I wasn’t and she only worked Saturdays, the first Saturday, she started, she had five clients that I did not give her. And so that’s what you want, you want people that are able to go out there, that are able to say, “Hey, I’m now working at Michelle’s practice, I can’t wait for you to join me, you know, if you have people that are struggling with these things, you know, come to my practice, and you know, come see me,” you want those people that are going to help promote it, and they also aren’t necessarily going to go out and start their own practice. Does that make sense?

[MICHELLE]:
Yeah. So, that does make sense. And I guess then another just, you know, another mindset is a fear in you know, I didn’t realize there were so many fears with them, not letting it stop me, but I didn’t realize that those feelings were there, the fear of kind of like, okay, where do we it’s like, you know, it’s like handing over your baby to somebody else and trusting that they’re going to take care of it.

[JOE]:
And they aren’t, I mean, like, they’re never gonna care about your business as much as you do.

[MICHELLE]:
Yeah. So how do you know I guess what? I can’t even put it into words like how do you take your, how do you take your hand out of something and let them run with it? And then do you just do damage control if they aren’t good caretakers of it? Or, you know how, how much of an allowance of them doing it their way because then wouldn’t that be like their private practice? So that’s kind of like, you know where I’m getting stuck.

[JOE]:
Yeah, I mean, within your contract, you’ll want to have something about non-compete, and not stealing clients to the best of your ability, but a lot of counties and you know, judges will respond differently to that. My mindset is, yes, they aren’t going to do it like me, they may do it worse, they may do it better. The more that I can have them be the ones that develop their own plan. So for example, we’re evaluating a bunch of things with Next Level Practice right now. We brought on Dana as an accountability coach, and she and Jess are working together to improve our onboarding process. Dana noticed some things being new, where she said, I think these things could be improved. And so I said, Dana, you and Jess, schedule together, talk, come up with a plan and then we’ll do a 15 minute call where you guys present the plan to me. And then I’ll do the final sign off. So they do 99% of the work. And they’ve created it, they want to implement it, and then I have the kind of final eyes on it to just poke holes in it. That’s what you want. You want to be able to say, Yeah, go ahead.

[MICHELLE]:
Wait, just if you looked at your role, when you were leading your group practice, how would you put that into terms as far as your role, given the fact that you were working yourself out of a job? In a good way.

[JOE]:
Yeah, I mean, I would say first, you want to be someone that inspires, and so you’re setting a vision for where you’re headed, you want to be someone that’s out there, to the public, cheerleading the practice, being the face of the practice, doing talks on behalf of the practice, being on local radio, so you’re a marketer for the practice. And then lastly, I would say that, that idea of kind of putting out fires, like, you’re going to put out those fires, but then you’re always gonna look upstream and say, “Well, why did this happen? What system or process can we put into place to make this not happen again.” So we aren’t gonna get upset that there’s a fire, we’re gonna say, okay, we’re gonna put this fire out. And then we’re gonna figure out why was there a fire? And what can we do about it?

[MICHELLE]:
Gotcha.

[JOE]:
Michelle, thank you so much for being on the show today. We covered a lot of ground and seeing your progress in Next Level Practice and everything that you’ve been involved in has been just incredible. And if you, as a listener, want to join Next Level Practice, we are going to have cohorts opening up just a couple times this year, over at practiceofthepractice.com/invite, you can read more about that. Also, if you’re ready to really level up and you want to do consulting with a member of our team, you can apply for that over at practiceofthepractice.com/apply. Michelle, thank you so much for being on the podcast today, we so appreciate having you here.

[MICHELLE]:
Thank you, take care.

[JOE]:
One last thing before we say goodbye. If you have not checked out Gusto and you want help with your payroll, your benefits, onboarding, and HR tools all in one place. You want to automatically file and pay all of your state, local and federal payroll taxes and have simple time tracking and time off requests and more. Head on over to gusto.com/Joe again, that’s gusto.com/Joe. You’re gonna get three months to check out Gusto, it is an amazing solution that I use for my own payroll. You’ve got to check it out over at gusto.com/Joe. Special thanks to the band Silence is Sexy for your intro music, we really like it. And this podcast is designed to provide accurate authoritative information in regard to the subject matter covered. It is given with the understanding that neither the host, the publisher, or the guests are rendering legal, accounting, clinical, or other professional information. If you want a professional you should find one.