Joe Sanok 00:00:00  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 and 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 practice of the practice. Com forward slash apply. Again, that's practice of the practice. Com forward slash apply. This is the practice of the practice podcast with Joe Sarna. Session number 1106. Welcome to the practice of the Practice podcast. We are going to be doing a series between now and the beginning of November, where we are going to be playing all of our level Up week trainings that we did in September of 2024.

Joe Sanok 00:01:20  And we're going to be talking about from empty to overflowing, talking about your branding, talking about Multi-location shifting from 1099 to W2, all sorts of different things during this series. And if you want help from one of our consultants for every single phase of practice, or if you're just not sure where you fit in our memberships versus our consulting, I would love for you to talk with me over at practice of the practice. Com forward slash apply. We can schedule a 30 minute call together and dig into all those different areas that you want to get started again. That's practice of the practice. Com forward slash apply. Now let's get started with the Level Up Week series. Welcome! I'm so excited to have all of you hanging out today with our final session of our third day of Level Up week. We have one more day left. we are going to be talking all about from solo practice to group success. We're going to be talking about the, blueprint for you to successfully transition from solo to group practice.

Joe Sanok 00:02:23  We'd love to have you in the chat area. Just put. Why are you interested in this? Are you are you full as a solo practitioner and you think you want to maybe go into group? Maybe you're on the edge of starting a group. Maybe you already started a group and you're thinking, I want to make sure I did it right. maybe you have a solo practice. It's not really even kicking yet. And you're like, you know, I know I want to do a group someday. We'd love for you in the chat to just put a little bit about your, why you're interested in going from solo to group. and we'll check that out in a second. if I haven't met you, I'm Joe Sana. I founded practice of the practice. back in 2012. We launched the podcast the next year. We have over a thousand episodes of the Practice The Practice podcast. It's the number one podcast for counselors in private practice, and I do lots of other stuff too. Last night, man, it was busy after level Up week.

Joe Sanok 00:03:12  This was an insane evening. This is not how my evenings usually are. I afterwards I went to a counseling appointment. I had my own therapist. I think that's good to to do our own work. then immediately after that, I went and I taught improv for an hour and a half, and then I learned improv for two hours. And if that wasn't enough, it's a it was a full moon, and there was a group of friends that were going for a full moon hike out at the Sleeping Bear Sand Dunes National Lakeshore. Didn't get to bed till one in the morning. but it was it was an amazing hike, under the moon with a bunch of really cool, creative people. So I like doing that kind of stuff, hanging out with my daughters. I'd love to hear what you all are into, but let's talk group practice. So why should you consider group practice? well, for one, some of the benefits of a group practice are increased revenue. there's some shared workload that's there.

Joe Sanok 00:04:04  also, there's a potential for greater impact on your community instead of just you doing the work of, say, you doing couples work, you can now help kids. You can help, people that are divorced, you can help people dealing with anxiety, eMDR, so many different things. you can have more professional collaboration, and work with other people. there's a lot of benefits to it. And we're going to talk through a lot of those benefits in that plan today. But why are you considering it? So, I had asked that right at the top. So he has a solo practice, interested in starting a group practice solo, interested in doing something more. I don't want to have certain work hours. So a lot of kind of great reasons to think about a group practice. Well, the first thing we want to think about our understanding your office capacity. So the maximum number of sessions one office can handle. so let's think through this. Most people think oh, one office, one clinician.

Joe Sanok 00:04:52  But I would actually argue that you can have up to 85 sessions per office per week. So how do we do this? So we start at 8 a.m. and some people even do like before work type sessions. 8 a.m. to 9 p.m.. That would be 13 sessions per day. I would encourage you to teach your staff to be a little bit more efficient instead of saying, okay, we're going to do 50 to 60 minute sessions, but we're only charging for a 45 to 52 minute session to really look at. Can you schedule sessions every 45 minutes for a little bit to really maximize that time? So 13 is, if we're just doing it on the hour, how many during the weekday weekend, probably 9 a.m. to 7 p.m., is about what you could get in on a Saturday and Sunday. So that collectively is 85 sessions per office. So if you have one office, you probably could have two part time people that are in there, maybe even three, depending on how you do your scheduling.

Joe Sanok 00:05:45  So we want to think about when is the right time to expand. A couple of indicators of a thriving solo practice are some of these questions to ask yourself first? Are you consistently 60% full or more? not that you have to be to start a group practice. Group practices can be a multiplier. They can continue into new markets. they can help out in a number of different ways. Like I think about, when this one lady, Sarah, joined my practice. So she was working full time at Community Mental Health, she just wanted to make some extra money for her family for vacations or paying off student loans. And, she was only going to work on Saturday mornings and Sunday, just a couple in the morning. So probably 6 or 7 sessions a weekend. knowing, you know, she'd bring in, you know, 200 bucks per session or so. So take home about $100 a session, 700 bucks a weekend, you know, times, times for weekends. that's going to be like, you know, almost like almost another paycheck a month.

Joe Sanok 00:06:40  So she was doing that numbers. and we started promoting her ahead of time, and she started promoting herself as well. Now, her parents were real estate agents in town. they were well connected in communities that I wasn't connected in. Her first weekend, her Saturday morning was full very first weekend because she got into markets that I didn't have connections in. So sometimes, even if you're not 60% or more full, then you still can add people to your practice. do you have a waiting list? when I had my part time side gig counseling practice, mental wellness counseling, I was working full time at the community college, and I was only working on Tuesdays and Thursdays, and I was I would get out of my work early because I'd work through lunch or go in a little early. So I think my first session was 430. I would do a 430, a 515, a 6:00, and then from 645 to 7 I would take a break and then I would do one more 7 to 745.

Joe Sanok 00:07:34  So it packed them in there, get as much done as I could, but I was at capacity for what I wanted when I had a full time job. So I was doing, you know, eight sessions a week on those Tuesdays, Thursdays, but Monday, Wednesday, Friday during the day lunches, those were all times that that office could be used. So I had a waiting list and so it was really easy to start to divert those people to work with other clinicians. Can you financially support another clinician? We're going to talk about how do you set it up so that it's less risky, so you don't have to take on debt to do this sort of thing? are your administrative systems in place? So do you have a good EHR like therapy notes? Do you have payroll set up for yourself through something like gusto? have you if you're doing insurance, did you do insurance credentialing? what are the systems that you have? What are the systems that you need? And then do you have space for another clinician if you're subleasing? Sometimes if you sublease, you only get ten hours a week, 15 hours a week.

Joe Sanok 00:08:29  It might be time to upgrade your office or to talk about that sublease with whoever you're subleasing from to see if maybe you could get some extra time there. So recognizing the right time to expand is important as well. So we want to make sure that we're financially stable, that we're able to say we've got probably three months of expenses for what that group practice is. We want to have really efficient administrative processes. So have we evaluated the user experience when they come to our website? When they walk through different things, are we able then to make things happen? Are we able to help them get into the office and then that adequate physical space? Next we want to look at the financial impact. So understanding your revenue versus expenses in a group. Practice calculating that profitability with multiple clinicians and then deciding between W-2 and 1099. If you missed Andrew's presentation earlier, definitely go back and listen to that. I'm talking all about W-2s and how you can do that and why you need to think through it. So I want to show you this thing that we created called the Staff Wage Calculator.

Joe Sanok 00:09:33  Let me pull that up so that you can see, kind of how we run those sorts of numbers. All right. So this is something that we put together for our consulting clients, kind of behind a password wall, just so that they can really run some of these numbers and you can run these numbers on your own, or if you sign up for one of our memberships, we're actually giving access to this. So, when you're thinking about the numbers, thinking about, okay, if I'm just thinking about adding one person, so there's me and somebody else will have two full time staff, say your average reimbursement is 150, total sessions, maybe we do 25, 48 weeks a year, $180, $180,000 per clinician. Now, if we say our admin is, say, 25 an hour, and maybe right now you're at like three hours a week or so for your small group or your small solo practice. So maybe we double that to six hours a week. you know, maybe we don't have any supervision, at all.

Joe Sanok 00:10:30  or maybe we do one hour a week, with the new person, giving ourselves a budget for that, even though that money is going to you to say, okay, if I break up the amount of money that I make, how much do I make as a clinician, a supervisor, the owner or CEO time? And then the owner draws and then, you know, say we spend you really with, you know, one other person shouldn't spend more than five hours a week working on your practice. So say we put the owner time at $100 an hour. That'd be a great hourly for a CEO of a small company. So now we have some really basics in regards to some of those costs. And then we can say, okay, how much are we going to put into advertising per year. If we're doing insurance, how much is that going to cost us our rent it? And then maybe we give ourselves ten $10,000 in extra and then we can start to look at, okay, if we pay hourly, you know, say $65 an hour, I mean, you as a clinician is making 78 K.

Joe Sanok 00:11:23  That means that the other clinicians making 78. So then if we kind of look at with this model, you would be making $78,000 plus. Then if with your owner time that's $12,000 plus if you are the supervisor, because we want to kind of parse all this out to know where all the money is going. And then we look at your net profit, this is going to be the amount after everyone's paid. So the net profit would be and then an extra 106.940. So in this situation, you'd make $199,820 per year, working 25 clinical hours, working one supervision hour, and five hours as the owner. Okay, so our gross revenue is 360. So now we can say, wow, that's a lot of money. what would happen if, say, I added a third person, around this and then we look at, well, what are some extra things? Maybe we don't need six hours, maybe we now need maybe eight hours. And then we can start to say, well, do we want to increase our marketing budget? Do we want to increase our IT budget? Do we want to do health insurance or retirement or any of those extras? Well, then we start to see your net profit is nearly $200 off of just having two people plus yourself as full time staff.

Joe Sanok 00:12:35  So running those kind of numbers is really important to help us be able to just understand that financial impact of what it means to have a group practice. So as we look at that financial plan, we want to be able to know, okay, what do the moneys look like? Then we want to start to graph our profitability. So some factors to include our our price per session. So with that calculator I just showed you you can play with okay. If we raised it by $10 per session $20 per session. What does that do to the bottom line that you take home. You know, if you're going to be still paying a flat fee like a $65 per session or, are you going to be paying a percentage? I tend to recommend a flat fee. I think that that's a little bit easier for people when they're especially w-2s. and then creating a profitability graph to be able to understand that there's fixed costs, like renting your office, that whether you have, say, you have a for office suite, if you have four people there, if you have eight people there, that cost doesn't change.

Joe Sanok 00:13:31  So we have our fixed costs, just the cost of doing business. Then we have variable cost costs that go up and down based on how much business or how many staff we have. So, for example, you know, therapy notes, you'd be paying a certain amount per month for every single clinician. The more clinicians you have, the more you're paying. so that's variable based on clinicians and the number of clients. And then we want to understand some of those breakeven points. So just, you know, how much does it cost for your admin, for your marketing, for your website, for your rent? Okay. It costs $5,000 a month just to keep the doors open. So our break even point is, you know, at $5,000 a month, that means that we're charging 100 bucks a session. That's our first 50 sessions. Basically pay for the space. So understanding some of those things, in regards to it, and that would be if you took 100% of the profit. So obviously that was quick math.

Joe Sanok 00:14:17  That isn't exactly the same, but just understanding how many sessions per month do you need to have just to break even? All right. So when we're looking at your profitability graph we want to first determine your price per session. So what are you charging per session. What could you charge estimate that number of sessions per week that we just talked through in regards to, that calculator, calculate your 20% profit margin in general after the expenses of you as the CEO, you as a supervisor. If you're doing both those things, if you're doing the clinical work that needs to be parsed out as almost like it's another person. then what's your final profitability? And we want around 20 to 30% to be your profit margin. So a lot of times when people do like a 6040 split, you only have 40% to pay for everything. and that's pretty tough oftentimes to then make a profit. And we're going to plot these values on a graph to visualize the profitability. that staff wage calculator, I jumped the gun there.

Joe Sanok 00:15:12  But, with this tool you can start to input your data. You can change things out. So if I go back over to that, I can start to change out. Okay. What would happen if we raised prices? So, let's actually look at that. Let's bounce over to that staff wage calculator. so if I'm here and I'm like, okay, I have three staff right now, my net profits. 185 what happens if I just raise rates by by $5? All right. Whoa. That adds some change to that. Okay. So now what happens if we were, say, to leave some crappy insurance companies and now we're just doing private pay completely. I'd say 195 per session. now we're at 338. Holy cow. That probably more than $100,000 extra. but I imagine if we're charging that, maybe we want to pay people 75, you know, per session. Okay, so now that changes and brings things down a little bit. So that just allows us in different ways to play with those numbers, to interpret the results and determine what our staff wage is going to be.

Joe Sanok 00:16:11  So how do you hire your first clinician? And feel free to start to put some of those questions into the chat area. as I'm talking about this, I want to make sure that we can talk a little bit more, in depth. Now, I see there's some questions coming in. I'm going to pause. I see, what does that mean when you say not to spend more than five hours per week on your business, like doing admin duties? So, Daniella, in that example, if I go back to that staff wage calculator, let's, we'll, we're going to go, go back here and then the staff wage calculator, when we look at this, admin wouldn't be what you're doing. That's what you're paying someone 25 bucks an hour to do eight hours a week. If you only have 2 or 3 people total, you're probably talking anywhere from 25 to 32 hours per month that that admin is working for the practice. there shouldn't be 40 hours a week. So if we're talking about owner time this five hours here, this is stuff that a CEO should be doing.

Joe Sanok 00:17:11  So this is speaking at rotary. This is being on local radio. This is meeting with the accountant or attorney to look at risk. The things that only you as a, as the owner can do or as the CEO role can do. So when we think about that, we want to be thinking about what are the top tier things that as the CEO of this company, I should be doing, and we're not talking about taking out the trash, we're not talking about answering phones. We want to make sure that as we grow group practice, we have an admin that can do that and that can do that well. So hopefully that answers your question. if you have other questions, let me know. All right. So. So hiring your first clinician we want to look at qualities to look for in a clinician. We want someone that's humble. Someone that's hungry. Someone that's going after big things, that has good clinical sounding. Also, that has a niche that you're looking for. So to to look at what is it that you offer? Maybe I offer eMDR to people that had some sort of trauma.

Joe Sanok 00:18:10  and then that's manifesting in anxiety and depression. But I'm noticing while there's kids that are going through trauma, that maybe aren't appropriate for eMDR, but maybe are more appropriate for play therapy. And we keep getting these play therapy trauma referrals. but I don't I don't want to do that kind of work. So you might want to start looking at other niches we could focus on. that could really help in that area. and so then we're looking at, how do we interview and look for these people, how do we market to these people? So we want to look at our own groups that we're connected to in town. We want to look at alumni clubs. We want to post them places like indeed or LinkedIn and then have a clear onboarding process. How are you going to get those applications? How then are those applications going to move forward and then starting to think about all that? Next, we want to be setting expectations and responsibilities before we even hire that first person. All right I see there's a follow up question.

Joe Sanok 00:19:03  so the admin is like hiring an assistant. Yeah. So your admin, you might call them the intake coordinator. admin is going to be all that behind the scenes paperwork stuff initially. they may help with billing. They may help with coordinating with Billers. They may do the scheduling. They may be the first person that's talking to someone that, you know, reaches out. We want to think through what are the parts that you just hate doing or that you really don't think you should be doing? Usually that's the intake phone calls, intake, emailing back and forth and scheduling, getting that initial paperwork, maybe even scheduling you on things like local radio or, you know, writing for the local paper. So networking and marketing type things, that sort of thing. And then over time, those roles are going to start to turn into various people. if we think through kind of different seats in a business, that comes from iOS entrepreneurial operating systems, the entrepreneurial operating system. The idea is that you have different seats, within your business.

Joe Sanok 00:20:02  Now, one person may be in three different seats. So take Jen, for example, who works for practice of the practice. she is our head of projects and people. so one seat she sits in as my executive assistant. Another seat she sits in is the head of Level Up week, kind of overseeing all of that. there's other things that she just oversees and kind of communicates around. And so there's different seats. And we want to have each of those seats have kind of a KPI key performance indicators. So for example, as my administrative assistant, there's certain emails that I want to know right away if those come through. if it's during regular business hours. And so thinking through those expectations really helps you and those people be on the same page with each other. And if there's kind of miscommunications, then we can see like what's going on here. It's never too early to start thinking about tax season. That's why I've partnered with my friends over at Hurd. Hurd serves as the financial back office built specifically for therapists in private practice.

Joe Sanok 00:21:13  They're an all in one financial solution that combines software with human support to handle bookkeeping, taxes, payroll, and more. Regardless of whether you're a seasoned clinician or in your first year of your practice, Hurd will identify growth areas and streamline best financial practices for your business. When you sign up with Hurd, you'll connect to 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 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. Sign up for a free consultation today at join herd.com/jo and get one month free with promo code Joe. Again that's join heard.com/joe. All right. Next managing a group practice. We want to start to, establish some clear communication channels. So being clear about how do we communicate to we text do we email.

Joe Sanok 00:22:32  Do we call do we use slack? If we're using slack, we make sure that we don't have client data in there thinking about like during what situations do they want a phone call during what situations does it weren't a text or a slack message or different areas? How do we create a supportive environment where people know who's doing what? one thing I started doing in my practice, I had realized, I think I was at 5 or 6 clinicians at the time and, people, you know, kept asking like, like, Joe, what are you doing with your percentage? And it was like, I'm the owner. And my I have risk involved here. I'm renting the building. And at first I got defensive internally and was just like, what do you mean, what am I doing? Like you. How dare you? You don't even know what it takes to run a practice. And I was like, that's it. They don't know what it takes to run a practice. So I started sending a monthly email saying all the different things that I was doing for the practice that maybe they didn't even know.

Joe Sanok 00:23:26  And so it was like I met with four different referral sources to develop those relationships. I was on local radio twice. I wrote one article for the Record Eagle newspaper. I worked on SEO, with this company. We were working on a website update, and part of it was so they weren't asking like, what are you doing with your money and your time? But also it was, here's all it takes to run a practice. And if that's in your blood, if you want to do that, please go do that. Follow me on, practice the practice and learn how to do that. Don't be a contractor here at Mental Wellness Counseling. but for a lot of them are like, dang, that's a lot of a lot of work. I don't want to do all that. I just want to show up and do counseling. So it then helped people understand my role, not just as a clinician, but also all the things that I was doing to keep the practice going. And then we want to implement effective management systems.

Joe Sanok 00:24:15  And so, a few things that we want to think about is when you have a group practice, what sort of regular communications do you have in a team meeting format. And so do you meet once a month every two months in regards to a zoom call, or do you meet in person, or do you have some sort of rhythms as a business? Do you guys do each quarter. So we want to think through that. one thing I found was in staff meetings to allow the staff to tell stories of success, areas that we've been struggling in. So, for example, networking was always an area that it seemed like people kind of struggled in. People, didn't know how to do it. and this one guy, Steve, he, we had kind of identified together a business avatar. So his ideal client, one thing he did was addictions work. And in Michigan, if you get a DUI for driving drunk or intoxicated, you have to go to this, like, state mandated program that walks you through all sorts of different steps.

Joe Sanok 00:25:14  Or you can go to three counseling sessions with a licensed professional, and that counts. So there was one New Year's Eve where our mayor got a DUI. It was all over the news. That's someone that's probably not going to go over to the courthouse and go through that state system. so he became our business avatar for what Steve wanted. And so we started thinking about when the mayor gets a drunk driving, you know, DUI. Like, who did he call? We called his attorney. he may have called his wife. And, that attorney then is one that's referring someone that maybe even he says, hey, why don't you, before the sentencing hearing, go do your three counseling sessions ahead of time. So then when we go in there, we can say he already did his state mandated, you know, things. Maybe they'll give you a lesser sentence. So those attorneys Steve went around to, and I think you talked to eight of them. and then in November and December and January, when, you know, there seems to be more, at least in Northern Michigan, DUIs for, people enjoying that season with alcohol.

Joe Sanok 00:26:21  So you've got a whole bunch of referrals. And so in the staff meeting, he was sharing that and saying, this is what I noticed last year. Here's how Joe and I talked through it. I just did a bunch of kind of referral development over this year. And then November, December, January I got x number of new referrals So a couple marketing tips for your new group practice as you look into this. So we want to start to build a strong brand identity outside of yourself. So if you've named your business after yourself, if your website is after yourself, it's going to be a lot harder for people to want to see someone else in your group practice than to see you. So originally my PLC's name was Sana, my last name Sana Counseling plc. Super boring, not original, but I couldn't think of anything I needed to file the paperwork. Then I filed a DBA because in Michigan you can do that as a PLC to mental wellness counseling. And that became the name, it was no longer my last name.

Joe Sanok 00:27:17  and I liked the name better. So that allowed to transcend me as a person and eventually to sell the practice. to Nicole, who spoke yesterday, about mental wellness counseling. Then we want to do some effective online and offline marketing strategies. So we want to be getting good backlinks from places for group practice. We want to, be able to be in local newspaper. We want to be able to leverage client testimonials and success stories, but we don't want to do it in an unethical way. So this is an area I've talked about for a while. all of our codes of ethics say you don't go to your therapy clients and say, hey, will you endorse me as a therapist? Or, hey, will you rate and review me on Google? we don't want to do that. That's bad form. But what we can do is we can do an annual survey, where we say, something like, you know, what were things like for you when you first came in for counseling? How would you describe the transformation in your life? Would you recommend Steve or Joe or Nicole, as your therapist to your friends and family? What should people know about Steve as a therapist before they do it? And then at the end, we can say, do you consent to us in an anonymous way without giving any identifying information? do you consent to us using some of these quotes in our marketing, our website, to help other people find out how great your therapist is.

Joe Sanok 00:28:39  I really more times than not, people said yes. And so then we can say on Steve's bio quote, Steve's a great counselor. He really helped our family to navigate, my son's DUI and how to help him stay clean. And then we just say, client, those are things that you can then start to use in your marketing. Next, we want to look at some networking with other professionals. This can be more formal through like a BNI or a rotary. or it can be informal. You can start to do some presentations like parent teacher organizations. You can start to, just host therapists, hiking groups. there's lots of really unique ways that you can do this to connect therapists with therapists. Well, next we want to start B. And this isn't an order of what you need to do. I'd say this is more a menu. Also, we want to be utilizing social media platforms, using that to just learn how we can better speak to our ideal client. offer workshops and seminars, engaging with the local community, also creating valuable content.

Joe Sanok 00:29:37  So having blogs and videos and downloads that help around your niche and your specialty. Also targeted ad campaigns. Just in the last session, we talked about pay per click ads specifically on meta and why we see that sometimes work a little bit better, and then making sure we're tracking and analyzing all those marketing efforts. So when we're looking at client retention, there's a few things we want to do to keep clients coming back. And the most basic basic, basic one is set up our counseling appointments on a regular basis. So this could be that every Tuesday at four they come in. This could be that we schedule it for every other week. This could be that we in the first session scheduled the first five sessions. you know, recently my partner Claire and I started going to counseling together. because we're talking about, like, how do we merge our two different lives? You know, I'm a single dad. I have all sorts of things from my divorce that I appropriately or inappropriately bring into the relationship.

Joe Sanok 00:30:33  Claire has her own things, And it's like, well, let's just have a therapist help us just look at all these different things we're talking about. And just to schedule a pre counseling appointment, if this person hadn't been highly recommended to me, I would have moved on. it was so much back and forth just to get a phone call to see if we were a quote fit. We were ready to work with her. We didn't need a 20 minute phone call. And then yesterday I had my first session and, the EHR that she uses, not therapy notes pulled from her old office. So I went to her old office that she hasn't been in for two years. called her when I was there. I'm like, hey, this is where I'm at. She's like, oh, I haven't been there for two years. I don't know why that, you know, came up. that follow up, you know, even after this first appointment, I don't have my next appointment scheduled. So it could be based on my schedule.

Joe Sanok 00:31:24  It could be another month before I go in there. so that basic follow up of saying, all right, we're going to get you scheduled for two weeks out or we're going to get you scheduled for a week out. That keeps people coming back. The more frustration someone has, you know, even, you know, today when Claire went in for hers because two individuals, it's like the Gottman method, she didn't have directions on how to get into the building. And during one of the webinars, she was texting me, how do I get into this building? Like those basic logistics that a lot of therapists who are great at the clinical skills don't have the like operational logistical puzzle pieces, skills and thinking through that can help either retain or like retract, you know, retain clients or, turn them off. so we want to have regular follow ups, regular engagement and offering those valuable services. Well, and we want to overcome some of these common challenges of a group practice. So as you grow, as you scale thinking through okay, how do I think through my, my second hire or my third hire, how do we address conflicts within the team? So, for example, I remember I had this one lady, who I swear, like every weekend she would email the whole team something she was frustrated about who used my paper and my printer.

Joe Sanok 00:32:34  who hid my scissors? you know, the person she shared an office with worked with violent and angry teens, and this lady worked with little kids, and she would just leave her scissors out, and, you know, the other person would put them away because these are violent and angry teens. So managing that conflict, it was me as the owner saying, you know, I'm not sure you're a fit with just how much there's drama coming into this business. And, you know, she didn't realize how much drama she was bringing into the business and eventually realized she really shouldn't be working on a team and should go do her own thing. doing surveys on a regular basis to have a good quality of care helps you catch things early. It's one of the biggest things, though, is learning how to delegate to both people and processes, to just say, why am I doing this? To delegate beyond yourself is really how you scale a business. So when we delegate a growing business, it's you doing what you do best and outsourcing the rest.

Joe Sanok 00:33:30  So we want to first identify tasks to delegate. I would love for you to, even today, take a piece of paper and just write down all the things you hate about your practice. What do you hate doing? Taking out the trash? Doing the marketing, public speaking, billing, progress notes? What are all those things you hate? And start there. see if there's some AI that can help with your progress notes. See if there is someone that, relatively inexpensive, can help clean your office. Maybe they already clean other people's offices. start to delegate those things off. Because when when you're new to solo practice, we wear lots of hats, we bootstrap it. We keep our costs low, as we should. But then there's a certain point where we need to start professionalizing the business. Let's let's take some hats off. Let's stop doing every little thing ourselves. Let's stop bootstrapping and find the right people to delegate to. We want to also start looking at outsourcing, not just to people, but to systems.

Joe Sanok 00:34:19  So we have lots of awesome sponsors that sponsor the podcast and sponsor all sorts of things. Therapy notes is a great electronic health records. that brings together your billing, your progress notes, your tele therapy, all of that in one spot. Alma can help with credentialing and billing. We just in the last webinar or two webinars ago, had some people talk about specifically Alma and how that was really helpful. heard is an amazing accounting, place that specifically works with therapists. So taking that bookkeeping, taking those things off your plate. gusto, does all sorts of different things in regards to specifically like payroll, payroll benefits, keeping track of those things, paying state taxes. Those are all tools and services that really don't cost very much that you can start to outsource to. another one that's not on here is well received. So well received. does, virtual assistant type things where you pay for a certain number of minutes per month? then people are answering your phone and replying, and we'll put links to a bunch of these because we have discounts for every single one of them.

Joe Sanok 00:35:22  but as you start to build out those things, it helps you have a business where you focus on the things you're good at, and that's therapy. All right. We're talking about the launch formula for group practice success. so first we have we have learn, assess, understand needs, nurture and network commit. And hats off. So let's start with the beginning. L learn as much as you can about the solo to group transition. You're starting that by coming here, being in community with other people that are growing into a group practice, researching best practices, getting to know group practice owners, talking to them more, attending workshops, reading books, getting mentorship from group practice owners. These are all things that if you surround yourself with people that are doing what you want to do that can encourage you, that's going to be how you get there. So L is for learn, A is for assess. So where are you at? What needs to be fixed. First we want to conduct a thorough assessment of your current practice.

Joe Sanok 00:36:17  You may have heard of a Swot analysis a strength weakness opportunities threats doing a Swot analysis to look at yourself, to understand where you're at and prioritize tasks that need to be addressed before you expand. If you were to have five people or ten people join your practice. Where would there be cracks in your system? We want to address those before you go do a bunch of hiring. The U of launch is to understand needs. So we want to prepare your practice to move away from solo and update your operations. So we're streamlining that administrative process to handle that workload. Updating your practice management software. Maybe looking at your insurance, making sure the financial systems are flowing like they should. Anything manual that a person needs to do. We want to challenge that. If someone is taking this receipt and putting it here and scanning it and then doing this, are there ways that your bookkeeper could do that a little bit easier for you? Are there ways that we could improve our marketing differently? The N is for nurture and network, so finding the right people to join and share that you are hiring, that people are out there saying, hey, you know, Joe's hiring, build those relationships with potential candidates and other professionals in the field.

Joe Sanok 00:37:23  one thing I used to do is I spoke at the local university in one of their counseling classes about private practice. And every single time I was done, I would have 2 or 3 students come up and say, when I graduate and get my license, I want to work for you. And I said to him, please keep in contact. Let me know when you're looking for internships. I'll try to help get you a good one. we'd love to help you in regards to your licensure, that can be kind of a pain. if you're looking for a supervisor, I do that. But there's also other people that do that. So then they have someone that's mentoring them from the middle of grad school instead of them just being on their own. You know, when I graduated and finished my internship, my last meeting with my supervisor, he handed me the state of Michigan paperwork, and said, here's how you apply for your license. I had no idea I had to apply for a license. I thought it was like a diploma that when you graduate, they just sent it to you.

Joe Sanok 00:38:15  I'm so glad he did that, because I wouldn't have known that I needed a supervisor. I wouldn't have known I needed to apply for a license. You know, they just don't know what they don't know. And so if you can be that guide to someone early in their career, they're more likely in a couple of years to join your practice as you're growing. We want to promote your practice as an attractive workplace. So flexible scheduling to have four day work weeks. Those sorts of things make you stand out differently than other practices, and we want to use that professional network and social media to spread the word about your job openings. The key is to commit. So make your first hire. Learn with them. Document the process. Tell them, hey, you're my first hire. Like I am trying my best here. I'm going to do some wonky things. I want your feedback so that my second hire can be even better. So you're going to take that leap and hire your first clinician. Do it in a way that is low risk, where you're paying them when the money comes in.

Joe Sanok 00:39:04  You're not offering a salary where you're saying, all right, here's X number of thousand dollars per month, even when you're empty. Oh, we want to do it in a way that we actually get things going in a way that keeps that risk down for you. We want to collaborate closely with your new hire. This is true with clinicians and with any non-clinical staff. Have meetings early and often. And so it may be that you have a ten minute meeting with them every single day for the first two weeks. At some point you'll say, you know what? I don't think we need another ten minute meeting tomorrow. Let's let's meet on Thursday instead. oh. Let's just meet Mondays and Thursdays. to to check in. Oh, things are going well. there's this thing called the Carver model, which is used oftentimes in, board governance. And the idea is that the board of directors sets the ends. So we want to address mental health in Traverse City, Michigan, by getting 100 new therapists to move to town.

Joe Sanok 00:39:59  And then the means is set by the executive director. How are we going to do that? How are we going to get 100 new clinicians to move your town to address mental health issues here? So that same thing we can do with our staff. So, you know, I want I want you to have a process where the progress notes are in within 24 hours, there's a dashboard and that I'm going to check in and know where we're at with things. take the next week to outline what you want that process to be, and then I'll poke holes in it. We'll have a conversation. If they create the process in these areas, it's a lot easier for them to buy in and to teach the next person. Yeah, we do this because of this reason. This reason in this one instead of, I don't know, Joe told me to do it. And, I'm not really sure why we do this. We want to document everything as you're doing this so you can replicate it in your onboarding for persons two, 3 or 4.

Joe Sanok 00:40:49  And then also you might decide persons two and three. You're going to hire at the same time. So you can walk them through this process quicker together. The H is hats off. We want to delegate and let them create the best processes and practices. So the idea of you wearing multiple hats, yes, maybe that's how you got here, but let's start taking those hats off. Let's identify tasks that can be delegated. Let's empower your team members to take ownership of their roles and focus on the leadership and strategic planning that goes into the day to day with your team. So we put it all together. in practical application, we're integrating our financial planning, hiring and management. We're creating a personalized action plan and tracking that progress to make adjustments, with key takeaways here being recognizing the right time to expand financial considerations and profitability, hiring marketing strategies, and then the launch formula. We've got some chats that came through. can you define thriving practice? Is that predictable income or predictable referral source? so for me, a thriving practice starts with how do you define success in your practice? For some people, they might have been a stay at home parent, and now their kids are finally back in school.

Joe Sanok 00:42:04  and they still have some stay at home parent duties, but they want to get back into doing counseling, and they can do that two days a week, but they want to do it from 930 to 3:00. you know, when their kids are in school and to pick them up and drop them off. So really they can only do six sessions a day or so. So 12 sessions for them is thriving. And then maybe they're thriving at that. And they're like, you know what? I'm going to rent an office more than two days a week. I'm going to rent one five days a week, and I'm going to add another clinician in to help in some of these areas. So to me, predictable income and predictable referral sources are always intertwined. If you don't have referrals, you don't have clients. If you don't have clients, you don't have money and you don't have income. So those go hand in hand. So, we actually have another calculator that we're working on right now, that it's a staff hiring calculator to say, okay, if I have X number of referrals coming in, and this many convert and then the capacity for the clinician is 22 sessions, how many weeks will it take for that clinician to then be able to be full.

Joe Sanok 00:43:05  And when should I be hiring? If I'm thinking about 60 to 70% full is when I should be hiring. And so to me, when we're looking at all of this, we're always talking about having predictable income, predictable referral sources, and predictable growth because we don't always want to just stay where we're at. If we're busting at the seams, maybe it's time to raise our rates. Maybe it's time to add other clinicians that have more expertise than you in certain areas. Maybe it's time to add clinicians that are newer along there. So if you have extra questions beyond that, Daniella, feel free to raise your hand and we can go back and forth, if you have extra questions. All right. Next question. Will group practice launch be a cohort going through the six month program together? Yes. So this kicks off at our welcome party in late September. And then we start on Thursdays, going for six months together. yep. You get to know each other. it's an awesome community, to really see how people support each other through that process.

Joe Sanok 00:44:02  and then a lot of them probably will be coming to the group practice boss conference here in Traverse City, Michigan, in May 2025. So that's gonna be in early May. We're giving our members in group practice, launch group practice, boss, first access to that in a couple of weeks. so that's going to be something that's going to be a a awesome conference here for 120 people. and then it's going to go public early November. So we're expecting that to sell out, by early November. so, yeah, we believe in in connections that go beyond anything you have to pay for. I love when, you know, I host, sometimes some smaller group meetings here at my house where people fly in, that are consulting clients. I'm going to be hosting one in October that I think we have 12 or 13 people coming. And those people always have a WhatsApp group that, continues on outside of that event. they'll often keep meeting. And I love that, that even when you're not paying for consulting, even when you're not paying for group practice, launch, when you're done with that program, that there's not any gatekeeping where you can stay friends and connected with these people that are doing really big things.

Joe Sanok 00:45:02  I even hosted an event in the middle of the pandemic, and it would have been, I think October. Yeah, it was October of 2020, in Colorado, in a campground where because I was living on the road in a camper, it was called the Art of Dreaming Big. And each person had their own picnic table, and, we were outside. it was all this kind of dreaming big, creating things beyond just our practice. And those people still are connected from that. So to me, that having that cohort model where you can connect is so, so dang important. Well, that's it. In regards to this presentation, I don't see any other questions coming in. thanks to everyone for letting me into your ears and into your brain. Have a great day. We'll talk soon. Bye. Thank you so much for listening to the Level Up Week series. I hope you are getting so much help out of this. If you need extra help, head on over to practice of the practice.

Joe Sanok 00:46:04  Com forward slash apply. I would love to spend 30 minutes brainstorming with you as to your phase of practice, and helping you determine whether a membership, community, or consulting is right for you. Again, that's practice of the practice. Com forward slash apply. And we couldn't do the show without our amazing sponsors. We have tons of trainings here all around every single phase of practice, and we also love the tools that help you if you're thinking about the end of the year and taxes and wrapping all of that up, you need to connect with heard. Connect with them before the end of the year so that you can get a free consultation to talk through your tax situation. There's tons of things that you need to think about year end and heard is going to help you with it. Head on over to join heard comm forward slash Joe that's join h e a r d.com/joe thank you for letting me into your ears and into your brain. Have a great day. We'll talk to you soon. Special thanks to the band silence sexy for that intro music.

Joe Sanok 00:47:00  And this podcast is designed to provide accurate and authoritative information in regard to the subject matter cover. It is given with the understanding that neither the host, the producers, the publishers or guests are rendering legal, accounting, clinical or other professional information. If you want a professional, you should find one.