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 1100. So welcome. we are going to be talking about the ups and downs of having a multi-site practice. we’re going to have an interactive discussion with Isaac Smith, who I’m going to introduce you to in just a second. Joe Sanok 00:01:15 But if I haven’t met you yet, I’m Joe Cenac, and I started practice of the practice back in 2012. And, it was just a blog and then a podcast, and now we’re at almost 1100 episodes of the podcast. We passed a thousand in June and doing it 5 or 6 days a week. so we get a lot of listeners and I do a lot of writing and speaking and consulting, things like that. but also, I’m a single dad that is raising two amazing daughters that are ten and 13. just went paddleboarding and went to the beach with them yesterday and got tacos and, just had a really fun time. So, that’s my life. and I’d like you to meet Isaac Smith, who is the founder and executive director of Whole Wellness Therapy, a multi-site psychotherapy practice. He specializes in trauma, addiction, anxiety, and other mental health issues. Isaac is also a sought after speaker, consultant, and educator with over a decade of experience in various mental health settings. Isaacs, passionate about providing high quality care and advancing mental health services. Joe Sanok 00:02:16 He’s currently working on his doctorate in psychology at the Wright Institute. And Isaac is just a really cool guy. He’s come here to Traverse City. We’ve hung out in person. he’s doing really great work with his practice. So, Isaac, I am so excited to have you here hanging out with us. Isaac Smith 00:02:32 Yeah, thanks for having me. Cool. Joe Sanok 00:02:34 If you, in the chat, I would love for you to put. If you have a multi-site. If you’re looking at a multi-site, maybe you’re beginning stages. what is your interest in this particular webinar that we’re doing with Isaac? Because, that’ll kind of help us cater some of the questions. The way this is going to work is, for the next ten, 15 minutes or so, I’m going to ask Isaac some questions that are kind of standard. Just baseline. How did he get here? What’s a multi-site. How does that look for him. and we’ll walk through those. And then as I’m talking, if you have questions please just put those in the chat. Joe Sanok 00:03:07 we’ll do our best to get to as many of those as possible. Put your question in early, though, because oftentimes we get to the end and then we can’t get to all the questions. Now, you may have a question where you want to kind of pick Isaac’s brain. You may think that there’s some extra things you need to share, or maybe you’re going to ask a question in the chat and I’m going to say, hey, can we bring you on camera? so if you could just virtually raise your hand, that lets us know that you’re up for coming on camera. So you’ll go down to the react button at the bottom. that’s where there’s all sorts of effects you can do, but you’ll see raise hand right there, under that react button that just lets us know that you want to either come on camera or come on audio, to just talk a little bit more with Isaac about multi-site. So, let’s just take a look at kind of where people are at. We’ve got some people that own a multi-site practice. Joe Sanok 00:03:50 another people that have, three sites looking to grow more. Another one that’s considering multi-site and gathering data. We have one that’s a single site, but it’s now full, so they’re considering early stages of a second site, adding a second location. So a lot of people that are single site and looking to expand. So perfect. Glad that you’re here. So Isaac, let’s just start with, your first location. Tell us where it was at, kind of how did it, like grow? And then we’ll talk about when you first started thinking about having a second site to it. Isaac Smith 00:04:18 Yeah. So, my very first site, was a sublet, actually, out of a small space and, I’m in Sacramento in midtown area, and, that little tiny offices, probably no bigger than a closet. and, so I started from there, and then I ended up, subletting another space in the Fair Oaks area so that because I only had, a certain amount of days at that first location. and so from there, I got a, my own space in that Fair Oaks location. Isaac Smith 00:04:58 and so I had that one office and then the one office in Midtown. from there, we we we found another spot that gave us a few more office spaces in Carmichael, but, sort of the hiccup that we were running into with both of those places is that, both at the Fair Oaks location and the Carmichael location? one of them was trying to sell the building, and, so we were going to be kicked out of that building at some point. And then the other one was trying to rent a whole suite. And as we were growing, the whole suite wasn’t a big enough to accommodate that growth. so we decided to find a different location, which is our main headquarters now in a Fair Oaks. And we have, 11 office spaces there. We now have two office spaces, in our Midtown location. And then we this past year launched, a new practice location very far away from here in San Diego. and we have four office spaces at that location now. Joe Sanok 00:06:02 Well, so total offices. Joe Sanok 00:06:04 You said 11 four, and so was it 16 or 18 or like, I was trying to pay attention, but also my I realize I left my dog outside and started the webinar, and she’s freaking out at the neighbor right now, and I’m just like, oh, shoot, should I bring her in and pause the interview? So I was also listening to make sure she wasn’t getting attacked. So, but how many total, offices between the three? Isaac Smith 00:06:26 so that would be, 1717. Joe Sanok 00:06:31 Okay. And, one of those. You purchased the building, is that correct? Yes. Isaac Smith 00:06:37 So the main. Joe Sanok 00:06:38 Process of deciding to purchase a building and like how that went, why you decided to purchase instead of to keep renting? Isaac Smith 00:06:46 Yeah, I think the main reason was because I was sort of, I’m a person that is naturally anxious. And so, part of, my anxiety was that, hey, we had this looming threat that we were going to be kicked out at some point. and I wasn’t actually in the process of or thinking about buying a building at that point. Isaac Smith 00:07:10 And it just kind of came together sort of, I don’t know, the universe aligned. And there was this opportunity and we went and checked out the space. And, when I pulled up to it, just the outside of it sort of totally felt like us. The inside was a different story, probably like 13 or 14 different colors painted on the wall, a bunch of stuff. So we ended up getting that and doing a lot of the heavy lifting ourselves to get that space ready over a two month period. that was to save some money. the biggest reason, but it has worked out fantastically for us. and I don’t have to worry about. you know, us getting kicked out of there at any at any time? Yeah. Joe Sanok 00:07:51 That’s awesome. Now, I know some people are kind of putting in the chat and we’ll get to their specific questions, but, when it comes to buying a building like I’m right now, in the middle of buying a multifamily home, a three unit, and I’ve bought Airbnbs in the past, but not ones that were already cash flowing. Joe Sanok 00:08:08 And that’s just been a totally new experience for me to learn, like commercial lending, to learn interest rates being different. Do I sign on it also personally or just keep it in the LLC and like so tell me and I and you’re not an accountant, you’re not an attorney, you’re not a real estate person that is giving official advice. You’re just speaking from your own experience. What was that process like to purchase the building? What was like, oh, this seems like easy and normal. And what was like, oh, that’s way different than I expected. Isaac Smith 00:08:36 I think all of it, to be honest, was way different than unexpected because, like, it was just in that realm of things. I didn’t know that. I didn’t know, but, you know, the SBA has some great, opportunities for, for folks that have businesses and are wanting to kind of secure a loan, but we’re also not wanting to put down maybe like a giant down payment to retain some of that cash in the bank for, you know, oh, shit moments and that kind of thing that comes up with the practice. Isaac Smith 00:09:05 Yeah. but, I found, a really good lender and sort of worked with, with them, and he was really helpful and, and, and helping me get connected with the SBA. And, so it was a two process having like a one loan with SBA and then one loan with the bank that I now have, that’s attached to the building. Joe Sanok 00:09:29 yeah. Now, any advice for people that are thinking about purchasing a building that you just like, wish you had heard a year or two before you purchased? Isaac Smith 00:09:37 I think that one thing that would be, particularly helpful is just, to not exhaust all of your cash that you have in the bank in order to secure that down payment, obviously. if you’re thinking about if that’s something that’s of interest and you want to go down that road route, I would maybe start like, putting some of those funds into a separate account with the idea of this is the goal that I’m working towards. I think also like doing your due diligence to, interview different, lenders and banks in the area and see who is a best fit for you. Isaac Smith 00:10:20 Just even temperament and personality wise, working with someone. I, has been really important, with a lot of these different things and just how I operate, not only as a therapist and with my staff is like, I like to build long term relationships. So when I was in the process of, navigating and exploring who. Who I might want to work with or not. I found somebody that I really felt in alignment with, and he has been tremendously helpful over the years since purchasing that building. Just any time I have questions around financial things, or you have somebody in your corner that can help out. So I’ve tried to build like a team of experts, like that’s why I’ve been working with Joe, to help me in those areas that I, you know, where my naivete is, is just present. And to not feel like I got a bootstrap it all alone. I think that’s one of the. Joe Sanok 00:11:13 Good point of, like, building a team of people in any part of, especially things that you don’t know. Joe Sanok 00:11:18 Like for me, buying this multifamily, you know, talking with my realtor, but then also, you know, I talked to the zoning expert that kind of looked into things to make sure, like, can a three unit even be in that neighborhood, like, or was this guy kind of doing it under the table and just like making sure that we have the sign offs and, and do it correctly, like I don’t know all that stuff. Isaac Smith 00:11:38 Yeah. And I think one thing that that popped into my brain too is like if you don’t know where to look or start, if you’ve worked with a lender for your own personal home for instance, like, and you like that person or a realtor that you’ve like, like reach out to them and tell them, hey, this is what I’m thinking about doing. Is this in your wheelhouse or who would you recommend? And and for me, that was really helpful because I went into, reaching out to these folks with going, hey, I have a personal recommendation from somebody that I trust. Isaac Smith 00:12:10 and it helps, you know, you can Google anything, but it’s a lot different when there’s there’s somebody that has a relationship with somebody else, and you can start from there. Joe Sanok 00:12:19 Totally like this, this multifamily that, you know, I’m looking at I had been kind of planning and looking at podcasts and kind of thinking about that, and I just reached out to my real estate agent that I had worked with before, exactly what you’re saying, and just said, hey, I’m thinking about multifamily. And he’s like, literally, we are listing 1 in 2 weeks. I can get you in there before it’s listed, and you might be able to do an offer before it goes public. and it was like, what? Like this just went way faster than I thought. But it’s like, you never know. And so I think just like being prepared for those sorts of things, when it comes to managing two different offices and then eventually three different offices. What was tough, what was confusing about that process? Isaac Smith 00:13:04 I think just part of the natural, process of working through the kinks. Isaac Smith 00:13:12 Right. that, you know, some workflows work really well for one location and then don’t necessarily work the same way for other locations. So I think having a clear kind of process for your staff around, like even the smaller things, like, you know, our, like when we need toilet paper, when we need these kinds of supplies, how does that work? How does that work with the pipeline? To do those types of things, having, you know, we use I’ll create videos on my phone, for instance, of even things like, the opening and closing procedures. So it’s not just, you know, here I show somebody, right? We show them, we also have it written down and there’s a visual component so that there’s lots of touchstones to go, oh, wait, how was I supposed to do that here compared to the other place? Joe Sanok 00:13:59 And where do you keep where do you keep all those trainings and things like, how is that organized? because I know a lot of people will just have like a policies and procedure handbook that nobody ever looks at. Joe Sanok 00:14:09 I think you have a more dynamic system than just like a notebook. Isaac Smith 00:14:13 Yeah. So I started out using, Google Workspace, and that worked well for a while. And now I’m using a program called notion that I, that I like a lot more because it’s all contained in-house. meaning like, it’s like a giant wiki, but very easy to, to navigate. And so for a midtown location, it’s one of those pages is called, you know, Midtown office. And that will have the Wi-Fi code, like, when to water plants, when not to, where to get supplies, who to contact in case the power goes out, or how to solve that problem first to troubleshoot all those things. So I think if you lay out a lot of that, and, and the other thing that was a big learning, just in general for onboarding process is not to write things down in a PDF or in a word doc and then make it a PDF that you can’t edit easily. like anything that you’re going to do, do it in, in a way that allows you to make live updates that go automatically because it just will start consuming so much, unnecessary time having to, you know, redo things and download things like that. Isaac Smith 00:15:23 so we have it broken down by different locations so that the, the folks that need access to the Midtown location, they’re the only ones that get access to it. And because we don’t. Not that the staff, you know, we don’t trust the staff. It’s just like they don’t need access. I give them something else to, like, be confusing. Just we have it by location and they, the, the folks that need it can access the content that they need to. Joe Sanok 00:15:48 Yeah. That’s awesome. How did you. So one question that just came in is we have a single site. Curious as to timing and reasons for growing to a multi site. So how did you decide when it was time to add each site? Isaac Smith 00:16:02 Yeah. so I had built a big, presence in the Midtown area, and the our Fair Oaks location is about 15 miles from there, and that felt like a good, there was enough people that were like, hey, I’d love to work with you, but maybe that’s too far away. Isaac Smith 00:16:25 And it just helped us to to expand to other parts of our, our county and area to make things more accessible. So I think if you’re, at a single site, right. And there’s not an ability for you to, grow there, you know, either consider, getting a new location that has growth within that same area, or maybe you can expand to a different part of town that’s a little bit far, 15, 20 miles away, but still, easy for you to kind of get down and, and do things that need to be done for the building and whatnot, especially as you’re growing that. so, you know, we we kind of did it where we went to Fair Oaks. And then within the last year and a half, two years, I expanded to another location just at the Midtown space. So, you know, it was, it wasn’t like Midtown. And then we added another location at Midtown. Midtown was first and had that same location, and then we started expanding other elsewhere and which was closer to my home. Isaac Smith 00:17:26 And I wanted to be closer to my home for, for, for some of those reasons. So I think also keeping yourself in mind, when you are thinking about adding a site is super important, building a quality like leadership team that can help support that. So you’re not the the go to person. all the time is has been hugely helpful. You know, going from, you know, the first 2 to 3 years of working 10 to 12 hour days to, like, not having to do that anymore and is great. And my kids like it. because I’ve been to that. Joe Sanok 00:17:57 Leadership team a little bit like, how that developed over time from being kind of the main person that people would come to, like adding some layers. Isaac Smith 00:18:05 Yeah. that started for me with a hiring a clinical supervisor. and now we have, three clinical supervisors and a clinical director, and, also my, administrative administration assistant, my VA, if you will. She has been with me since day one, so she’s been with me since we were in my kitchen. Isaac Smith 00:18:31 you know, when I could only afford her for five hours a week trying to launch this group element of the practice? Because I started out as a solo person, and she has been one of the people that I also trust to give her honest input on, like, things related to the practice. And so the team has grown from just kind of her and I in that leadership role to like her and I and like two other people that now are in this sort of collaborative, collaborative leadership model. And it’s wonderful to have people that you can trust to give you their honest opinion about stuff, because there’s been times that I’ve gone there, like I feel anxious, but they’re like, no, that’s not even something I’m worried about. Like, great. And then other times we’re in alignment and then we can address issues that way. So I think building a team of folks that you really can trust, that are going to be honest with you is paramount, to growing because it’s too difficult to do something like this, I would say in isolation or as an island. Joe Sanok 00:19:31 Yeah, totally. Do you often find yourself overwhelmed by the influx of client calls you receive? Receptionists are expensive, but you can’t afford to let your patients go to voicemail. You care for your clients, so you try to phone them back. But more often than not, it’s too late. They’ve gone to another practice. When you partner with well-received, you capture every opportunity. Your calls are answered by professional medical receptionists 24 over seven, and they can support you with more than just message taking. They offer new patient intake, after hours service, bilingual services, medical appointment scheduling, medical live chat and so much more. All this at a fraction of the cost of an in-house receptionist. Your patients are well received as a priority as a practice and the practice listener. You can get an exclusive 50% off your first two months of service. Head on over to well received. Com forward slash Joe to start growing your practice today. I want to go back to the purchasing of the building. One question that we didn’t hit of Linda’s and Linda. Joe Sanok 00:20:47 If we don’t dig into this enough and have more questions about down payments, please let us know. You can always unmute yourself to, She wants to know, just can you speak more to like down payments, etc. like, are there typical percentages, typical amount down like, you know, typical in kind of buying your own home is if you don’t have 20%, you pay PMI. So like what was similar for you or what was different in regards to down payments? Isaac Smith 00:21:11 Yeah. Well, I’m, I don’t remember the exact amount for like the percentage wise for the SBA, but the SBA, I think it was around that 3 to 10%, that they’re required for, for a down payment. I’m thinking it’s probably closer to that 3%, but I don’t quote me. I honestly don’t remember. I was more in, like, I gotta knock this wall down and get this Green Force carpet out of this place, those types of things. So, I would explore some of those options that might be accessible to you or even, again, talking to the bank about, hey, I’m considering, you know, purchasing a commercial building, like, what programs are available that you know, of, like, somebody that you trust. Isaac Smith 00:21:58 but again, if you think that you’re going to go that route, start like putting some money away towards that, so that it it’s not coming out of your, Oh, I just saw that comment. Well, yeah. I would, I would look into the SBA, the Small Business Administration because they, they do they’re interested in helping businesses grow. Obviously, benefits them and and you. So I would start with the Small Business Administration, or just thinking about who’s in your network that might be in that, that field or adjacent to it. Joe Sanok 00:22:35 Awesome. Next question is, do you have someone from the leadership team running each location? Isaac Smith 00:22:41 Great. no. But, well, yes and no. So for the location that is, like nine hours from us, I do have somebody that is running that location for the other two locations. and the goal will be for the, the San Diego location to, to have it more be automated. But the, the Midtown and our Fair Oaks locations, like I said, we spell out kind of what it what needs to be done and how it gets done and who to contact. Isaac Smith 00:23:12 So the benefit of that is that there isn’t a whole lot of people coming to you asking for questions. It’s already laid out in advance where they know where to look. because we do trainings on that, I don’t think it’s necessary to have somebody, be the leader at each location. You. It’s. And it’s innocent. The locations are an extension of our practice as a whole. So if you have some of those things laid out in a, in a really clear and, defined way, the random things that pop up should only be maybe the big things and not the little things, because people know how to solve those problems on their own. Joe Sanok 00:23:54 Awesome. next question is when you look to hire, what do you look for? Isaac Smith 00:23:59 I got this, from, Allison, who used to be with Joe, which is a hungry, humble and smart. Right? Somebody that has a really hungry, work ethic. Somebody that’s humble. That doesn’t, you know, that pursuit. Like, we have a value of lifelong learning and clinical excellence and and humility, like, so somebody who doesn’t think that they’ve arrived at some artificial finish line. Isaac Smith 00:24:29 I’m very allergic of that to that. You know, I still I still feel like a kid running a business. so, and then smart isn’t just like, academic smart, but like, common sense smart like people smart. those types of things are what I look for, when I’m hiring anybody. Are they hungry? Are they humble? Are they smart? if they have those three qualities, like, all of the rest of the stuff, in my opinion, can be shaped, then. Daniela, what was the one ten millimeter move that had the largest impact on growth? A huge one, especially with, like, when you’re the person who is. Okay. Let me back up. My brain works too fast sometimes. Two things. nobody is going to give a shit about your business as much as you do. Nobody. Even when they’re the greatest, staff member and their trusted leader like you are going to care about your business more than anyone. So adjacent to that was learning that things can be good enough. Isaac Smith 00:25:37 And I think this is one thing that Joe taught me is like, if they can do it 80% as good as you, that’s good enough. I think that if you can move in that way and, and kind of figure out not that you’re building the plane as you’re flying it, so to speak, right? The plane should be mostly built, but like some of the smaller things that we can kind of get stuck on as business owners because we’re so passionate and committed about what we’re doing, can end up being barriers to actually moving forward. So, I think that that would be the biggest impact on, on growth and, and and also with that, not like selling your, your practice to people that are interested in working with you like staff members, like they should be drawn to wanting to work with you. one of the first people I hired, she was great. Wonderful. but I was like, I really wanted her to be a part of the team, and I was trying to, like, sell her on, like, okay. Isaac Smith 00:26:42 And like, she she jumped on board. But I think that if I would have done that differently, I would have tried to, like, put out an ad and try to hire people that, like, were really excited by what they, they read, and then excited after meeting and hearing about the practice. Joe Sanok 00:26:59 Cool. a couple questions. Can you speak to multi-state practices? What are hoops and hurdles? And, Isaac, I know all of yours are in California, but, they’re both connected to a lot of people that have multi-state, whatever you can speak to, go ahead. And I can also jump in after. Isaac Smith 00:27:11 Yeah. so I don’t I can’t speak to the multi-state part, but what I can say is, like with our San Diego location, right? We have done, in the Sacramento area, you know, with our midtown, our Fair Oaks, like, we have that process of getting referrals, building relationships, all of those types of things, marketing, you name it. Isaac Smith 00:27:33 We have that down packed. And so part of that, like, not knowing what you don’t know, was in my naivete, like I’m like, oh, we’ve got this figured out. We have this system like we can just like plug and play this in different locations, right? And part of that, part of the learning that I’ve experienced is like, just because it works here and we have all of those things figured out doesn’t necessarily mean that it’s going to work the same way and, and quicker at a different location. I’ve, I’ve since started to treat that as like it’s a it’s own business. It’s it’s own startup, if you will like of course, there’s a lot of things that you know, so you’re going into it different and there are processes that speed up, but it has its own hurdles and struggles related to marketing and whatnot that will have to be worked through. So I think if you’re going to do something that’s much farther out of your area, like you need to do your due diligence as far as market research, as far as all those things that you would have done for, when you’re launching your first group practice, the same things need to happen at, you know, if you’re doing something that’s much farther away, it’s not going to work the same way, even when you try to make it work the same way. Isaac Smith 00:28:52 so you have to just sort of be prepared for, that you’re going to run into some, some of those hurdles and some things that worked really well in, in this area might not work at all in a different location. Joe Sanok 00:29:07 we’ll come back to the Maltese state in just a second. I want to go along with what you just said. and have you talked a little bit about your San Diego location. Because I know that, that location, you know, you had certain dreams for it. Some of those have come to fruition. Some of those. Can you talk about specifically the ups and downs of a location? That’s, what, 3 or 4 hours away from you? Isaac Smith 00:29:26 It’s not like nine hours away. Like nine. Joe Sanok 00:29:28 Hours away. Okay. Nine out. Yeah. Isaac Smith 00:29:30 Yeah. Joe Sanok 00:29:31 Nine hours away from you. Like what? What do you maybe wish you had known? Like, what advice would you have for people specifically when they have a location that’s so far away from where they’re at? Isaac Smith 00:29:40 Yeah. Isaac Smith 00:29:40 I think like I said, one of the biggest things is just not expecting it to go the same way. I think other things that you just don’t think about logistically is, you know, when I was getting those buildings that those spaces set up, right, like I had to fly down, and I had to coordinate a whole bunch of stuff with purchasing, purchasing furniture and, you know, I had to work with companies in order to get things all aligned so it fall right into place. Like so logistical. Things like you can’t just like a 45 minute away location, you can’t just get in your car and go solve a problem that day, like it takes a lot more. so I have somebody down there that is a person that I trust. and they’ve been helpful in a lot of those things. but the there’s a challenge with distance. right. Because I can’t I can’t be the problem solver for all of those things. I it takes much more planning and time. yeah. And I think having a staff member that you really do trust to kind of be an extension or like basically you there. Isaac Smith 00:30:50 And as far as, like building relationships with referral partners, like that’s really important because, they will start to become the person that those folks go to naturally and, but yeah, the marketing stuff like SEO, like all the things that you have for your, for your website, like, they all have to be redone, for a site that that’s, that is that far away. and those processes take time. It’s not something you can necessarily just throw money at and it starts solving itself. so you have to sort of be more realistic about what that, growing process is going to look like for you. And I think that maybe one of the things I might have done differently is sublet a little bit longer until, you know, we were able because, you know, I’m not really interested in trying to get tenants. That’s a whole different challenge that I don’t want to open up in a location that I can’t have face to face meetings and be right there all the time. It’s my, you know, for other folks, that might be something that’s easy to do. Isaac Smith 00:31:58 but, you know, building a team in a new location and trying to maintain that culture to that you built, like in, in this location, all of those things are going to take work. Joe Sanok 00:32:10 Yeah. Well, so I think a number of the things that we want to as to specifically accounting, licensing, and then looking at the SEO and how well you work in those areas. Now, a lot of those are going to be similar to, you know, Isaac being nine hours away from one of his locations and knowing who is it that is getting the toilet paper and those sorts of things. But also, you know, what are the bigger picture things. Do we need to have a employment law accountant in that state, in addition to your own employment law accountant, or does your employment law accountant work across state lines on more of a national level? So those are, I think, some extra things to to factor into. I know there were extra chats that came through because I got kicked out again. Joe Sanok 00:32:50 I can’t see those. So either Sara or Isaac, maybe you can help with, those. Isaac Smith 00:32:56 Yeah. Allison, I can try to speak to your, question. Like the top three considerations to determine. I think number one, would be just doing some market research in the area. like, how saturated is that area with, therapy practice, solo or or group? being able to somehow determine, like, what your ad spend might have to be. So in San Diego, what we found thus far, right, is that, running some of the ads, in that campaign, is three times more expensive than it is in the area that we’re at. so those are things like, I didn’t really know. the the other thing that complicated it is that, you know, one of the staff members who’s there who’s, in leadership there, she, you know, the way that the San Diego practices came together is that she was going to move to San Diego to be closer to her fiance, and she didn’t want to leave the practice and was kind of like, hey, how can we do this? Is it going to be telehealth or not? And I was like, well, why not? Why don’t we open up another location there that would give us another market to, to to expand our team. Isaac Smith 00:34:13 and so some of those things that maybe I would have done differently is I would have done maybe a little bit more of that market research of the area. I would have talked to our, my marketing guy and some of those things to help me determine, hey, she’s going to be in the San Diego, where might be the best place to to to launch our, our office space. so like kind of the pre-work of, figuring out, how saturated the market is, what, what marketing costs are going to potentially look like. and then, I would say those are the biggest ones that I can come that come to mind right now. I don’t know if you have other thoughts on that. Joe Sanok 00:34:55 Yeah. I mean, I think, you know, when I think about when I went from just subleasing an office with a, I had four staff, but they were all had full time jobs. And so together we probably equaled about one full time staff. it was clearly time to level up into an office. Joe Sanok 00:35:09 And, the newest person I invited to go around with me to look at offices, which in retrospect was a really bad decision because instead of me just making that decision, she’s like, oh, I don’t like the carpet in this place, or I don’t like the location of this place. I don’t like this about this place. And, you know, I end up leveling up to this place that cost more than the mortgage for my house, you know, per month to rent and a five year lease. My name’s on it. I had to stick with it. and two months after we moved in, that lady who had so many opinions said, you know, it’s just not worth it for me to be in group practice with you. It’s better for me to go out on my own. And it’s like, oh my gosh, like, I just got this beautiful corner office view of the water, all these things. And I’m on the hook now for five years. And I think that was one of the really big life lessons in business of sure, you want to give your staff feedback, you want to get their opinions, but ultimately you’re the one that’s on the hook for these financial decisions. Joe Sanok 00:36:00 And if you’re making it because you think staff will stay or you think it’ll make staff happy, that doesn’t always happen. So let’s look in here. So we’ve got lots of things coming in. Linda said we almost signed a $10,000 lease and my spidey senses couldn’t do it. I decided to stay where we were and rent more space and spending half of that during the health care cyber attack. I was so glad I made that decision. It was rough. Oh love that. Thanks for sharing that. That does sound rough. next question. What are your thoughts on growing to a larger site versus opening a second site? Is one easier than the other? We have four offices with an opportunity to add two without moving. A great question, what do you think about that, Isaac? Isaac Smith 00:36:42 I think the question I would ask is, why do you want to have a second location like so for, for example, if you’ve got, would you say for offices and your marketing is is piping and like your, you know, your clinicians are full? Well, why not add two more spaces and, and and do that there before deciding to get another location and and reason being like, you know, that site like you have all of the kinks worked out with that, your staff gets more opportunities to talk to each other and, and be with each other. Isaac Smith 00:37:18 if if I was in that position and like I said, my marketing, my referrals, they were just coming in and I needed to grow, grow, grow. And I could do it by just opening up to offices and put some furniture in there and, and get it going, like I would do that first, because then if you do have ambitions to open in a different site, well, two more offices with potentially 4 to 5 more therapists will help fund that ability to open up a different site, which is going to take you’re going to have its own challenges that they’re going to be associated with opening a different location even ten miles away. so, I would just be thinking about like, what are, you know, get clear on what are your goals for opening up a second site versus just expanding, and growing where you’re at? You don’t have to do either or. You know, it could be a both and it might just be a timing issue. Joe Sanok 00:38:12 Yeah, yeah, I’m with you, Isaac. Joe Sanok 00:38:14 I think when you think about opening a two office location across town or adding two offices right down the hall, it’s so much easier to add those two offices to then help fund it. Exactly what you said. So awesome. Isaac, thanks for saying. I’m a group practice boss alumni. Thanks for reminding us of that. And we’ve got Linda saying I’m in group practice, boss. So worth it. Isaac. Sorry, I thought I had sent you the staff wage calculator. We’ll go over that. I’ll we’ll go over that in your next one. I think as we wrap this up, we’ll see if anyone has any final questions for you? But, any advice or thoughts or things around multi-site that we didn’t touch on that? You’re like, oh, we gotta squeeze this in. Isaac Smith 00:38:56 Nothing that’s really coming to mind. just maybe again, treat it like it’s its own little business by its own. Even though it’s part of one thing. Treat it like it’s, you know, it’s its own unique, location and business that’s going to have its own challenges. Isaac Smith 00:39:13 And I think, also, if you are considering doing a multi-site, I now have like even processes within notion where I’m like, I have a furniture checklist. Yeah, I have like a, like startup checklist, like, what are all the things, you know, get business license, get that, you know, all of the things that you need to know before you’re going to do that as you do it, if you have ambitions to grow and grow, like start creating some of these checklists that are easy for you or easy for you to send to your staff like that you might put in charge. Hey, we need furniture like my VA. We need furniture. Here’s the things you need to like put in our Wayfair cart or whatever. give me some just like, little things like that that can save you time in the long run. and help you feel more contained because it is going to kick some hornet’s nest inside. Just naturally. but the more that you have, like these places, or you can remind yourself, it will feel a lot better and go smoother. Joe Sanok 00:40:16 So awesome. Thanks for leveling up with us while other people give up. And thanks for letting us into your ears and into your brain. Have a great day, everybody. We’ll talk to you soon. Well, thank you so much for doing this training with us from Level Up Week 2024. We are here helping you build a thriving practice that you absolutely love every single day. And we couldn’t do that without our sponsors. And our sponsor for today’s episode is well received. Oftentimes, you know, people are calling through all the phone numbers, and if someone answers the phone, those are the clients that actually get in. If you want help getting every single phone call answered 24 over seven, you need the support of well received. They do new client intakes after our services, bilingual support and so much more. You can get 50% off your first three months over at well received.com/joe to start growing your practice today. Special thanks to the band Silences Sexy for that intro music, and this podcast is designed to provide accurate and authoritative information in regard to the subject matter covered. 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