• Visit the Center for Child Development website. 

• Connect with Clinicians of Color on Facebook and Instagram.

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 would 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. Again, that's practice of the practice. This is the practice of the practice podcast with Joe. Session number 1170. I'm Joe and I'm your host. And welcome to the practice of the Practice Podcast, where we are helping you build a thriving private practice that you absolutely love. We are interviewing people depending on the week 3 to 5 times a week.

Joe Sanok 00:01:17  We're doing this show, so if you've missed any of it, make sure you go back. All this month we've been talking about marketing. So we've interviewed all sorts of people around marketing. Last month we did the Even Better Year series, and next month we're doing better mental wellness series. So the first three months of the year, we're doing some series to just kind of have our guests all be in a certain kind of way that we're viewing the world and the way that we're thinking about it during that month. So I'm so excited to have Lisa our Savage, back on the Practice Practice podcast. Lisa is a seasoned mental health professional with over two decades of experience in clinical practice and mental health advocacy. She is the founder of the center for Child Development in Delaware and co-founder of Clinicians of Color. And at the time of this recording, you're gallivanting through Europe. Welcome to the Practice of Practice podcast, Lisa.

Lisa R. Savage  00:02:09  Thank you Joe. I know, I didn't know that I would be here when I scheduled, the podcast, but I'm loving it.

Lisa R. Savage  00:02:17  I'm absolutely loving it.

Joe Sanok 00:02:19  well, tell me some of the highlights of your trip where you've been and, just some of the cool things you've done.

Lisa R. Savage  00:02:25  Yeah. So we started out in Turkey, which was amazing. delicious food. But more importantly, the people in Turkey are just so kind and helpful. And, even though, Istanbul is a very bustling city, people were very gracious. Then we went to Croatia. We went to Zagreb, which, the city is, is very small. The country is small. But I also found the people there to be extraordinarily kind as well. I love, love, love. I want to go back again and visit the coast of Croatia. And then while we were there, we were going to go to Germany. but my husband loves Paris, so he said, let's switch things up and go to Paris. And of course, I wasn't going to say no. so we've been here since we got here on Monday and we'll leave on Sunday, but it's been really amazing.

Lisa R. Savage  00:03:23  I love culture and I love learning about different people, so I make lots of observations when I'm in different countries. And, I have to say that this trip has been really, enlightening for me in a lot of ways. So it's nice to visit Eastern Europe. Yeah, yeah.

Joe Sanok 00:03:40  Oh. That's wonderful. You know, my grandma, who I called Boucher, which is Polish for grandma, but she wasn't my Polish grandma. She culturally appropriated that from the other side. but my my Polish grandma wanted to be grandma because they wanted to be all, like, Americanized and so. Right. Boucher had always wanted to wanted to go to Paris and, when I was in college. so it was I had just graduated from my undergrad, and I took a year off between undergrad and grad school. and I just decided I was going to travel the world. And so, I, I was on one before it there was like, you know, a trip advisor and all that. There was these, like, email lists.

Joe Sanok 00:04:14  You could pay like 100 bucks a year and they would send you all these, like, travel deals. And I was on this one and I got some killer deals. but they had this deal out of Detroit for $250. You could fly direct to to Paris. And so I bought two, two tickets in, like, the middle of the winter. and didn't tell her where we were going to go and just told her, you know, bring your passport, bring your medicine. we're going on a trip. and totally. She she was so funny. She's like, I bet we're going to Paris. When I told her she was Paris, Tennessee, and I said, no, we're going to Paris, France. And she was like, starts crying every every stewardess on the airplane. She'd tell me, like, bring us a bottle of champagne. And it was just like, so fun. We stayed at the the Three Ducks hostel, which was a Napoleon's old like horse stable. They turned into a hostel and it was like 20 bucks a night.

Joe Sanok 00:05:02  And she was awesome. She loved it so.

Lisa R. Savage  00:05:05  Oh, that is wonderful. That's a very, very heartwarming story.

Joe Sanok 00:05:09  Oh, yeah. And Boucher and I had so much fun there. We were there for, I think, four nights and went all over.

Lisa R. Savage  00:05:15  So nice.

Joe Sanok 00:05:16  Well, I mean, I'm sure we could spend this whole time talking travel because it seems like we're cut from the same cloth there. but, you know, it's marketing month and, you know, before we even dive into marketing, you know, what have you done with your practice? And also, you know, with your community of clinicians of color, what have you done to make it that you aren't so essential that you can never take a break because you're going across Europe. You're like, hey, we decided to go to Paris instead of like stressing about my practice. Oh my gosh, I gotta get home. what have you done to set up a practice that you can just go do that?

Lisa R. Savage  00:05:48  Yeah. So, I think I interviewed with you maybe two years ago.

Lisa R. Savage  00:05:54  Maybe a little bit longer than that, I can't remember. In that time, I, really focused on creating an infrastructure that could exist with or without me, because I think that's important. As a business owner, is that your business can survive, being without you. So I have this amazing leadership team. one of them is actually my biological sister. and she's worked for me for years. So I know one, that she's going to look out for things because she has a vested interest. But also my the other leaders on my team are just really good people, and they're self-starters and they're smart. and they just know how to do things. So, there are nine of us altogether who are on the leadership team, and they each have a different role, but they just step up and do the job. We've grown a lot since I last talked with you. I think we're up to maybe close to 80 clinicians at this point. so it's, you know, it's it's a lot to juggle, but I know that whenever I go away and my husband and I like to take two big trips a year, I really don't have to worry about the operations.

Lisa R. Savage  00:07:11  Things are going to go the way that they they go. we try to automate things as much as possible. and so it just kind of flows. I, you know, while I'm away, I won't lie, I still do. You know, I check in my email and that kind of thing. Check the bank account balance to make sure we have enough money to pay our bills. But, otherwise, it's a very well-oiled machine at this point.

Joe Sanok 00:07:39  Now, if you had tried to do this two years ago, what would have fallen apart?

Lisa R. Savage  00:07:44  So, two years ago was that was right after the pandemic, I think. Yeah, because that would have been like 2022. I don't know that anything would have necessarily fallen apart, but I do know that I probably would have been, handling more phone calls, responding to more text messages, more, emails and that kind of thing. Now, I get text messages just saying things like, so what time is it there? And how's the weather there? It's nothing, you know, nothing, really that, that requires me to be mentally present.

Lisa R. Savage  00:08:30  it's just all, you know, checking in kind of thing. and then, of course, coordinating it, because I am six hours ahead of you guys back in the States. or back on the East Coast, at least. So, but it's, you know, I mean, I figured I figured out, I think I hired the right people for the right job, and I think that's a really important point to point out is that having the right people to do the right job. And I and I lucked out, to be honest with you. It wasn't like I was terribly conscientious about that at the time. but I lucked out, and I have I have a super team.

Joe Sanok 00:09:08  Yeah. Now, tell me about some something we've been talking about recently is framing out that really, most practices only have three pillars. They have their operations, they have their clinical and they have their marketing. Pretty much everything falls under those three areas of, you know, doing the good work of the clinical work, just the behind the scenes billing and all the way that things flow.

Joe Sanok 00:09:27  And then how do people find you that marketing side when you think about marketing with your practice? what has worked best to get people to know that you exist, to know who you help? to just want to work with your team.

Lisa R. Savage  00:09:43  Yeah. So a couple of things come to mind. One is, and I think this is just really important for people, Especially new private practice owners, is developing those relationships with people in your community. And I feel like in the beginning I kind of laid the groundwork for that. my practice is mostly school based, probably 90% school based. So getting into the schools, getting developing relationships, building that trust. and so I had to do that when I was a solo practitioner. And then as I grew, it was really important for me to convey that to my staff who were representing my brand in the community. You've got to build relationships. You gotta show up. and this is what, you know, I expect, because this is the groundwork that I have laid.

Lisa R. Savage  00:10:36  So as time went on, I, one of my leadership team members is. my marketing and promotions person. I recently hired my niece, who is also doing marketing and promotions for me. And she's really, really good at it. So she's out in the community at least once or twice a week talking about the services that we offer, doing promos, making sure social media looks really good and professional. And that's what's helped us to grow. I think the other thing too, Joe, that that is important, particularly for new people, is developing a niche and doing that really well. So mine was school based mental health, and I spent a few years really honing in that model. And in Delaware, which is a very small state, but I wanted to be known for being the expert in school mental health. And that's what really having a niche is about, is being known for an expertise.

Joe Sanok 00:11:46  Yeah. Now I think it's one thing to be good at an expertise. what would you say? You did? Well, to be known for an expertise, because there's lots of people that are good there.

Joe Sanok 00:11:57  They may not be known. So, like, were you writing blog posts? Were you doing a lot of networking, doing public speaking? Like what? What position you to do that?

Lisa R. Savage  00:12:06  Yep. In the beginning, it was a lot of, what I call free work because I wasn't getting paid necessarily to go out and speak to schools about trauma, to speak to schools about when a kid is self-harming. What does that mean? So I did a lot of, free public education for for people in the community. I did it in community centres, schools, churches. and so that's what helped to kind of elevate, people elevate my level of expertise and becoming known for that. I did write blogs in the beginning. I grew my, my Facebook page. we have my gosh. We probably have 50,000 people on our Facebook page. They don't all live in Delaware, but I just worked really hard at creating a presence. and speaking to people who were in the position of helping me to get connected into schools.

Lisa R. Savage  00:13:05  So I knew that one of our strongest voices, to getting me into schools and parents. And so that's why I went out into the communities. I started talking to parents about mental health, and they were the biggest supporters of helping me to be able to forge those relationships in schools.

Joe Sanok 00:13:23  Now, what would you say you guys have maybe set as goals for the practice or things you've overcome, say, in the last six months to a year? Because I feel like most practice owners are constantly thinking how can we improve. How can we grow? Like how do you think through those things? in regards to where you want to kind of push into the opportunities that you see.

Lisa R. Savage  00:13:46  So such a great question because, many of us practice owners went through the change health cyberattack and it it was one of those things where I wasn't sure that we were going to survive. we survived Covid, but that felt harder and more traumatic because it was the unknown. so we started out hearing, oh, this will just be a couple of days and this will be fine.

Lisa R. Savage  00:14:14  And then it turned into being, you know, a disaster for a couple of months. and so learning how during that time of crisis, I was thinking, you know what? We have all of our eggs in one basket. That is not acceptable. So when the bottom literally fell out, I had to start thinking about how do I create other streams of revenue so that we could survive a crisis. Now, given that my practice is so big, I don't know that I could create another stream of revenue that would be as large as my primary revenue. But having something to fall back on is really, really important and where my attention is right now. So I'm doing things like, leveraging AI, which I absolutely love, creating products that are related to mental health, creating, clinical manuals that are related to, to mental health educational materials as another stream of revenue. we also recently got a state, contract. And so we'll be doing a lot of consultations in the community. So I think the takeaway here is when the bottom falls out.

Lisa R. Savage  00:15:37  And I knew we would survive, but I wasn't sure we would survive. I had some doubt. But it kicked in. That part of me that knows that you cannot rely on one stream of revenue. You've got to create other opportunities. It's not always easy because the demand for mental health therapy is so high, especially with children and adolescents. So sometimes you're time you don't have a whole lot of time to create these things. But I think that it's important to think about it and not wait until the bottom falls out. Because in being in business, it's going to happen again. and so being strategic about looking forward and saying, here's the direction that I want my practice to move. We'll always do therapy. We'll always accept insurance. But I'm really focused. Me personally really focused on building some other revenue streams for us.

Joe Sanok 00:16:37  Now how does being the co-founder of Clinicians of Color, how does that add into the revenue streams. Or would you say that's more just for social impact and exposure? How does that play into your business plan and how you think about that?

Lisa R. Savage  00:16:52  So, clinicians of color, I mean, I get paid for the work that I do.

Lisa R. Savage  00:17:01  but it's, I think for me, it's more a passion project. and so we focus a lot on supporting other mental health professionals, educating other mental health professionals, giving access to other mental health professionals. And so, Kim Knight, who is my co-founder, and I, we're constantly looking at what does our audience need? and then we try to provide that to them. So, it's it's grown a lot. I think we probably have our Facebook page got to be like 27,000 at this point. so it's a it's huge. Then we have our membership academy. We have a directory. Recently we started doing some advocacy work. and this is based on the whole change health, incident. Again, I think all of us felt really vulnerable at that moment. but I think also what's really important to highlight is that most private practices operate with a very thin profit margin, such that when there's a crisis that occurs, we don't have any money to fall back on. And so in clinicians of color. Kim and I are also teaching people how to leverage things like AI, how to create other streams of revenue, so that we stand a chance of surviving again when the next, shoe drops.

Lisa R. Savage  00:18:28  Because like I said earlier, in business there's always going to be some challenges that you face.

Joe Sanok 00:18:36  Yeah. I think that, you know, those communities when you can be able to just help with a variety of things. Like, people may come for one reason, but then there's all these ancillary things like, you know, what happens if you don't have three months of of income saved up, both personally and in your business, like then you're going to make really dumb decisions if you're backed into a corner financially or you're going to take, you know, the wrong insurance, you're going to take the wrong clients, you're not going to really say, who am I helping here? As a therapist, I can tell you from experience that having the right EHR is an absolute lifeline. I recommend using therapy notes. They make billing, scheduling, notetaking, telehealth, and e-prescribing incredibly easy. Best of all, they offer live telephone support that's available seven days a week. You don't have to take my word for it.

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Lisa R. Savage  00:20:26  Yeah. Well, I mean, again, a great question. The biggest thing that I'm seeing in clinicians of color is, therapist burnout. A lot of people, are expressing concerns around being burnt out.

Lisa R. Savage  00:20:43  And I understand that. I do. It's it's hard work that we do. and the world has faced some challenges lately that I think, you know, are acutely impacting us, as, as mental health professionals, because they're impacting our clients, too. So what I'm seeing is people looking for other ways to utilize their skills and their expertise. And that's where Kim and I come in because we're teaching them that you, you, you have a body of knowledge that you could do multiple things with. You don't just have to do 1 to 1 therapy. another trend that I'm seeing is people moving less away, moving more away from providing one on one therapy and providing more, group therapy to people, because then they can they can reach more people. And it's not as, it's not as difficult as it is sometimes doing. 1 to 1 work or couples work. So those are the trends that I'm seeing. And so we encourage people, you know, would we meet a couple of times a month to do, some self-care activities? We actually meet we lately we've been meeting three times a month, to help support people, and to create a space for folks to, take care of themselves.

Lisa R. Savage  00:22:05  So we've invited experts in who do various things music therapy, art therapy, yoga, and this is all virtual. and so it's kind of a drop in thing. And it's, I think it's been really good for our members.

Joe Sanok 00:22:21  Yeah. I would say that self-care and burnout are definitely things that in our surveys, we're seeing as well, where people feel like they don't have enough time to do it all. They're not sure how to automate things that that razor thin margin that you're talking about. other than doing good self-care with, you know, the things that we know our bodies need. what else are you seeing be helpful to? To push back on burnout? to help people, be able to get into balance a little bit more?

Lisa R. Savage  00:22:50  Yeah. I mean, I think people, particularly mental health professionals, I think we sometimes tend to be all over the place. we hear we see a shiny penny, and we start running in that direction, and then we see another one. And I try to tell people, narrow it down.

Lisa R. Savage  00:23:05  You don't have to do everything but narrow it down and focus on what you really enjoy doing. Focus. Focus on something that you feel like you could be an expert at. and so I think having to reinforce that over and over again is because most a lot of us have the shiny new penny, syndrome. And so, you know, we're trying to do and be everything. In reality, we can't. because that that goes counter to being able to take care of oneself. So which tries to let people down and help people to kind of focus on what it is that they are passionate about and what it is that they think they can either have an expertise on or develop an expertise.

Joe Sanok 00:23:53  Yeah. I think that idea of slowing things down, of simplifying, is such an ongoing process. I know it practices the practice. Some conversations we're having with the leadership team is, you know, what are we actually really good at and how do we do more of that? And how do we let the other things fall by the wayside? So, like, even just yesterday, I went on our Google Analytics and looked at, so how do people actually end up on our website? You know, I mean, I don't remember how many in the 90 last 90 days came on.

Joe Sanok 00:24:21  I think it was like 30,000 or something like that. And so to look at what percentage came through organic ranking, through direct links, all these different things. One thing I noticed was only about 3% of people that came to our website came via social media, and yet we put so much time and energy into our Instagram, our Facebook, and we're ranking really high organically. I think it was almost 60% just came from organic searches. It's like, well, why aren't we just focusing on that? Like, why are we putting so much time into social media? And it's like, you know, you we're kind of at the point that you have to have something on social media, but do we need to have a daily or 2 or 3 times a day post that looks really good and is well edited to get that 3%? I mean, that's a conversation we're going to have. And it's like, I would rather.

Lisa R. Savage  00:25:09  That makes more sense. Yeah.

Joe Sanok 00:25:11  Yeah. Well, and like even for me, it's like these kind of conversations are so easy where I show up, I talk to interesting people, and then I'm done and we make this, this good content.

Joe Sanok 00:25:21  And then the team, you know, does these show notes. And so then we rank higher for all these different things. It's easy for me and it's easy for the team. And it's sort of like we gotta keep reevaluating like what's working, what's not working. Where are we putting our time? How do we simplify it as much as possible? So how do you think through that in regards to simplifying your business model?

Lisa R. Savage  00:25:43  so recently, in my practice, again, because it's gotten so big and, and the demand for services has increased. I have, set some limits on my, my employees. Like, this is a number of clients that you need to see so I can afford to pay you and pay for your benefits. But I don't want you seeing any more than this many clients. I think also, we had started out with a model where all of our mental health professionals are working in schools. And what I've learned over the years is that that can that can lead to, some dissatisfaction.

Lisa R. Savage  00:26:25  It can kind of pigeonhole people. And so we've started to branch out just a little bit. Like we have quite a Quite a few therapists trained in play therapy now. And so we've created this play therapy suite. And I've given those therapists leverage to be able to do more of that. because I feel like having a little bit more diversity in what they're doing is going to also help to avoid some burnout. And so because they're passionate about, play therapy, we also have a modality that we use called trauma play. And so I've been supporting individual growth, but also put some boundaries in place so that my folks don't end up burnt out. It's a it's not a good feeling to reach a point of burnout. And I know that because I reached that point several years ago personally, and it's not a good feeling. So from what I've learned from what I'm hearing from my own staff and in therapist communities, is having a little bit of flexibility in how we and how we do this work and how we serve other people.

Joe Sanok 00:27:41  Now you said your practice keeps growing and you're growing staff. How many staff do you have at this point.

Lisa R. Savage  00:27:47  I think that we're up to about 80. and I say I think because, before I left my trip, I know, my school based, director was hiring another person, so I think we're in I know the person accepted the position. So I think we're up to about 80. and again, it's really driven by the need. It's driven by the need. But I also think it's driven by our good reputation for great services, great customer service. and getting results with, with our clients. We we do measurement based care. and so we know what's working. What's not working down to each individual client. And that's another thing that we do too, is when we see a therapist who's struggling with maybe a kid who's got ADHD and we're looking at the kid's, measurements, we can provide that therapist with additional training, which helps them to feel more competent, but it also helps us to get better outcomes with our clients.

Lisa R. Savage  00:28:55  So I love the whole measurement based care model because it informs us on so many different levels. but it also helps us to be able to support our therapists in getting any additional training that they need to to get the outcomes that we're looking for.

Joe Sanok 00:29:14  Man, I have I have so many questions now on the the other side of all that, which obviously would be a whole nother episode, but, I mean, if you have 80 people, obviously people like working there, what are some and I don't want to get into like all the like, nitty gritty HR type things as much as I want to get into your mindset with with how you like, what are big picture mindsets that you want to just be the DNA of this practice of why people want to work here and stay here? Because I think that that's where early phase group practice owners, so under 20 clinicians, sometimes take it so personally when someone leaves. yeah. But then they start to figure out, here's the DNA, here's who we are.

Joe Sanok 00:29:53  Then people start staying and they really become true to like, yeah, we're unique in a certain way. What are your guiding principles in regards to kind of what you want, the DNA of the practice to be from the lens of attracting clinicians to stay?

Lisa R. Savage  00:30:06  Yeah, yeah. Another great question. I focused and I started this several years ago on, helping our clinicians to determine what their best skills were. and so it gave it gives our clinicians an opportunity to say, you know what I really want to do? I want to become a registered play therapist. And so we provide them with the training, and we pay for it because we want people doing what they feel they are most competent at doing, because that leads to greater job satisfaction. We also invest a lot in our clinicians. and so I think that's also part of the DNA too, is that we demonstrate to them that they matter, and that how they feel about their work matters as well. we have gone through so many different iterations of this model and how many clients you should be seeing each week.

Lisa R. Savage  00:31:14  And, and I think we've, I think we've gotten to that sweet spot and we've got, we've kind of got that nailed down. And so when we hire new staff, they know what the expectations are. We lay it out to them, and they buy into it because it's, it's it's how we work. It's worked for our other mental health professionals. We we went through a spate of people leaving, and this was right after the pandemic. I think we were all just kind of, like, burnt out and disillusioned. And, some people didn't want to go back to the office. and so since then, I feel like we've kind of fine tuned things. I also think it's really important to take good care of your staff, and to show them that you appreciate them. you know, either by going out of your way to do things for them or setting up structures within your practice that, that, that reinforces that they're valued. we pay our therapists a salary, and I have to tell you, it's it's not the it's it is not the most The best salary.

Lisa R. Savage  00:32:29  I think they deserve a whole lot more, but we're limited by insurance reimbursement. But I think the other things that we do for our providers is really what keeps them, going. And I think they also get the vision of why we do what we do, and that's helpful as well.

Joe Sanok 00:32:46  It is so amazing what you've created. the final question I always ask is if every private practitioner in the world were listening right now, what would you want them to know?

Lisa R. Savage  00:32:56  So I think the biggest lesson I've learned over the years of being in private practice is that you can survive anything. because I have, I survived some of the most horrendous situations with insurance companies and then with the hacking of Change Health. So we just went through an issue where one insurance company randomly stopped paying for providers, just random. It was and it was an error and they did it for almost a month. and but at the end of the day, I how I got myself through that. And I think this is just so important for people to to recognize this.

Lisa R. Savage  00:33:36  You can get through any and everything and you will, you may not know it when you're in the middle of it, but you can get through it because I'm a living example of how how that works because we face some challenges.

Joe Sanok 00:33:51  So awesome. Lisa. Yeah. if people want to connect with you, if they want to follow your work, where should we send them?

Lisa R. Savage  00:33:57  So, they can follow me. Let's see on clinicians of color, which, we have a TikTok and we have a, Instagram, so they can follow me there. If people have specific questions, they can always email me. Lisa at your Lisa at color. but those are the the places where I think we post the most and we have the most impact. and I and I hope people will follow us.

Joe Sanok 00:34:27  So awesome. Thank you so much for being on the practice of the Practice podcast.

Lisa R. Savage  00:34:31  Thank you. My pleasure.

Joe Sanok 00:34:42  You know, if you're looking to be around other, people that own private practices that are group practice owners, you're going to want to come to Traverse City.

Joe Sanok 00:34:52  we're hosting the group practice Bass Conference May 6th and seventh, 2025. And whether you're beginning your journey or you have scaled your group practice, the group practice boss conference 2025 is your chance to unlock just all those strategies, tools, and connections in those two days. we're going to have 120 other group practice owners there. the speakers are short form, 20 minute talks. So kind of Ted talk style with lots of time for you to meet other people that are at your phase of group practice so you can sign up. Tickets are on sale now over at practice of the practice conference. Also, we could not do the show without our sponsors therapy notes as our sponsor for today. they are the best EHR out there. They'll help you move away from whatever EHR you're on right now if you're frustrated with your current EHR. they have HIPAA compliant video embedded within their system. It'll do the billing for you. It's so easy to use. so therapy notes. Com use promo code Jo at checkout to get a couple months for free.

Joe Sanok 00:35:54  Thank you so much for letting me enter your ears and into your brain. Have a great day. I'll talk to you soon. Special thanks to the band. Silence is sexy for that intro music, and this podcast is designed to provide accurate and authoritative information in regard to the subject matter covered. It is given with the understanding that neither the host, the producers, the publishers or guests are rendering legal, accounting, clinical or other professional information. If you want a professional, you should find one.