Joe Sanok 00:00:00  Hey, hey, you don't know me, but I'm Joe from practice of the practice. I'm hosting a conference in May, and I want you to join me. If you own a counseling group practice and want to scale without burnout, the group practice boss conference is for you. May 6th and seventh, 2025, in Traverse City, Michigan. There are only 30 spots left of the 120. Grab yours now at practice of the practice conference before it sells out. That's practice of the practice conference. I'll see you there.

Andrew Burdette 00:00:30  The Grove Group Practice Podcast is part of the practice of the Practice Network, a network of podcasts to help you grow, manage and promote your business and yourself. To hear the other podcasts like The Practice of the Practice Podcast, go to practice at the Practice Network. You're listening to the Grove Group Practice Podcast, a podcast focused on helping people start, Art. Grow and scale a group practice. Each week you'll hear topics that are relevant to group practice owners. I'm Andrew Burdette, a practice owner, and I love to hear from people.

Andrew Burdette 00:01:09  Their stories and real life experiences. Let's get started. Hello and welcome to another episode of the grow Group Practice Podcast. Today I'm here with Elizabeth Burke, who's the founder of Empowered Therapy, a group practice based in Chicago. She also supports other therapists growing their own practices through consulting services. So welcome to the show.

Elizabeth Burke 00:01:33  Thank you so much. Thank you so much for having me.

Andrew Burdette 00:01:36  Yeah. So like always, I like to get a little background from guests about how they got to this point in their careers and what led them here. So what's your story leading into what you're doing now?

Elizabeth Burke 00:01:49  Definitely, yes. I always kind of knew that I wanted to be a therapist. I think that as can be natural for many clinicians that I speak to. I was kind of the go to person with friends, family, in terms of just kind of helping them through whatever was coming up for them. And it really felt like a natural career for me. but as I kind of navigated through graduate school, I wasn't exactly sure where where it would take me.

Elizabeth Burke 00:02:21  I had envisioned working one on one with clients, but I never really expected to be in the situation I am today with the large group practice that I have, which has really been just a wonderful experience to learn and grow professionally and personally. so yeah, I mean, I just, I kind of always knew that I was going to work in a client facing way. but I as I said, I didn't expect to grow such a large group and wear so many different hats.

Andrew Burdette 00:02:55  Ahead of the episode, we were kind of talking through topic and, the the need to, like, identify the different roles that we assume as business owners. So most people listening to this podcast are group owners, or at least considering that. So I, I kind of make the assumption that a lot of the, the listeners for this particular podcast already know their business owners. I think locally, especially people really, when they're first thinking about going to private practice, the idea that I'm an entrepreneur and a business owner isn't really as loud as it might be, as I'm a therapist.

Andrew Burdette 00:03:32  And so do you remember kind of your process, or do you want to comment on your work with others about helping them realize like, hey, I am a therapist, but I'm also these other things and bringing some awareness to these other hats.

Elizabeth Burke 00:03:49  Yeah, definitely. I mean, I think that many therapists become Comfortable being therapists. Right. And so they have their theoretical orientations that they utilize, and they have their sort of structures in place that they like to work within when they're treating clients. But then thinking about owning a business, I think therapists, because we are definitely not trained in graduate school to develop that business acumen. I think that therapists often aren't exactly sure how to make that transition to also identifying themselves as a business owner, which then means having to create different boundaries with, I think, themselves and then with other professionals that might end up working with them. Right. And so I think that, it's just a really sort of unique business. I often tell people whether that's, my own staff or, you know, therapists that I'm consulting with who are wanting to develop a group because we have so many skills related to engaging with others, right? But they can be those skills can be both helpful and I think sometimes more challenging when we're trying to apply that to working with staff and developing policies and procedures and all the things that really are necessary in a business.

Andrew Burdette 00:05:18  Yeah, my, my graduate school background and training and licensure is counseling. And, speaking of identity, since we're on that topic, like the idea of the counselor identity is like drilled in and drilled in and drilled in and drilled in, at least it was in my program. And the idea that we're a counselor kind of before anything else is interesting. And the way languaging I remember working for grad school was really about were providing, you know, treatment and caregivers and these things we're not maybe identifying like we're providing a service and this is what the service is. And then we create a container for what this service manifests as and these other things. There was a kind of a blurring of professional and self identities, and then lack of clarity about where professional life ends and personal life begins. And it gets complicated.

Elizabeth Burke 00:06:08  It does. And I think that we're right. I mean, we think about ourselves as clinicians and then business owners versus I think being both equally in some ways and not necessarily both equally at the same time, and giving attention to both of those things in the same way at the same time.

Elizabeth Burke 00:06:30  But that, you know, being a business owner means structuring your practice as such. It means having hard conversations about policies and procedures, and it means trying to figure out how to, you know, offer your staff benefits and a safe place to work while balancing, you know, managing sessions completed and revenues and all of these kinds of things that I think can sometimes feel sort of uncomfortable as therapists because we think about ourselves as, as you were saying, like treating, treating needs and helping people kind of navigate themselves and the challenges that they're facing. And if we have a staff member having a challenge, right. it's like, how do we approach that from the business perspective, while also being sort of in touch with the therapeutic side of it, or how much of our sort of therapist training is overshadowing what we're trying to accomplish with them, and then maybe not respecting the business side of it. Right. So I think it's really sometimes hard to separate those two identities or marry them in a way that can be.

Elizabeth Burke 00:07:48  Can sort of work for the business and for the personal and professional self.

Andrew Burdette 00:07:53  I think some of this too comes down to just boundaries in general, to where boundaries as a concept gets introduced. But talking about how to then put boundaries into practice as a professional outside of like, hey, don't date your clients, right? There's that. But the the just day to day like functional boundaries of like an eight hour workday is probably good. Like, there's only so many people you can kind of see in a day before you're going to get burned out and, and just the other boundaries around functionality with business stuff like, hey, so we do still live in a capitalist society, so revenue is important and we have to pay attention to that. So is your setting functional for you to do the work and even just things like, what does it mean to show up in a workplace and say, go work for a hospital or an agency or a private practice? And how Being a therapist in those different settings has different expectations and needs that support the business existing to do the therapy service.

Elizabeth Burke 00:08:53  Right. And I think that I had to really through, I think a lot of trial and error and, communicating with other colleagues who also own group practices really come to understand how do I sort of combine my value system. Right, which, which so combine that with the, you know, thinking about the success of the business because this is the success of the business. What that translates into and trickles down to is the success of my staff. Right? They are working here. They want to have benefits and they want to have, you know, they should have benefits and they should have, a wage that allows them to live in a way that they want to and, and work life balance so that they're not working, you know, and seeing, you know, way more clients than probably appropriate just to make the amount of income that they need and, creating a safe workplace for them and all of these things, right, that are so, so important. And so how do I do that while also.

Elizabeth Burke 00:10:04  So it's like, okay, I have these values, right? That I want to make sure that I uphold. And then there are also pieces that I think are just sort of part of how our society is structured in terms of, you know, hitting a certain number of sessions a week and then that, you know, translates into revenue, which translates into bottom line, which can often be really important if we want to put that back into the staff. Right. And so I think it took me a long time to sort of figure out how can I lead in a way that really feels true to who I am, both as a person and a clinician, while also maintaining the integrity of the business, because I think that can be very tricky and lots of hard conversations. Have, you know, been had, whether it's internally or, you know, myself professionally with other professionals to figure that out because it's really, I think can be complicated.

Andrew Burdette 00:11:01  Yeah. And I think it's also important to have a degree of just openness and compassion around things of like, hey, ideally this would be great, I would want this.

Andrew Burdette 00:11:11  And here's what the math says the math is going to do, and the math is informing what we can and can't do. Because if the if the math is in the red, then we all don't have a job anymore kind of thing, right? Right. You can have those, right? Just unfortunately uncomfortable conversations sometimes. Or if you are an insurance practice and you go through things like the change health thing that happened last year, like, where half the country's insurance building got shut down for a couple of months. Like that's a even as somebody that's really planning oriented, like no one's going to plan for that, like, you know, or my area just went through a hurricane. So similar kind of thing. Like there's just there's certain things to where you just have to. And I think even getting back to the identity piece, too, like you can't rescue everything and you can't plan for certain levels of catastrophe, but on the day to day and trying to communicate like my value would be to pay you $1 million for the services we do, because it's hard and insurance is going to give us 50 bucks.

Andrew Burdette 00:12:13  And so, you know, like, how do we where can we find some balance to where you get what you need to exist as a human and understand that the business has some needs to exist to so that we can co-create this whole environment for everyone.

Elizabeth Burke 00:12:28  Definitely. I mean, the example that you just gave is what I often use with people, because I think it's an important illustration of these challenges that were sort of, you know, we only can give so much, even if we want to give way more because of the structures in place. And my practice does accept insurance. So, you know, we do talk a lot about that, that, you know, we can put our efforts into advocacy in terms of, you know, working towards one day maybe having a different rate paid out for the work that we're doing. But as it stands right now, here's where it is. And so here's why we pay the way that we do, or these are the benefits we offer right now.

Elizabeth Burke 00:13:15  Here's, you know, another thing that we do very much so in my practice is, we're very transparent about why things are the way that that they are. Right. And so it's very important to us that the staff understand that, you know, we can add a benefit if certain things happen and some, you know. Sometimes that means okay. This is the reason we're hiring more people, right? If we have more staff and our revenues look a certain way, we can add benefits. We can put that back into you. Right? Or, you know, we can offer raises when or we can, you know, just sort of help them understand what really, as the sole owner, I'm up against. And I think when, there is transparency, I think it can help people really feel more comfortable, really just right. Understanding this is this is the landscape. And this is why things are the way that they are. And so whenever I'm coaching clinicians, as they're developing their practice or developing really into a group practice or wanting to grow at a certain rate, I talk a lot about transparency because we have done a lot of surveying of our staff, and we've really tried to figure out what would be really meaningful for them, even if we can't make certain changes.

Elizabeth Burke 00:14:36  And by and large, people come back and say transparency. We want to understand why things are the way that that they are. And we really work to do that so that it doesn't feel like they are sort of doing the work and not really understanding why certain policies and procedures are in place.

Andrew Burdette 00:14:56  Yeah. The other thing I'll say about transparency, I have a similar thing to you. I'm like, I will sit down and walk through whatever you want to know. Happy to do it. And just that also can explain, like, hey, this is why we're maybe not doing health insurances here because of just it's a size thing, right? And this is what it would cost. And this is where our numbers match up. And just there's that desire to do things versus the reality of can we do it practically. And to me it also it changes that concept or perception of that identity as a boss. So what I want for people is to to feel like I'm in a more lateral roll. Nearly all the time.

Andrew Burdette 00:15:34  Like, I'm going to make some decisions that impact all of us. But I'm a human doing certain kinds of things so that you can focus on just the being a therapist part. It's not because I'm somehow in a vertical relationship to you as it comes to like, leadership and things like, and I do tell people I'm like, if I need to put my boss purchase on and put that on, like, that's a different conversation. And it's not what I really want to have. But talking through like, can we do this? Is it possible maybe six months from now, we could kind of move the whole practice in a direction and then sometimes also just saying, look like we are going to go this one direction because it's what's functionally necessary. And just the transparency piece being a rapport building thing and building trust among staff, because I have staff that have come from some big institutions and have some trauma related to management styles over there, and I definitely don't want to recreate that for my practice.

Elizabeth Burke 00:16:29  Yes, yes.

Elizabeth Burke 00:16:30  We also, work on trying to sort of support people as they join us and figure out, right, where did they come from, and what are some of the things that maybe their old place of employment had had done that really was disruptive for them or they didn't really quite understand? And then, yeah, how can we sort of help them settle in with us and empowered and figure out how to sort of work through that? And yeah, I'll use the word again. I think transparency really is, is helpful for that. And I think as people are growing their practices and trying to figure out, you know, how do I retain staff? And, you know, we are in the age of, you know, telehealth and other kind of big conglomerates popping up and all of these kinds of things, like how can I retain my, you know, my group. And I think it is really about, you know, working with your staff and understanding what they need, and creating a place that aligns with the values that you have, right? And I'm comfortable, really comfortable with how we do things and empowered because I think it really matches up to the way that, I am, who I am and how I am as a person.

Elizabeth Burke 00:17:52  And I think that that really helps with people wanting to be there.

Andrew Burdette 00:17:57  So you're kind of I'd say, like amid the large group size at 40 people, that's that's definitely on the high end of mid and definitely in the largest group size of things. when you transitioned over to doing private practice, like and on the identity kind of focal point of things like, what were some of the other identities that kind of quickly became apparent? Like, now I'm an entrepreneur and now I run a business. How did those show up and what were some of the like, learning curve areas you kind of quickly noticed about, well, if I'm really going to do this right, and this is an identity I need to wear, and I need to put my business hat on at the moment and take off my therapist hat. How did some of that transition happen for you?

Elizabeth Burke 00:18:38  Oh, yes. I think, you know, it came up right. It's like I think after having, you know, maybe two, three, four employees, I realized pretty quickly, wow, I have to get comfortable with numbers.

Elizabeth Burke 00:18:53  I have to get comfortable, you know, analyzing the financials, which is definitely not a hat I really ever like wearing. I have to really sort of look at myself and look at, you know, what are some of my blind spots? I mentioned earlier to you when we were, chatting before the show, my tendency to people. Please. Right. And so looking at that and exploring that through the lens of being a business owner, right. I explore that interpersonally as it relates to my personal relationships. But then what does that mean as I'm leading clinicians? Or I am making decisions about what it is that they want and need, but then also what works for the business. And it took me years. Okay, years, until I was able to separate out myself from empowered. Right. There's the business and then there's even myself as an owner and then myself as a therapist and myself as a person, and even referring to the practice as like the business, what's going to work for the business, right? Because, when I thought about, okay, you know, I had a few people working for me and they'd come to me and say, you know, oh, you know, I think I need a raise, or I want to be able to run a group or I want to do, you know, any sort of things which are reasonable? I leaned probably too far into my people pleasing part and not as much into Hold on.

Elizabeth Burke 00:20:24  Let me analyze this. Let's see if this works for the business. Before I make a decision. Right. And so over time, as I developed the group and grew it, I, you know, so that was something I quickly recognized and then figured out, okay, that cannot be the mode with which I lead, because I would love to give the people what they want. But the reality is, we were speaking about a few moments ago is such that I cannot do that all the time. And so I really had to separate out. Like, how do I communicate that? How do I help them understand I want to do this, but here is what I can do. And I had to learn what I can do, right? I had to learn about the business. I had to really examine some of those areas that I had not really understood in terms of business and structure and, you know, all of those fun things to figure out how then to go back and have conversations about what can work if we're going to be a sustainable place to work, which really has been one of the sort of key parts of running this, how can we sustain, how can we grow and sustain so that everyone who wants to be here can continue to be here and again, have this safe place to work where they really thrive as clinicians and as people?

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Andrew Burdette 00:23:11  which kind of track with like, I'm in solo practice, which sort of fits better because you are.

Elizabeth Burke 00:23:17  The same.

Andrew Burdette 00:23:17  Solo practice versus I'm a I'm a we organization is a little little.

Elizabeth Burke 00:23:22  Weird.

Andrew Burdette 00:23:24  Yeah. And just separating out and really having to kind of shift balance. And I liked how you were talking about there is that kind of threshold that is unique to our field, to where it seems like that 3 to 4 person size group is where things go from solo with extra people to actually a group, because you're really the next real threshold is starting to outsource and delegate and consolidate and have a main admin person with everything running through when those types of things. So how did reaching that point, in your reframing, like, were there any additional roles you could have recognized, like at that 3 to 4 person group size, like an example is, when I early on in group practice, I had a staff issue and called a supervisor friend of mine and was like, hey, so like, am I a clinical director now? And they were like, yeah, oh, you know, like swear word into you.

Andrew Burdette 00:24:20  They're like, didn't realize I also put that on to you. I was like, oh, I just it's me. Plus other people was like, oh, there's all these other layers. And so, you know, did you have a surprise kind of realization like that too, or like, so there's this other identity I didn't realize I assumed and, and also like, how did you then maybe address the am I going to be up for this challenge? And if so, how do I best meet this challenge now that there's this additional challenge that I'm I'm engaged in?

Elizabeth Burke 00:24:47  Yeah. No, it's it's I what a great question. Because I smile along with you here because I'm like, yeah. Right. When you first start and kind of transition from individual to a group and you have those three, four staff members, you're not just therapist plus business owner, but also you are probably supervisor clinical director. And so then it's kind of managing that role too, of, okay, you report to me if you want to look at it that way, just for the purpose of the conversation, for, you know, all sorts of different sort of administrative and employment type concerns.

Elizabeth Burke 00:25:33  And then I also supervise you in a clinical capacity, whether that means somebody fully licensed and I'm overseeing it or they're, you know, provisionally licensed, and they need that weekly supervision. And then all of these roles are sort of overlapping. And how do you manage that and then decide when it's time to outsource that. Right. So I think it was about when we had maybe 5 or 6 clinicians on staff that, the first person I had ever hired who's still with me today, became the clinical director, and it was because it became clear to me that it was hard to manage the clinical issues that were coming up, or just clinical questions that were coming up, as well as, again, kind of employment questions just to, you know, briefly sort of summarize it in that way and so on and so forth. Right. It was like, okay, there's more here that's coming up, because now we're a group of people all with full caseloads, all of whom are working clinically in probably different orientations and capacities.

Elizabeth Burke 00:26:51  How do we navigate some of the natural clinical things that are going to come up for? And if someone is provisionally licensed, then they need to meet weekly and discuss that at length. And then also there's an issue with my paycheck, or there's a question about sick time or there's a question about right, some other or often there can be intersections between clinical and sort of professional employment issues. So it's like how do we separate all of that? And so I think, yeah, I often advise people as they are working with me in a consulting capacity, to think about when it would be important for them to outsource the role of supervisor and or clinical director, because I think that becomes one that just quickly is a really big job. that maybe somebody didn't realize they were going to take on.

Andrew Burdette 00:27:47  Yeah, I feel like some of this I knew ahead of time and some other stuff just kind of was like, oh, I guess it makes sense that this comes along too, right?

Elizabeth Burke 00:27:54  And yeah.

Andrew Burdette 00:27:55  Yeah.

Andrew Burdette 00:27:56  so so when you're working with consulting clients or even just trying to figure out what's next for you, do you have, like a decision making process or like, recommendation for helping people figure out what what's a good thing for me to then move off my plate or give the entire plate away? Depending on what we're talking about.

Elizabeth Burke 00:28:18  Yes. I mean, I think that it's really important to know your strengths, know your growth areas. Also know sort of when you look at your calendar, what are the things that you are excited about? What are the things that you may not be so excited about, but understand are part of owning a business? And what are the things that you're not really excited about and recognize somebody else on your team might be able to do more effectively at this point, given your many hats, right? And so I think that it would be important for a business owner to look at that and say, you know, I spend 3 or 4 hours a week meeting with clinicians in a kind of a in a clinical capacity.

Elizabeth Burke 00:29:07  What could I be doing with those 3 to 4 hours that only maybe I can do as a business owner, and somebody else can step in, in my place and be more efficient or more effective because my head is in, you know, other places. Right. And so I think that it's important for people to really understand what is working for them or what feels really good for them, what can really only they do. Right. There may be certain meetings or certain, you know, administrative tasks that really only that business owner or business owners can do. And then there may be some really great people on staff who would love a promotion to, clinical director or supervisor who could really step in. And so I think it's kind of a mix of what do my staff need or what have they indicated that they might want in terms of, you know, promotion or additional roles? What also am I recognizing that I might need? Or where are the areas in my week that I really feel like are not working for me, or my time is could be better spent elsewhere?

Andrew Burdette 00:30:17  It's an ongoing thing I've learned.

Andrew Burdette 00:30:19  so my first outsourcing was insurance billing because I realized switching into the mode where where's my $10 from? Blue Cross was a waste of my time, honestly, for one thing. And then two, I just couldn't do that and alternate between therapists and chasing down money like The Big Lebowski kind of thing. And, it's just. Yeah, it's just I always think about, like, where's the money in the basket when you're like, Blue Cross, where's my $10 or whatever? So I just that was I hated that the most. And so I got rid of that first. And then there's some other things like, I hate rescheduling clients. So that's, that's about 200%. Go over to my admin because I'm just done. I don't want to do any of it anymore at all. And not even like a little bit. And so, some of it's just preferential. Some of it's just a 100% don't have time to do any of the front end stuff. And so as that business owner, as you're kind of transitioning out, even if you're in solo, you may just realize, like, you know, I can do 28 sessions a week and stay balanced if I'm not doing the scheduling.

Andrew Burdette 00:31:21  And so you can decide if I had an AB in five hours a week and it cost me two sessions to pay for that admin, but I could do five more. Well, you've kind of improved your business model because you've outsourced something that takes up too much time. It's not worth it to you to do to then make more money for both of you.

Elizabeth Burke 00:31:41  Oh yes I mean I think right. So there's the clinical pieces that I was talking about. And then you're bringing up the administrative back and aspects of running a business. And I think exactly, even if you are in solo practice, recognizing that the time spent on the phone with the insurance company is just, oh, it's just a challenge and and it's and it's a lot of time and it's energy and it's maybe not something that the clinician part of you wants to do. So okay. Right. At what at what point in your maybe individual practice does it make sense to hire a biller or an admin person to help you? as you think about group ownership.

Elizabeth Burke 00:32:25  You know, I think about even when we were much smaller, the amount of billing that that, you know, even 4 or 5 clinicians that we had with 4 or 5 clinicians, right. Just was just it feels like it grows exponentially in terms of any insurance challenges or questions. And so I think it's like, okay, at what point does it feel like, well, you know, I can't spend X amount of hours chasing down answers from the insurance company or trying to figure out why claims were denied, so on and so forth. And so I think getting a really strong billing person or administrative intake person or combination of both even. Well, yes, definitely as an individual practitioner, but even as a group, when someone has 2 or 3 employees makes sense because there's just so much work that that person or people may need to do that is can be time sensitive and pulls you away from things that, again, you may really need to focus on.

Andrew Burdette 00:33:33  One of the things you talked about was the the overlap between the administrative supervisor and the clinical supervisor.

Andrew Burdette 00:33:41  And how do you navigate that in your practice.

Elizabeth Burke 00:33:45  Well, I have really a lot of wonderful, people on my team. because I think that as supervisors. So one thing that we do at my practice is even if, even if somebody wants to become a supervisor, right when they become fully licensed, we make sure that they, you know, meet certain marks, if you will, before we promote them to supervisor, because part of their role is not just supervising from a clinical capacity, but it is working with their supervisor on administrative pieces like billing. Right. For example, we have billing department, but client owes billing department can't reach that client. Clinician can reach the client and sees the client. How is the clinician speaking to the client about the balance that they owe? And is it an intersection of clinical and administrative challenge. Right. So maybe the clinician and or the client struggle to discuss financial obligations. And so then what does that look like from a supervisory standpoint in working with that Supervisee on managing that.

Elizabeth Burke 00:35:01  Right. And so I think that, we work really diligently with our supervisors to be trained, of course, they are clinically, but also in kind of navigating some of the administrative side of the work. And even though my group has run such that clinicians and staff members don't have to do really much of the administrative work outside of, of course, their clinical notes. there may be times where they have to communicate with their client about a balance or something, related to insurance if it makes more clinical sense for them to do that.

Andrew Burdette 00:35:39  I like how how I mean, correct me if I'm wrong, but it sounds more like how you're describing supervision is more like you have someone that becomes a mentor for somebody else. It's newer into the setting that they work in, and so it's teaching the, you know, the discussions that are kind of unique to private practice in general, whether it's group or solo about, hey, insurance deductible will show up from time to time. And since you and I talk every week and you don't know our billing person, I figured I would start talking with you since you and I already know each other versus, you know, random random billing person over here.

Andrew Burdette 00:36:12  Right? that's really cool. I like how that's again, it. I'm a very developmentally oriented therapist anyway. And so that's kind of also what I bring to leadership style. So I appreciate the here's a way to kind of build things in. And to me it also seems like it builds in some a greater sense of ownership with the people that are working in your staff already to feel like they really helped develop something for the company as well.

Elizabeth Burke 00:36:41  Yeah.

Andrew Burdette 00:36:42  do you find that, do you have a clinical director like a specific single point of contact clinical director. Or is it more like your structure to where it's more spread out among the general staff.

Elizabeth Burke 00:36:54  So yeah. So we have a clinical director and then, Larissa Gorski, who was my first hire ever, was clinical director and was promoted to chief of clinical staff. So what that means is that she really works closely with the clinical director. She manages any kind of clinical issues. She also really works, as a liaison between the clinical and administrative staff.

Elizabeth Burke 00:37:23  She does a really good job of that. So, so there are sort of those two people in leadership in that capacity, and then there are other people in leadership who, for example, run our recruiting department. Right? So help us grow in that way and interview and, work with candidates in that sense. And we have a really strong administrative team that, again, has become sort of trained and really well versed in certain aspects of just being in this business. So of course they are not clinicians and they don't say that they are, but they really have the clinical speak down and really understand how to kind of navigate our clients and work with the chief of clinical staff and clinical director. So, we really work though to even though there are people in leadership, right? We work to work together with everyone in a way that isn't so hierarchical. but, you know, as we were speaking about earlier, sometimes there's a need to be putting on our, you know, my boss hat or the chief of clinical staff had or clinical director hat, in that sense.

Elizabeth Burke 00:38:41  But, you know, my leadership team really works well with the staff and with one another to manage all of the different things that day to day can pop up when you're a group of this size.

Andrew Burdette 00:38:54  Are there any of those, like, identities or roles that you have going all the way back to solo, to where we are? All the hats we wear them all, and then small group where we still wear most of the hats. have you fully given away any of those roles?

Elizabeth Burke 00:39:08  Oh, what a beautiful question. And I say I responded that way because I want to say, oh yes, yes, of course I have. and in some ways, it's hard to do that when it's your business, you know? but because I have really, truly, an amazing staff, I feel strongly that I can shut down my computer or take a vacation or do whatever I need to do and not worry about the way that the practice is running on a day to day basis. So I can say yes in that I do not do anything related to billing.

Elizabeth Burke 00:39:50  I don't do anything related to the intake process, meaning I oversee it, but I don't answer emails or phone calls. I don't manage clinical crises unless they need my attention, of course. Then I'll be involved. But on a day to day level, if there are things that are popping up with clients that clinicians and supervisors and clinical directors can manage. I'm not involved in that at all. so in a lot of ways I can and I fully credit my staff for that. and I laughed a little when you asked the question because I feel like, given my own type A tendencies in running and owning a business, it's hard to just sort of totally let go. And so what that looks like in practice for me is I do not micromanage, or at least I think I don't. But I just look at everything, right? I'm I'm looking at all of our systems and making sure that things are attended to and making sure that our clients are cared for in the way that they need to, or that our staff are getting, you know, answers to the questions that they might have, or you know, that their payroll is accurate or that there and not that I need to do that because my staff is so great.

Elizabeth Burke 00:41:12  But I do that because I feel that, again, as we talked earlier about values, it just aligns with my values to run a place that really works well and is meeting the needs of the people who are here. And so yes and no.

Andrew Burdette 00:41:34  How I hear that is it's this I've taken my step back and I'm trusting I have quality people I can trust to get the job done, which then allows me to allow them to do This fulfilled the process that I've assigned to them. And I'm also still aware of what's going on, because I care about those people doing these roles and the health of my business. So it's I'm not running, but I'm aware of it nonetheless. So I think that's that sounds like a balance point. It doesn't sound like micromanagement if that's the concern. So it sounds pretty decent. Yeah. So just, comment and awareness about like things we've talked about and stuff. Are there any key takeaways like listeners out there you want to make sure that they know, based on what we've talked about, about identities and kind of identifying what those are as you grow and then kind of recognizing maybe some of these are not things I need to invest as much energy into, and maybe can hand this persona or identity off to others.

Andrew Burdette 00:42:34  Any key takeaways for listeners?

Elizabeth Burke 00:42:37  Great question. Yes. I mean, I think that the ultimate takeaway is if you lead with integrity, if you lead in a way that aligns with your value system, you can lead a practice, whether it's a practice of 2 or 200, in a way that is going to work for clients, clinicians and yourself as a business owner. And I think reminding yourself that you may want to wear all of the hats, because that might be what you're used to. Whether you come from individual practice ownership, or just because it feels like that's what you're supposed to do if you're the sole owner or, you know, co-owners wearing all the hats together. but you don't have to. And in fact, a business can be run more efficiently and effectively as you sort of work with your staff to figure out who might be a good person to step into certain roles. and I think really elevating your staff is such an important component of running a group. So offering promotions or, you know, role changes, giving them opportunity if they're interested and seem to be a fit for different roles, to work with the clinicians so that you know they have that opportunity.

Elizabeth Burke 00:44:02  Clinicians can interface with other members of the staff versus just the business owner, right. And I think it just offers a well-rounded experience for everyone. I think one of the greatest things that I have done is given people roles and more roles and offering to people the opportunity to come to me and say, I really want an additional role. I don't really know what that even means yet, though. I already am a supervisor or I'm provisionally licensed, I can't supervise what roles are available, and often we try to figure out if there are openings for something or if there's an opportunity for something or, we really work with them on how they can grow their career with us versus feeling like, you know, I'm seeing clients. I enjoy that, and that's the extent of what I can do here, right? We don't want anyone to feel that way because we want to grow with them. and I think really being flexible with the idea of identities and what you thought maybe you would have to sort of be as a business owner and what it what you can be and how you can kind of shift and change those identities as you learn more about yourself personally and professionally.

Andrew Burdette 00:45:25  I'll just add a quick little, some of what's been interesting is the identity you thought, and maybe what the identity means can change too. And having some flexibility there about what you can conceive of a clinical director being. And what that looks like has been helpful for me too. so if people want to work with you, how can they get Ahold of you? And we'll have all of this linked in the show notes, like every show?

Elizabeth Burke 00:45:49  Yeah. So, the easiest way is to go on my website, which is empowered therapy, and, contact me that way. I really love working with clinicians on the development of their practices, because I think that it's just it can be challenging when you are first starting out, or even just growing or wanting to grow further. And having a partner and doing that can always be really helpful. So, that is a passion of mine, and I hope that some of the listeners will reach out.

Andrew Burdette 00:46:23  Awesome. Well, thanks so much for this great conversation.

Andrew Burdette 00:46:27  and being a guest on the show and, look forward to featuring actions with you down the road.

Elizabeth Burke 00:46:33  Thank you so much.

Andrew Burdette 00:46:40  Thank you so much for listening to this show today. We could not do this show without our amazing sponsor therapy notes therapy notes as the best electronic health records out there. You can go over to Therapy Notes. Com and use promo code Jo at checkout. That's going to help get you a couple months off for free. It also helps let them know that their podcast sponsorship is working. Thanks so much for hanging out with us today on the grow Group practice podcast, and we'll talk to you soon. If you love this podcast, please be sure to rate and review. This podcast is designed to provide accurate and authoritative information in regards to the subject matter covered. It is given with the understanding that neither the host, the publisher or the guest are rendering legal, accounting, clinical or any other professional information. If you want professional, you should find one.