PoP 227 | 5 Common Issues With Growing a Private Practice

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5 Common Issues With Growing a Private Practice

Today, Joe Sanok speaks about five common issues with growing a private practice.

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In This Podcast


When you hit the growth phase of private practice, you will be bringing in between $50k to $100k or more! This can be a daunting time and there are various issues that could arise. These include time, rates, people management, flow of clients, and self-confidence (or lack there of). Some of these may be issues you have never come across before, and you may not know how to deal with them. Below, and in this podcast, Joe provides some tips and advice on how to overcome these.

3 Phases of Practice

  • Start-up phase:
    •  $0-50k
    • Boot-strapping
  • Growth phase
    • $50-100k
    • Outsource
  • Scale phase
    • $100k & over
    • Automation

5 Common Issues With Growing a Private Practice

1. Time

Make yourself less and less available. Squeeze your schedule in more. Take one day / slot a week where you don’t see clients. Get one of your consultants to take over this time. Make sure the hourly rate that you’re making working on your practice is more than what you’re making hourly from counseling.

2. Rates

Regarding time and money, you need to be the most exclusive person at your practice.

3. Managing Others

This includes scheduling. Consider handing this over to an assistant. You will also need to manage your team’s bios on the website, social media, etc.

It also involves the ‘human side’ of management. The culture of your office, etc. Consider the personalities and character traits of the consultants you bring into your practice.

4. Flow Of Clients

Adding clinicians is a multiplier for your practice, not a subtractor. Each person brings their own network of clients.

5. Believing In Yourself

Fear of failure is normal. But, it makes you raise your game!

Useful Links:

Meet Joe Sanok

Joe Sanok helps counselors to create thriving practices that are the envy of other counselors. He has helped counselors to grow their businesses by 50-500% and is proud of all the private practice owners that are growing their income, influence, and impact on the world. Click here to explore consulting with Joe.

Thanks For Listening!

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Podcast Transcription

Pop 227 | 5 Common Issues With Growing A Private Practice

[0:00] It’s hard to believe that i met jamie just around like six months ago and he has this awesome website company cut slap shot studio.
And they do custom amazing website design that they cater exactly what you need head on over to slapshotstudio.com/joe,
to get an awesome custom website.

[0:22] Music.

[0:29] This is the practice of the practice podcast with joe santa session number two hundred twenty seven.

[0:34] Music.

[0:46] Hello everybody i am so excited to have you listening to the show today thanks so much for being a part of the movement were doing here at practice and the practice i just.

[0:57] This last week and can on cloud nine where in the middle of the world changes challenge that we had about three hundred fifty people do and by the time this comes out will be completely done with and it was a seven day challenge.
And it’s really exciting to see a group of people which is run full tilt towards their goals and.
How many do a couple more challenges this year and next year i’m so whether not you hear this now or in the future,
i’m just keep re directing practiceofthepractice.com/challenge to whatever the newest challenge is going to be at think the next thing i’m gonna do is probably gonna be in september two thousand seventeen,
alright writing a book in a month so rating of thirty to fifty page book in one month.
And how you do that and how the techniques and doing as a community so you can really help your ideal client,
feel connected with you before they come and i’m so that’s what i’m thinking about right now another one that i might do you mean early two thousand eighteen that i’m working on,
is how to add two hundred people to your email list and in two weeks can they do that to get all your mls your cup first couple automation set up.
And then moving into getting two hundred people on your email list or growing it by two hundred people that’s okay thing about all these different things i know i can help you and how i can get,
you involved in our kirby amazing fun things that were doing with practice the practice cuz seen this community of people come together just felt like the same feeling i get when i host a live conference and i need to meet you in person.

[2:29] So this is just super fine cuz i’m hosting that slow down school in late july and tickets in just a couple of weeks are gonna close out no more people can come in.
And at this time right now we’ve got nine people coming in asking me a small group of people excuse me while i was left side of her years.

[2:51] It’s like three in the afternoon i can we rest of coffee in my mug been drinking smoothies like an oasis totally off topic i really care mentoring smoothies every morning.
Amazing how when you drink smoothies.
And i could do this green smoothie and i had just a little bit of fruit to it and then some like ginger and chia seeds hemp seeds and i have so much energy and i don’t even feel like i need my full coffee which i used to be a total i’m still in addict.
Hi my name is joe welcome joe sorry i’m at a tecumseh coffee,
i did i need to have at least some but not as much as i use to and so effect is three in the afternoon i saw some one cup of coffee left overs just crazy at this clean cantina keeps it super hot all day long so,
who was i talking about i feel like i have a squirrel brain today shoe what was which.
I’m little already in the world just challenged got the conference coming up and so it’s gonna be awesome are gonna be sitting on the beach and we’re gonna be around a campfire and wine tasting and planning out,
on people’s growing businesses and helping them scale and then also had their big ideas and so seeing these people that went through this World Changers challenge this week I’m just even more excited about,
july thirtieth to august fifth one week hanging out on the beach going wine tasting and it really building businesses so super geeked out about that.

[4:17] And some and continue to do these challenges just as a way to connect with people that are listening mean we just were talking over fifty thousand people month there listening to this podcast and,
no some abuja email us some of jumping the communities and i want to hear from ya wanna be a part of your life and hope you grow.
And so if your starting practice you can join the email list at packs of the practice at home for slash start.
If you want to join that challenge you can go to Ford / challenge I’ve so many different tools that would love to help you with and really there’s not an area that’s far that I think I haven’t developed something around.
We’re gonna talking about issues of growing practice and i talked about this a bunch in the past but for those of you that are new twenty three k the three phases of private practice so we know,
there’s a start up fees that’s usually when you bring in about an hour about you bring an zero to fifty thousand dollars gross per year so the difference between gross and net.
Gross means that you know i get.
You know two hundred twenty five dollars for this one session or hundred dollars for the session of the actual money comes in and then not,
is the amount of money that is left over after you take out your expenses and so your net you have to take off your rent.
You grasshopper phone lines your website design you know maybe for every $100 you bring in it’s about $75 or leftover then you pay your taxes off of your neck.
Unless you optimize them and then put some two for one k and i should do whole episode just simple many things that i’ve done to rock out money maybe that’s a good the other.

[5:49] So anyway so there’s that starting a practice mean goes really just get the infrastructure built get new clients coming in and can focus in on who you want to attract your perfect.

[6:01] And that’s about fifty thousand up to that hundred thousand gross this can be a growth phase during that feeds you really wanna be focusing more on your ideal client.
And i’m sure practice is full and you’re gonna start towards the end of that he adding clinicians to your practice.
And there are people that said everyone at clinicians mostly fine you’re just gonna probably stab me,
where the you’re going to have an upper income limit unless you start to look at other multiple streams of income like e-courses podcasts Consulting Keynotes things like that.
And above hundred k we’re looking at with call the scaling phase the phase of practice where you really wanna eat reverse everything you’ve done the two hundred thousand to two hundred thousand you need to bootstrapping able hats you need to just like.
Work so dang hard to get clients in there and then.
When you get past hundred kg of start removing things are going talk about that transition when you’re in around sixty seventy thousand and how to really start moving into this killing facing the five things that really.
Tough during that phase like i get emails all the time.
And so i wanted which triggered this was one of my past consulting clients the pull up your email not your name so they don’t have.
Permission to say her name but want to pull this and just read you what she said to me.
Because this to me totally captures this FaZe she said Hey Joe I hope you are well and wondering if you have any tips on how you schedule yourself after scaling.

[7:36] I am finding in the business they’re pissed in my group practice but also the owner who has to do the business development and manage everything at i’ve admin which is great my schedule is wonky.
How do you schedule your clients vs work to give us some life two i’m trying to please evening clients for the same time these.

[7:57] Days are not sustainable any advice is appreciated thanks on this stuff to me that.
Question captures exactly how i think i have six people i was doing consulting yesterday and literally every single person in one shape or form ask the question.
How do i add commissions payed practice is all for different reasons one was feeling really burned out another was looking at reducing their time because the little kids another one was just like to grow their income so they could.
Can I help with their mom who’s aging they all have different reasons but this question of adding clinicians to your practice is a really really big one.
So let’s talk a little bit about exactly what are these five things that are kind of the big issues of stealing and growing your packed.

[8:46] The first one is that time that back consulting claim mentioned e to e day did.
You really need to start looking at your schedule special as you add clinicians in.
You wanna make yourself less and less available to you are more and more exclusive in your time and we’ll talk about how to do that when it comes to how much you charge is well but over time you wanna start to kinda squeeze your schedule in more.
A&B raising your rates so you’re making the same amount in fewer if fewer amount of days.
So far this individual and asked me this question i would recommend to our committee pick one day a week that you’re gonna go home at four or four thirty.
And let your clients know a couple of weeks in advance that you’re going to be you are eliminating tuesday nights and that.
You are gonna be having to squeeze them all in on monday and wednesday night.

[9:41] So even if you’re completely full nice most people are gonna drop down to every other week maybe might wanna move to work with a different conditioner practice.
Or you may just want to wait until looking at people he’s out and then you don’t take on any new evening.

[9:55] Of what you wanna do is you wanna then be looking for people you can add to the practice that can fill in those tuesday nights and so you’re gonna working currently with one of your practitioners and say.
And as of july first to stop doing tuesday nights my office will be free at four would you like to use my office from four until eight that night so you can still serve people on tuesday nights.
But you’re not the one that’s always doing that as well you need to be asking yourself when you’re spending time on your practice.
How much time are you spending I remember I was talking to someone on Apria Consulting call.
And i was like to get whole numbers from them to really understand what’s working before consulting color pre-consulting call.
And some people will have a half hour to re talk or hear their numbers you the practical advice and say history should spend your time your money.
And that maybe consulting me something else about tell you that’s really practical advice i remember asking someone how much are you making from the clinicians in europe.
Jesse and i feel like she said it was her number is like a couple thousand dollars a month series numbers and can’t making his numbers up.
Is it going to be pretty close so it was like $2,000 a month Maybe.
No i asked how many hours a week they were spending after spending like twenty to twenty five hours a week in admin type things in their practice.
And so it ended up being with twenty five cents for saw about a hundred hours without your shoes making twenty bucks an hour thing yes there between dollars and our.
It’s under i remember it being issues making twenty to thirty dollars an hour for her admin time on the practice.

[11:29] And you really wanna think about that if you’re doing an extra twenty hours of counseling you make way more than twenty dollars an hour.
Sue your hourly that you’re working on your practice to be more than we are hourly is for counseling otherwise you might as well as to the council.
Now when you first and people to the practice of course you can be putting in some extra time that you wouldn’t do but he the first thing that first big thing the first issue is.
Time you’re looking your time with how you using it are you making more per hour are you going to be making more per hour by putting in that.

[12:02] I have a five clinician practice it was a twelve commissions but then can i moved away from having as many people.
Yeah i bet i spent a total of a good week probably half an hour and a tough week maybe ninety minutes for the whole week working on the practice.
And so my hours for that is much higher than my counseling it’s issue number two rate.
You want yourself in time and money to be the most exclusive person at the practice so that if someone calls and says joe i really want to work with you i see you know my rate is this.
And the clock.
That’s that’s a lot of money i can see where that i am running really high quality connections to the practice and so it says rate is this sounds great is that there are also here on these days which artie’s you wanted to come m.
You can always schedule them and if for some reason it’s not fit let me know you can come work with me and so it makes your time or exclusive so you’re making the same amount that you are now but in fewer hours it then really pushes.
New clients want to see your clinicians more and more and more write the third big thing is managing others.

[13:15] I don’t mean just managing the personalities but managing a starter schedule so before you have a virtual assistant or the system that’s doing this.
It’s gonna fall on us i would highly recommend that you have an assistant or virtual assistant that’s doing the scheduling that’s doing the phone calls is doing the intake so you’re not.
Feeling those phone calls.
As well you’re gonna have to be updating their bios on the website you can be managing social media you’ll be managing their profiles on the website,
they may change but they’re working on so they might change that i don’t want to work with people dealing with depression and get the different age group.
So i have to manage all of that with the website or have a web designer that you can have on called a pizza as well on the human side of it.
I had a condition that works for me and she said several kind of skiing e-mails on the team saying where my scissors i left on the desk and the scissors are there in that this is begins being deal.
It is right behind the computer like i know you don’t know your scissors are and i feel for you but the way you million of pieces that you would’ve thought like i took your car keys or something.
And she would leave scissors on her desk and she shared an office and there are people that there mean clientele were angry kids like.
We’re not really scissors just on the desk we put it on the desk if you wanna leaving there to that would probably be safer.
And so there’s this human dynamics sometimes come up and when your on the front and bring people into your practice that’s really something you want to consider is.

[14:48] They find get along with people do they bring drama to practice you don’t you don’t want that.
So i have a phase is called the on boarding phase that its kinda like it you know we get you going you’re not quite and we want to see how you’re going to,
a basin but you know i always have an out cuz there to ninety nine’s and it’s just a one year contract.

[15:07] Fourth is the big one of the biggest.
Push back to get people as i just don’t have the flow of clients to bring someone and yet at wholly used to think this way i use to think just like you.
But i no longer think that way i’ve actually seen the adding clinicians is a multiplier for your practice not subtract or does not subtract from your practice.
Each person brings in their own network of people one lady i drive to the practice sarah she her parents and grandparents,
are like yacht club royalty and sarah is so well connected in the foster care community and other agencies around town shelter them million adoptions.
Her first edition going to work saturdays she’s saw four people the shoes full after for saturday and are very for saturday she cards printed the month before the surpass them out yoga joining june two thousand fourteen or whatever your was.
And she was full i found over and over that if you look for people that have different spheres of influence the new,
the day and being a multiplier rather than a tractor so all of sudden your connected to a new b and i group your connected to rotary your connected to aquinas or the club or the country call,
all these areas that you were connected before and you’ve got five or six people that are out there and are talking about the work at your practice.
The first issue of time then rate managing others that you don’t need to have referrals coming in and the last one and probably the most important one is believing in yourself.

[16:43] I know it when it melts mental accounting when i start adding clinicians i was full time at a community college.
In our website was simon who are group practice how we have these people and i’m like i never sees people except for maybe every two months we do a staff meeting with one office that we shared and.

[17:01] Four people share the office with this with a different schedules every day there’s different people in there and at times it felt like i was a poser that its like ads grouped practice but i’m literally in there like six hours a week.
And as i grew as i grew up i realize that you know what these people are doing really good work and it is a group practice.
But that poser that’s kind of the year of failure of the year of being found out that is something abnormal if something makes you raise your game it’s something that we all deal with.
There’s plenty of times i say to myself joe why would anyone listen to your podcast you just this random northern michigan guys figuring it out,
why should you be a consultant and then there are moments where.
I’m like doing that worked out awesome looking awesome that person and of launching or any email from someone that says thanks so much podcast i never thought of it that way.
You as well have those moments when you really really doubt yourself and you doubt yourself as a group practice owner when you doubt yourself.
In so many levels and you’ll later realize just how much you knew i have new consulting client him and i’m super excited about it he was and i didn’t get his permission to say this but.
He was talking about how you was chatting with a mother father practitioner.
And how much he realize he knew and it was just cuz he listen to podcasts and read the blog for so long.
That you’re investing in yourself you’re investing in your own knowledge you’re helping yourself to grow and expand and it’s just so cool to see you doing that so.

[18:39] Issues of scaling with factoring in time make sure your whittling away your time so that you don’t burn outs the could have lifestyle you want,
in the become more exclusive which in turn allows you to then raise your rates and pass more people on to your practitioners.
Third managing others make sure you have good systems in place,
i’d say you want to be outsourcing as much as you can especially when your above that’s unit sixty to eighty thousand dollar range.
And then you don’t need to have referrals and lastly believe in yourself i believe in you i know you doing great work.
I am just gonna be a little teaser i don’t have the link quite ready to publicly announce but i am going to be launching a mastermind group and there’s a game to people that are at the scale and the women structure it.
He is not here from you guys if you like this idea if you don’t but i’m gonna have twice a month were gonna have hot seats on for a mastermind group.
And then probably once or twice a year were gonna do an event at my house,
where for two days we just dive deep into your practice is not included in the price of the mastermind group and so you’ll have to come to traverse city but honestly chairs that is an awesome place i can’t speak highly enough about it.
And you love you guys come so i’m brainstorming at a lake has no power on the email list how do i apply for that when it’s ready to watch with us this tool around my brain.
Thanks so much also the snapshot studio who makes amazing websites to the amazing design,
the vin sponsors whole month and they just ginger can we can meet in person comes to slow down school does less tickets lot of school are over slowdownschool.com.

[20:18] Thanks for let me into yours and answer words bet that’s disgusting i’m so sorry about that rule which without.

[20:25] Thanks so much for letting years into your brain have a great day see.

[20:29] Music.

[20:41] Is podcast is design right after thirteen information regarding the subject matter covered it’s given with the understanding that neither the host the publisher or the gas surrounding legal accounting or other clinical.
Information on your professional you should find one thinks also been sciences sexy for intro music.

[20:59] Music.