• Visit Practice Vital and listen to the Testing Psychologist. See also, Proactive Therapy.
• Apply to work with us one-one-one!

Joe Sanok 00:00:00  How long do you spend writing your progress notes? Every day. If it's over 30 minutes, you should check out describe. Describe is a HIPAA compliant. I note taking software that I and many of my students use daily. It saves me 1 or 2 hours a day on my documentation around consulting, and I know it's going to save you more in counseling. Also, it customizes exactly to my own writing style. I recommend that every therapist give it a trial. It's free. Go to describe how to get started for free. Again, that's describe Mediacom to get started for free. This is the practice of the Practice podcast with Joanna. Session number 1198. I'm Joe, your host, and welcome to the practice of the Practice podcast. I am so excited to have you here today. We want you to build a thriving private practice you absolutely love. You know we want both sides. We want the thriving side, the operations, the analytics, the KPIs. And we want also you to love it.

Joe Sanok 00:01:14  We want you to show up at your practice and say, I cannot believe I get to do this. This is amazing. I there's so many things in my practice that I absolutely loved. The part that didn't thrive was understanding my numbers, looking at what was working, what wasn't working. I tend to be decent with kind of organization in life, but for some reason, in the business, it was like I wanted to do the stuff that that makes the money that pays people, and then I want to get out of there. I don't want to just do all the work of running a practice. And that that wasn't a that wasn't a good thing for mental wellness counseling. You know, if I had known kind of exactly how people were finding us and exactly who converted and understanding just all the different types of numbers and metrics that go into kind of a dashboard for a business. I probably could have scaled differently. I could have made different decisions that would have made money, that would have brought in more of the ideal clients.

Joe Sanok 00:02:08  It just it just would have helped. but it's sort of that like, you know, I remember in grad school learning like, you don't know what you don't know, then you know what you don't know, and then you don't know what you know. And then finally, you know what? You know, it was one of those things where I didn't even know what I didn't know. and I think a lot of that, especially for those of us that launched practices in the early 2000. just the access to information and access to good products and supports, just wasn't there. And so, you know, it would be, you know, some chat group that I'd somehow get into or some Facebook group and someone would say, oh, here's how I'm hodgepodge ING these types of things through, you know, Google Docs or here's how I'm putting things together manually in an Excel spreadsheet. it was kind of I just got lucky sometimes when I would learn something. I even remember I didn't know about Psychology Today, and I was at a LPs of Northern Michigan meeting.

Joe Sanok 00:02:59  And I was talking to this guy, Nick, who is another, group practice owner. And we always kind of SEO wise for kind of Traverse City councilors. It was like me and him. And then, I didn't realize it was also Psychology Today. And he's like, oh, yeah, I'm on Psychology today. and I went on there in the first week, I got a new client. And so it was one of those things where, you know, at the time, you just kind of learned stuff kind of as you learned it, instead of really having some good just planning behind it. Which is why I'm so excited about our guests today. so we have we have two guests. So, Tori Crone, is an LCSW and owner and founder of Proactive Therapy, which is a successful therapy practice based in Chicago, which she established in 2015. In 2023, Tori began working with her husband to develop a custom dashboard designed to provide insights into the health of her group therapy practice and to empower her team with data.

Joe Sanok 00:03:54  From there, Tori went on to co-found the first ever automated dashboard practice vital, and then Madeline Larson. Madeline left her 15 year career in advertising to spearhead practice, vitals design and marketing efforts. Both their husbands, Brendan, a technology consultant, and Tom, a software engineer in the startup space. Round out practice. Vitals. Founding team. Welcome to the Practice of Practice podcast.

Tory Krone  00:04:18  Thanks. Thank you for having us.

Joe Sanok 00:04:20  Well, I got to start with. Okay. A husband and wife duo is one thing. Having a double husband and wife of four of you working together, that's. That's a whole nother dynamic. How's that going?

Madeline Larsen 00:04:34  It's great. I mean, every day is a new set of challenges. You know, working with family and friends. And just to add another layer to it. Tori's husband, Brendan, is my cousin. So we're actually family and spouses one.

Tory Krone  00:04:50  We're both.

Joe Sanok 00:04:51  Well, it's like it's interesting. I hired my partner, Claire to be our conference planner for the group practice bus conference that we hosted in May.

Joe Sanok 00:04:59  And it's interesting how, you know, there's these little things she needs to get off her mental to do list, but it's like 930 and we're in the hot tub talking, and it's like, I don't want to think about practice of the practice. Like, how do you guys set boundaries with each other? around when you talk business and when you don't?

Tory Krone  00:05:16  We haven't been super great about that. But in some ways, I think it's brought our relationship a little bit. I don't know about closer, but, it gives us a lot to talk about, for one thing, and a lot of things to talk about besides just our three young kids. so, you know, if we go out for dinner, I don't really mind talking about the business. I think a lot of times we have some really fun, creative conversations because of it.

Joe Sanok 00:05:41  Yeah. So, Tori, so you have a private practice, and before you developed this dashboard, tell me what how you thought through kind of your own dashboard in your practice.

Joe Sanok 00:05:54  Like, was it pretty good? Was it a solid. Things were clicking along. Was it kind of messy? Like what did that look like?

Tory Krone  00:05:58  You know, I didn't actually have a dashboard. I this is sort of when practice vital evolved was when I realized I really needed a dashboard. I started to pull metrics into Google Sheets. And, you know, there's a lot of just challenges with that. I think there's inefficiencies. There's a lot of different tabs with different information, different spreadsheets, and it's hard to remember where each of the information, where you put it. And I also had different administrators who I would have to retrain on some of the formulas or ways of collecting the data. And I also just found that it didn't happen regularly because it wasn't necessarily a top priority. So I, you know, I really felt like we needed those key insights in the form of a dashboard, but I wanted it all in one space where it could really present a full picture of what was happening at the practice.

Tory Krone  00:06:53  And I also wanted my clinicians to be empowered by having regular access to that data. Being able to see their data. So that was really the inspiration behind Practice vital.

Joe Sanok 00:07:05  Yeah. And Tori, when you think about what kind of things were, things in the dashboard before practice, vital what were let's maybe dig into, you know, whether or not someone uses your platform. What are some metrics that matter? What are some things that you see? And then, Madeleine, I'd love to hear because you have such an HR and and kind of marketing background. I would love to hear your thoughts on how people can can add some metrics that matter into their business. But, Tori, what do you think are the metrics that really every practice owner should be looking at regularly, and when should they be looking at it? There's probably things that are daily or weekly and things that maybe only quarterly. You need to look at. What are some of those metrics?

Tory Krone  00:07:45  Sure. So I was always tracking completed sessions by week, by therapists, practice wide by month.

Tory Krone  00:07:52  but I found it challenging to track the average per week and the average as it trended over time. And so that's something that I think is really important to do as well, so that clinicians are aware of, hey, I'm at 18 sessions on average. And, you know, they might actually think that they're at 20 or 25 and hitting their expectation. But when they really see the average on a regular basis, then they realize they're dropping below. So really looking at the utilization. some people call it productivity, but we refer to it as utilization. Looking at retention is just such a life force of a therapy practice. You have to know how long clients are staying, whether or not they're hitting treatment outcomes because of it. and whether or not the practice is able to, you know, have some kind of profit based on each client, rather than a loss. Churn rate is another, percentage that's super important to track. And we define that as the percent of clients who stay for fewer than four sessions.

Tory Krone  00:08:59  So think of it. It really is the revolving door metric. Clients are coming in and out. They're probably not getting what they came for. And, it's really important to track that separately from retention. And we can kind of talk more about that if, if it's of interest. Another area is of course the financials. So knowing your revenue across the practice, knowing your revenue by service, knowing your revenue by session. So your average session revenue that's one that most people aren't tracking because we're getting claims all the time. We have multiple payers. It's really hard to track that kind of on an ongoing basis. But it's it's really important to track. We also want to track things like rebooking rate, you know, to ensure that clients aren't falling through the cracks and how many upcoming bookings we have, as well as cancellation rates.

Joe Sanok 00:09:55  And for you, what were some decisions that you made as a result of starting to have that data?

Tory Krone  00:10:02  So many decisions can be made. I think one is around when to hire, when it makes sense, whether or not all clinicians are really maximizing their caseloads, or whether we need to make changes in those departments, whether or not we need to do more marketing or whether we need to do more coaching.

Tory Krone  00:10:22  So simple decisions like sometimes we see that a clinician isn't hitting their utilization goal, but it's not clear whether that's because we have a lack of referrals and we haven't given them enough clients, or whether or not we need to increase our marketing budget. or do we have a clinical issue? Right. So where should the intervention take place? And that's a really common question that I hear from practice owners all the time. It's sort of how do I diagnose the root issue of, of a concern, real time insights. So being able to make decisions around whether or not a clinician is the right fit for our practice, whether or not to continue giving intakes or new referrals to certain clinicians, or whether or not it makes sense to pause given that maybe they're just kind of churning through. And then a lot of big picture things, too, like the processes behind your intake, in the system. So, you know, do we want to reach out to clients after the third session to make sure they're having success in therapy? That might be a decision that comes from looking at the data and realizing that a number of clients are dropping off at that point.

Tory Krone  00:11:32  Those are just a few examples, but there's so many. I think it's really unlimited in terms of, the types of decisions that you can make knowing the data around your practice.

Joe Sanok 00:11:43  Yeah. And, Madeline, what about you? You know, you have a marketing HR background and you're bringing all that, to the Conversation. What for? You are some metrics that matter.

Madeline Larsen 00:11:53  Yeah, I think what's been nice about working alongside Tori is she's had a very specific knowledge base and experience in the mental health world, and my perspective has, you know, spanned much more variety and industries. But the themes are really similar in what business intelligence can be so valuable for, for a company that's looking to scale and grow. And I think Tory's hit on a few of them already. But just to to summarize again, I think the overall sense of productivity, you know, are your staff members really leaning into the expectations that you've set forth for them, engagement in their work or as we've defined it, as churn and retention rates and really being able to understand whether they're engaging and leaning into their caseloads in a, you know, fully enriching and successful way.

Madeline Larsen 00:12:39  And then, of course, rounding out that with the financial outcome, you know, making sure that both the productivity and the engagement and the work that these, clinicians are doing pay off in terms of helping drive your business goals forward as well. So I think coming from an outside perspective, in looking at this industry and working with Torry to define what matters, there's so many themes that really resonate across other businesses as well that we've been able to sort of collaborate and come together in a world of, you know, simplicity around, you know, productivity, engagement and financial success. And those three together can kind of create that trifecta for really managing and growing a business from a healthy starting point.

Joe Sanok 00:13:28  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, note taking, telehealth and e-prescribing incredibly easy. Best of all, they offer live telephone support. It's available seven days a week. You don't have to take my word for it.

Joe Sanok 00:13:49  Do your own research and see for yourself. Therapy notes is the number one highest rated EHR system available today, with a 4.9 out of five stars on Trustpilot and on Google. All you have to do is click the link below or type promo code Joe on their website over at Therapy Notes. Com and receive a special two month trial. Absolutely free. Again, that's therapy notes.com and use promo code Joe on the website. If you're coming from another EHR. Therapy notes will also import your demographic data quick and easy at no cost, so you can get started right away. Trust me. Don't waste any more of your time and try therapy notes. Just use promo code Joe at checkout. Now, as you guys started to bring this together into a company. How did you decide which kind of parts of the dashboard to include?

Madeline Larsen 00:14:45  Oh great question. You know, we, we started small, and I think we've continued to really lean into a customer first approach to building the product. And that really started with working with, you know, Tori and her practice first and foremost, and then expanding that to five, ten, 20 practices that we were collecting knowledge from.

Madeline Larsen 00:15:06  and really picking people's brains to understand, you know, what matters to you. What nuance do you need to see in this type of dashboard to be successful? we wanted to make sure it really felt grounded in the realities of mental health practices and not, generic or oversimplified in a way that would, you know, perhaps lose some of that nuance that was so critical for these business owners, and really trying to build something that felt organically grassroots from that community and that audience base that really, could benefit most from it.

Joe Sanok 00:15:40  Tory, tell me, as you start to kind of organize and use your own platform, what does that look like in, in your practice?

Tory Krone  00:15:48  Sure. So one thing is, you know, I'm able to provide really targeted coaching to clinicians on my team. So I meet with them each once a month, and we talk through the insights so that it can drive our supervision in a really targeted, data driven way. So we might look at, hey, your churn rate is a little bit higher than, than, than optimal.

Tory Krone  00:16:10  And so what are some strategies that we can do and bring in in the first, let's say three sessions in order to really move the needle, in terms of retaining those clients through those initial sessions. And sometimes it's as simple as a lack of confidence on behalf of the therapist. sometimes they address the intake session more like an interview, where they're just rattling off questions and they're kind of forgetting that part of establishing rapport and really making it more conversational and really just finding out why the client came. So I can provide coaching around those types of things and, and do role playing with them and really help improve those skills so that their clients have a better experience. Right? Right out of the gates. So that's one area is really in the targeted coaching around any areas we see for improvement. It also might be something like rebooking rate and recognizing that we really need to have that continuity of care for clients. And so let's make sure that we rebook all sessions. Right. Right after right after the appointment or in advance, with eight sessions scheduled right out of the gates.

Tory Krone  00:17:19  So that that's one area. Another is for leadership meetings, being able to use the data in real time to drive our goals for the big picture, for the practice. So we might look at our completed sessions for last month and say, how does this compare to last year at this time? And you know, with a click of a button, we can just get those trends over time. a lot of people who do iOS, this could be especially useful, to have those numbers sort of at your fingertips and, to, to come up with our goals based on what we're seeing in the data. Do we need, again, do we need more active clients? Do we need to increase our marketing budget? Do we need to make a change in terms of accountability across our practice? another area is to really improve team wide accountability. So making sure everybody's on the same page, knowing a common goal such as every you know, our goal is 70% retention or greater. And that would mean that eight clients stay for eight or more sessions 70% of the time.

Tory Krone  00:18:25  So if we all have that common understanding from the clinicians and the practice to the clinical director, everybody's working towards a common goal and they understand why, then we can really make a much bigger impact and really make, important changes. So those are a few of the ways. again, diagnosing issues. I check it every day and I look through and I just make sure that the, the pulse of the practice is really beating in the way that we want it to be and that, there are no kind of glaring issues, but also that we're moving in the direction that we want to be moving in.

Joe Sanok 00:19:02  Yeah. Tell me about, and Madeline, maybe this is more for you because you're on the air side. How do you think that practice owners can more effectively, when they notice a metric is off? how can those conversations look to help coach a staff rather than make them feel attacked or feel like, they're not doing their job? Like, how can that conversation be productive to help that person make change?

Madeline Larsen 00:19:28  Yeah, we get this question a lot from our customers.

Madeline Larsen 00:19:31  because I think numbers in general can be daunting to some, especially if it's not, you know, your natural realm and sort of language for speaking with one another as a practice. I think you know the words that I love to kind of live by our, you know. Be kind. Be clear and be concise. and if you can bring those to the table in a conversation with a clinician that may be struggling or having some issues, I think it's it's really couched in a, a means of bringing clarity to that person for what they may or may not realize is even, you know, happening within their their day to day or week to week and trying to have that conversation rooted in, numbers that are factual and that you can actually rely on to start that conversation, to neutralize the conversation in a way that's inviting greater dialogue. And sometimes, you know, helps remove some of that knee jerk, emotion even out of the gate. So if you can bring that sense of clarity through, you know, number backed dialogue, I think that can lead to a really fruitful, productive conversation with your staff.

Tory Krone  00:20:40  I also think it's really important that practice owners see it as their job to educate their team on the importance of these numbers and what they really mean, so that they can have their buy in and everybody's again working towards that common goal. So if they can explain this is why retention really matters. If clients stay for only six sessions or five sessions, they're probably not going to get what they came for, and they're not going to have had a successful experience in therapy. So we really want to educate first before we just kind of present numbers out of the blue. We want to say why why it matters.

Joe Sanok 00:21:15  Yeah, I think that kind of ongoing feedback and feedback loops, where where would you say people are maybe missing the mark when it comes to their metrics, where they're either spending too much time or not enough time?

Tory Krone  00:21:27  I think that a lot of people are spending time on the productivity measures or utilization, and also just emphasizing it in their terms of their compensation plans, etc. and yet they're missing the piece about retention and churn and cancellations as well.

Tory Krone  00:21:42  So, maybe not as important to focus on the cancellations in terms of top priority, but I think that retention is such an important indicator that should really be focused on and taken into account for our compensation as well.

Madeline Larsen 00:22:00  I think to add to that, I, you know, we're one tool in a practice owners arsenal to lead these conversations, but we're the quantitative component that should be married with a qualitative component. So, you know, when you're looking at numbers they can't exist in a vacuum. You need to lean in and understand your employee and what they might be going through in their life or in their day to day as well, and bring those stories together to really try to understand how you can best help and service them. You know, you might see, the numbers tell a story that says, this person looks like they're really, you know, under capacity or mailing it in. But the reality could be something's going on in their world that just really needs to clarify that story and help you understand exactly how you can help and support them in a way that can be productive and not necessarily punitive in the way that, you know you might be more intimidated and leaning into more of an accountability conversation.

Joe Sanok 00:22:55  Yeah. Now, I know that it seems like a lot of practice owners, as they start to get data are kind of getting flooded with, oh what do I do with this or how do I organize it. And to me, when I do my consulting, it's great when we start to get data, but to even just start with like one area like and oftentimes it's what's the area that just kind of you feel most confused at or that keeps you up at night or, that you think you might get a good ROI. Like just picking one direction to say, I'm going to really focus on learning this well and then move on to the next one, because it's like oftentimes they've gone years without even looking at their metrics. And so it's like just because you're getting all this data right away, like you can take your time learning it too. Of course, we'd love to optimize it all quickly. But then, you know, if you if you don't right away, that's okay. And I'm sure that, you know, platforms like yours, like teach people how to learn about how to kind of comb through their data and how to optimize it.

Joe Sanok 00:23:49  the last question I always ask, and, Tori, we'll start with you, is if every private practitioner in the world were listening right now, what would you want them to know?

Tory Krone  00:23:58  That they're not alone. this is such hard work, and there's a lot of burnout. There are so many challenges facing practice owners in in general. lack of profitability, burnout, clinicians not meeting job requirements, slow referrals, clinician retention. It can feel really, really overwhelming. And so just to really reach out to others to develop a network, of peers who are going through the same things and to recognize that there's really not, you know, it doesn't have to be a competitive landscape. I think that there's really, space for everybody. And if we can take that growth mindset, we can really support each other.

Joe Sanok 00:24:38  Madeline, what about you?

Madeline Larsen 00:24:40  I love that, Tori. I would say making sense of the mess doesn't have to be so messy. You know, oftentimes we feel a little bit overwhelmed in the day to day and all the, you know, data we might have at our disposal.

Madeline Larsen 00:24:53  But I think leaning on the right resources, partners, collaborators and technology to help make sense of that mess is in everyone's best interest and helps us all kind of get sleep at night and keep the wheels moving the next day. So lean into that mess, but know that it doesn't always have to be so messy.

Joe Sanok 00:25:15  So awesome. If people want to work with practice vital, where should we send them?

Madeline Larsen 00:25:19  Please find us at practice. Vitals? Com we'd love to hear from you and love to meet more practice owners.

Joe Sanok 00:25:25  So awesome. Thank you so much for being on the show today.

Madeline Larsen 00:25:27  Thanks, Joe.

Tory Krone  00:25:28  Thanks for having us.

Joe Sanok 00:25:37  You know, I think when when I think about the numbers, when it comes to, our practices, our businesses, you know, for us at practice is the practice. we know for a couple of years have, done an annual meeting, at the end of the year with our top leadership, looking at kind of the different domains and then saying, what's the main KPI key performance indicator for each of those domains? So for example, the podcast, saying we want to get to certain numbers with the podcast and then breaking that down into projects and just say, okay, what projects do we need to do? So this year, for example, you know, we've had Josh, who's done some great strategy around finding guests, that, you know, are just doing some amazing things.

Joe Sanok 00:26:19  And so yesterday at the time of this recording, the episodes went out at different times. You know, I interviewed, you know, one lady who had four Guinness World Records and had done marathons on all seven continents. Another guy who, his book was endorsed by the Dalai Lama and another guy who has done Ted talks that, you know, over 35 million people have watched and he does the official psychology newsletter for Ted. It's like, holy cow. Like, had we not taken the time to say, where where are we headed here? Where are we going? What do we want to do? Well, let's look at our numbers with the podcast and say what projects then support that? we couldn't be doing a better podcast. You know, we would have just kept doing what we were doing, and that was mostly responding to people reaching out and then occasionally saying, well, let's do a series on a certain topic and find guests instead of intentionally saying, well, let's look at people that have have really strong messages that Joe can be curious as he interviews them.

Joe Sanok 00:27:14  So, so the numbers are only part of it. It's it's representing all the projects that you're putting into your practice to, to see more clients, to have, you know, better response time, to make sure that the clients are are staying long enough to actually feel healing as a result of it. And so if you're scared of numbers, you know, things like practice vital can help you really figure that out. You know, we also couldn't do this show without amazing sponsors like Therapy notes. Therapy notes is the best electronic health records out there. They will help you switch over from your current EHR. They also give you two months for free or just money off if you use promo code Joe at checkout. they are phenomenal. They help with automated billing. it's going to make it easier to outsource your billing. So many reasons to switch to therapy. You know, it's just head on over to therapy notes. Com read about it and at checkout. Just use promo code. Joe. Thank you so much for letting me into your ears and into your brain.

Joe Sanok 00:28:10  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.