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[LATOYA SMITH] The Grow A Group Practice Podcast is part of the Practice of the Practice Network, a network of podcast seeking to help you market and grow your business and yourself. To hear other podcasts like the Practice of the Practice podcast, go to www.practiceofthepractice.com/network. You are listening to the Grow A Group Practice podcast, a podcast focused on helping people start, grow, and scale a group practice. Each week you’ll hear topics that are relevant to group practice owners. I’m LaToya Smith, a practice owner, and I love hearing about people’s stories and real-life experiences. So let’s get started. Hey everybody, welcome back to the Grow A Group Practice podcast. I am your host for season two, LaToya Smith and today’s guest is Brandy Mabra. I’m excited to have her on. I think she’s another person that I stalked on Instagram and I messaged out of the blue like, “Hey, would you mind please being on the podcast?” She has a great Instagram page, a great website. I mean, I told her when I looked at it, I was about to sign up myself, so make sure you check out our website, we’ll give out all that information as well. Brandy, welcome to the podcast. [BRANDY MABRA] Thank you so much for having me. I’m excited to be here. [LATOYA] Yes, I’m excited to have you too, and I really want to hear all about the great work that you’re doing. But before we even get into that tell us more about yourself, who you are and the name of your consulting firm. [BRANDY] Yes, yes. So I am the CEO of Savvy Clover Coaching and Consulting, and I am a CEO coach for private practice owners. I help private practice owners to grow their practices, scale their practices for profitability growth. I’m really big into operations, team building, team engagement, making sure that you are building a practice that is sustainable and that’s going to be here today in years to come. I have 15 years’ worth of business management, leadership experience building multimillion dollar practices so I come from a different skillset. Essentially, I’ve been hired for the smaller business practices, I’ve been hired for large hospital systems, I’ve done consulting work with payers and so it’s a lot of expertise that I bring to the table to try to help form best practices when it comes to building a practice. I’ve been hired specifically to fix broken practices, really what I call hot mess practices where the money’s coming in but operationally they’re inefficient. The team’s not happy. There’s a lot of turnover, the owner’s upset, leadership is not getting the best out of the team. So ultimately that creates a very chaotic environment and ultimately in the long run you end up losing money. There’s a lot that can go into building a practice so I love the work that I get to do and I’m happy that I am able to be in the space. [LATOYA] Yes, that’s good. I’m going to get to that hot mess practice in a second. There’s something there. I think that is, yes, we definitely going to dive into that. Tell us too, because what got you to even want to begin to work with private practices, because that’s a different niche for somebody. Because I know you’re not a therapist. What’d you study that? I’m always impressed with people to do operations and system. I’m just like, wow, because that’s just not my space. So I’m just like, man, it’s a special gift. [BRANDY] Yes. Well, you’re not alone. You’re not alone. Ultimately what happened is I had all this practice management experience and healthcare experience. So when I first got into the space, one of the things that I first realized is that business owners, entrepreneurs, they don’t have the skill set for hiring team, building operations, all of those things. Essentially when I came into the space I was like, I’ll just help business owners and entrepreneurs to be able to build a sustainable business essentially. But one of the things about building a practice is you still have to have an entrepreneur mindset. You still have to have that spirit. You still to think outside the box because you’re literally building something from nothing. What happened was people started to catch onto my healthcare experience, they started to catch onto the fact of some of the things I was talking about because naturally I was bringing a lot of my business experience, all of my business experience from building practices and working in the healthcare industry. People caught on and so I start talking and ended up on some podcasts talking about practices, owning your CEO mindset, the leadership piece. Then I had therapists start reaching out to me to want to work with me and working with them in their practices. You always listen to what the market is telling you essentially but also you listen to, for me I’m here for purpose and I believe that God has me here for a reason and so I know for a fact now what’s really fun is the fact that I feel like it’s like the best of both worlds and I’m able to use all of my knowledge. Because even when I was working with business owners, I felt like I had to push this whole knowledge set that I had to the side but when working with therapists, when working with just group practice owners I’m able to bring everything that I have to the table because it’s different. If you’re working with a business coach, they don’t necessarily understand what it means that you can’t double your rates because United Healthcare says that they’re only going to pay you a certain amount of money or because of some of the compliance that goes into it; patient relations, HIPAA, how to make sure that you’re getting the most out of like your EHR system. All of those things have become really important. The fact that you have to think about the clinical hire compared to an administrative hire, those are two different types of hires. So there’s a lot of thought that goes into it, so it’s just nice to be able to have the, I feel like I get to have my cake and eat it too, essentially because it’s just fun. I love, love, love practice management. I think that when you can have a practice that you’re able to leverage, that you’re able to make the world a better place, the community a better place. That’s really powerful and so I appreciate the fact that a lot of therapists, they don’t have that skill set because nobody went to school to be what I hear a manager, to build a business, the business management, how to manage your financials, how to market. You went to school for your skill set and it’s the clinical piece of it, but the business part of it is so important and you have to make sure that you’re putting yourself in a place to be successful and learn the business skills in order to build practice. [LATOYA] That’s awesome. When you’re talking, I’m like, you remind me of cleanup. It’s like the therapist in the front doing the work, but you sweep in through the bad door, put it all back together like the CSI, Olivia, without the dirty skills. You know what I’m talking about, and clean up? [BRANDY] I love it, yes. [LATOYA] And were like, Hey. It was always like this. [BRANDY] It’s so funny, that is what I’ve been hired, my significant other, he calls me the fixer and the cleanup woman because that’s essentially what’s happens. I come in and I love putting together puzzles, so coming into a space that needs to be cleaned up or needs to be fixed or needs to be refined. That’s my sweet spot and I absolutely love it. So the messier the practice the better. I’m like, yes, because I can see the potential. One of the things, too, is I know what it looks like from the other side because I’m putting in best practices. I come from a place of not what does a six-figure practice or a seven-figure practice, but honestly what does an eight-figure practice look like? What does the multimillion-dollar practice look like? Because if you come from that space, you’re going to make sure that you’re putting in best practices, you’re going to make sure that you’re hiring the right team, you’re going to make sure that you’re showing up more powerful as a business owner. You’re going to make sure that there’s policy and procedures, company handbook, that you’re taking the practice seriously and not just always implementing bandaid solutions. There’s a time and place for everything but when you come from the mindset of an eight-figure practice that’s a game changer. That is a game changer because now you’re thinking outside the box, you’re thinking about how can I leverage the practice, how can I offer additional services? How can I show up more powerful? How can I build real wealth when it comes to that. So yes, so it’s fun. I can talk about it all day. [LATOYA] Yes, and you hit on something too, and I think, especially in therapists circles we say this, we went to school but went to school for clinical stuff and we learned that, and we’re all feelings oriented and stuff. Then we get out. If you decide to do a private practice you got to learn though, like you said, the marketing, the hiring, the entrepreneurship. Some people have different gifts and talents and we can move into that but I want to talk about the hot mess now. So a lot of times when you start a practice, even myself, I’ll always tell the story, like, I started my practice after getting laid off from an organization I was with. So I had very little money. It was about, listen, yes, I care about the people, but I got to eat and whatever bit I get, let’s go. So let’s talk about that part now of, and I hear a lot of that when I work with therapists, “Of course, we care about people, but the money now, how do I pay the people? How do I get the money going? Now I need therapists.” And I’ll say it all the time, we say it to our clients, two things can be true at the same time. That could be an amazing therapist, but just not the right therapist for your practice. So let’s talk about you sweeping in what’s it look like when we ready for cleanup? When you enter into the hot mess practice right through the side door you come into for cleanup. You got the gloves on. What’s the moves that you’re making? What are the questions that you’re asking? [BRANDY] Yes, the questions, I have a whole checklist. And a lot of times owners, they get intimidated. They’re like, “What?” [LATOYA] I just got nervous when you said a whole checklist. I was like what? [BRANDY] Wait a minute. So we’re looking at not just the money piece of it, so the money piece, yes, but I believe that there’s six pillars to business excellence. You’ll often hear me say that because any practice that you go into, there’s the marketing piece, there’s the financial piece, there’s the operations piece, there’s the practice experience, or the client and patient experience. There’s the team and then there’s you as the business owner. So when I’m coming in, I’m looking at ultimately all of it because to your point, when you hire, if you hire a provider and that provider is not a good fit or if you hire a provider and that provider isn’t filled, that falls into marketing. If you have operations with like, your EMR system that you picked, if that’s not efficient, or if you don’t understand it or you’re not utilizing the correct reporting, or if you’re not actually paying attention to how you’re doing things a lot of times when you get to multi six, seven figures, you have to change EMR systems, go with a different EHR. So I’m looking at a lot of different things, but ultimately I am paying attention to how you run. So the first red flag is if you are coming in the early mornings, the late nights, the weekends, and you’re always feeling like you’re in this constant cycle of just on the hamster wheel, then that’s a telltale sign first that something’s wrong, especially if you’ve already hired. Because your team should be there to help relieve, your team should be able to take things off of your plate. So I always start with you first, what’s happening with you? What’s your schedule, what’s your skill set, because you said it perfectly, everybody comes with a different strength, everybody comes with a different expertise. So where do you fall in line with that? How are you taking care of yourself? Then we dive into what’s happening with the practice. Oftentimes it’s, “Well, I feel like I’ve hired this person, but they’re not a good fit, or I feel like I’ve hired an admin but they’re not, essentially they’re not showing up the way they need to or there’s things not falling through the cracks.” I feel like we are getting even client complaints with different things with lack of follow-up, so there’s a lot of different things that I’m asking when it comes to just how the practice runs and I wish I could show you the checklist because there’s literally probably like 50 different boxes on there. But yes, it’s just digging deeper, looking at the questions that you don’t normally ask for yourself, and then I’m asking you to write things. So on a scale from one to five how would you rate your marketing? On a scale from one to five how do you rate your financials? Looking at like your payer mix, so for example, if you’re trying to hit a certain financial goal and the insurance that you’re bringing is a lower payer compared to another payer who might be paying more, do you know that? Do you know who your leading payer is? Do you know if it’s time to increase your rates when it comes to self-pay? Do you know how much money’s actually coming into the door and where it’s coming from? Do you understand, when it comes to your schedule, are you setting yourself up for success? What’s your new blood? Essentially what new clients do you have coming in the door? What established clients do you have coming in the door? Is it time for you to maybe have an established client graduate so that way you can make room for a new client because that’s a higher price point? So just looking at some of the things. I’m looking, paying attention to a lot of the operational workflows, processes, and systems that get overlooked. I’ve had practice owners who have gone through the checklist and actually feel like, “Wow, I haven’t looked at this, I haven’t looked at it from this perspective. I haven’t paid attention to it.” I’ve had people cry after going through it because they’ve been reintroduced to their practice and they feel like, oh things aren’t as bad as what they thought or they’re doing better than what they are or they realize, man, I didn’t realize that, I’ve had a practice owner who was a seven-figure practice owner, and they didn’t know. Because they hadn’t looked at their financials. And part of it was just fear-based. So a lot of times, to your point, you talked about feelings, you’re feeling it one way or another so we try to dig deeper into the feeling like, what are you feeling and why are you feeling it? Then we bring in all the other pieces to try to investigate it. 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To take advantage of this amazing deal, head to brightervision.com/joe. Again as brightervision.com/joe. [LATOYA SMITH] Yes, and I’m thinking like, who doesn’t need this? I’m thinking at a certain point, as you grow and level up, you can’t be, I mean, there’s nobody that rocks out the 50-point checklist or they wouldn’t, you know what I’m saying? So it’s like at all levels, as we grow, there’s going to be some things we need to tweak so that we can go up higher. I guess what I’m trying to say, everybody got a little mess and they practice somewhere. [BRANDY] Yes. That’s by design, especially if you’re growing. I mean, if you’re starting our practice, to your point, you need to put food on the table. Yes, you’re there to make an impact, yes, you’re there to for your purpose, but you have to make money. So even from the practice standpoint, the practice, in order for it to even stay open has to make money. You have to bring in revenue. Then after you get used to bringing in the revenue, after you get used to working with the clients, then the question becomes, what do I need to do in order to take myself out of it a bit? That way you could actually focus on the practice and what does the practice needs. Because if you’re bringing in money, if you are talking about hiring or even just how you are showing up, all of that is important. So you can’t just stay in the day to day in the weeds day in and day out years from one year to the next because you’re going to burn out, you’re going to resent the practice, and then ultimately you’re capping the amount of income and revenue that you can even bring in. So it’s all important. Everybody needs to do it at every stage of business growth, whether you are trying to get to six, whether you’re trying to get to seven. Definitely if you’re trying to get from seven to eight figures you have to take the time to start paying attention to some of the deeper things that are happening within the practice. If not, you’ll be stuck. You’ll be stuck. [LATOYA] How long do you work with, like, what’s the process that you actually work with a therapist? Is there a set? Is it just like, hey, three months, what I give you, you should learn it and go? Is it ongoing? What does that look like? [BRANDY] No. Well, I work with my clients in two different ways. So we do one on one, limited amount of one on one because of just my schedule but I have my group program or my CEO school for private practice owners. So that’s the private practice CEO. Inside of that, there is a whole CEO curriculum that’s a signature of mine based on my 15 years’ worth of business management, leadership experience building practices. We start there, we do a deep dive with everybody, everybody goes through this checklist and a questionnaire to get a really good understanding of what’s happening in the practice and then they learn. We go through operations, we teach how to hire, the right way to hire, making sure that from a legal standpoint, that you’re setting yourself up for success. Oftentimes, it sounds good, I’m going to hire a W2 versus a contractor, but if you let that W2 go and you don’t let them go in the right way, then you’re now paying unemployment. So those are things that are important. We give job descriptions, we provide company handbook, templates for evaluations, performance evaluations. I was on a call yesterday with our group, and so we went through what do you need to do in order to equip your team to help you more as the CEO? So if you have a team that is set up for success, if you have a team that has the resources that they need to be successful, that’s a game changer. So you should be able to step away from your practice and not come back to like 50 million emails. You should be able to step away from your practice and be able to come back to, “I’ve handled this problem. I’ve been able to do this.” A lot of times when I say that people are, especially with established owners, they’re like, “What? What do you mean? I’m not supposed to come back to the 50,000 things I come back to?” “No, you’re not, because that’s a red flag, that’s a starring that your practice isn’t running sustainably and that your practice can’t run without you. If you are building your practice to run without you, then you should be able to do, have the freedom of time, the freedom of purpose, being able to actually have an engaged team who has buy-in for what you’re building.” That’s a game changer. So we go through those types of things. We look at workflows, how to map out workflows, we go through marketing, I mean, we literally dive into everything that goes into a practice, and I take my time to make sure that they understand it. I teach live, there’s videos, there’s worksheet templates, everything, guides in order to set you up for success, but it’s in a way that makes sense too. [LATOYA] How long is the private practice CEO, how long is that group? [BRANDY] That group is six months, six months. [LATOYA] Okay. You have therapists from all, like from the ones that are a million dollars to approaching million dollars or six figure? [BRANDY] Yes. A lot of the seven figure practice owners that I work with, I work with them one-on-one. For example, I have a client who, private advisory, so with her, we’re transitioning her EMR system. We are setting up her HR structure making sure that she is set up because there are 1099s that need to transition over to a W2. There are W2s who need maybe promotions. There are some team members who maybe need to be weeded out. [LATOYA] Sweet, maybe you need to weed out. That’s a sweet way to put it. [BRANDY] Yes. Just in case. You never know who’s listening, but ultimately, just making sure that the practice is protected, that she’s equipped with the skill sets that she needs, that she has additional resources. Because ultimately at the end of the day all that matters and so making sure that she has policy and procedures too. I find that when I work with my more established business owners. They are always requests, like, I wish I would’ve gone through this program before I even got to this point. Because a lot of what we’re doing is just refining and putting things in place that should have been put in place before they even, once they got booked and busy, is what I say. That’s when it’s a really good time to start paying attention to those team building, hiring, how you’re hiring, compliance, all that good stuff. [LATOYA] So you come in on board is really, it’s a good thing to have because basically somebody has grown so much or have been so successful now they take a look back and realize, oh my goodness, this stuff isn’t working right. So really somebody’s going to call you when they are doing well, but need to clean up as opposed to, hey, basically a mess sometimes is a good thing, like, do so fast or so, but now you got to take care of the areas that, like the blind spots. [BRANDY] Yes, and that’s a good point. I think what I’m trying to do and what my goal is though, is to get to the owner before they’re at that place where they have, where now it’s like, oh my gosh, I have this, I need to fix, I have this, I need to fix. Because a lot of it you learn like, okay, I need a policy and procedure for this. I’m trying to change the thought pattern, too, that’s happening before they get to that place. [LATOYA] Tell us about this nine-step signature method that you have. [BRANDY] My nine-step signature method, part of it is definitely diving into the six pillars of business excellence. That’s one step of it. But just to go through it when you are building a practice, regardless of the stage. There’s different ways that you’re going to do it, so how a seven-figure practice owner might market their practice might be different from how a beginner markets their practice. But you have to market your magic and so that is step number one. Step number two is you have to optimize your operations. That means that you’re paying attention to workflows, you’re paying attention to your systems that you’re using, you’re looking at reporting, what type of reporting. I know a lot of times Therapy Notes, I always say Therapy Notes is a really great starter EMR system. However, once you start to get more providers, once you start to need additional reporting, sometimes making a switch is a good thing. We’re doing that with one of my clients. We’re actually switching her out in order to give her more information about the providers about payers and things so that way she can make better decisions. So optimize your operations, distinguish your mission is understanding what your vision and your mission is because that’s business culture. When you’re hiring, it’s one thing to say, hey, we have these types of people. Yes, I have a practice, but what’s your mission? Why are you doing what you’re doing? What’s the vision? Because that’s where buy-in comes in. Anytime you hire people want to have a buy-in for what you’re building and what you’re coming to the market to do. It allows for team engagement, allows for your team to go out and search for business, so that’s one of the conversations that me and my client had the difference between having a 1099 contractor versus a W2 employee. The W2 employee went out and found new business because they have buy-in for the mission and the vision. So distinguishing your mission. The next step is equipped your experts so that is making sure that your team has everything that they need. That’s job descriptions, policy procedures, company handbooks, standard operating procedures. That would be from an administrative standpoint, a clinical standpoint, company handbook. You’re meeting with them regularly. One of the things I always recommend is doing like a team huddle, a daily team huddle in order to enhance communication between you and your team, meeting times, agendas all the good stuff. The next step would be, discover your dynasty, and that is hiring, so that is hiring what I call your ride or die dream team. That’s just making sure that you’re not just hiring a warm body. A lot of what I hear is I’m busy, so let me just go ahead and hire somebody to help, whether if it’s an administrative or if it’s a provider. That’s not good either. So yes, there’s a lot that goes into it. [LATOYA] There is, and I’m excited. It’s all good stuff. It’s all what I hear from practice owners, I mean even myself of things that as you grow now you’re thinking about, but when you started you were not thinking about that, especially the hiring piece, getting a very clear mission in the start. This is really awesome and I appreciate it. Brandy, tell people how to get in contact with you if they’re like, my practice is a hot mess, or before it becomes a hot mess, I need to call Brandy to help me. [BRANDY] You can find me at www.savvyclover.com. S-A-V-V-Y C-L-O-V-E-R.com, and there is waiting for you a business health checklist. So feel free. I’ve had clients show up to calls where they have printed it off, written all over it, stapled it together and said this is great information. That’s there waiting for you. Also, I host workshops, so there’s that. On the website, there’s that. Then you can always find me on Instagram at Savvy Clover Coaching there. [LATOYA] That’s where I found you on, Instagram. Awesome. Well, Brandy, thank you so much for being on the podcast. [BRANDY] Thank you. [LATOYA] I love your website, love your Instagram and everything you said today. [BRANDY] Yes, it’s a lot. It is a lot to try to dive into, but yes, there’s a lot that goes into growing a practice for sure. [LATOYA] Yes, that’s right. All right, well thank you so much. [BRANDY] Thank you. [LATOYA] Thank you once again to Brighter Vision for sponsoring this episode. Remember to head on over to brightervision.com/joe to get your first three months of website service completely free. 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 guests are rendering legal, accounting, clinical, or any other professional information. If you want a professional, you should find one.