Sara Makin on How She Built a Large Online Group Practice | GP 83

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Image of Sara Makin. On this therapist podcast, Sara Makin talks about how she built a large online group practice.

Are you thinking of starting or moving your group practice online? What is the best way to communicate with your clinician team online? How can you live out your company’s mission virtually?

In this podcast episode, Alison Pidgeon speaks with Sara Makin about how she built a large online group practice.

Podcast Sponsor: Brighter Vision

An image of Brighter Vision Web Solutions is featured as the sponsor on The Practice of the Practice Podcast, a therapist podcast. Brighter Vision builds all in one websites for therapists.

How would you like to fall into cash this month? Every year, my friends over at Brighter Vision kick off the fall season with a month-long digital conference event they call ‘Fall Into Cash’.

For the entire month of September, they’ll be teaming up with the top brands, consultants, and coaches in the mental health industry to provide you with the best advice, tools, content, podcasts, and giveaways; all centered around one main theme – helping you grow your practice and make more money.

Plus, in celebration of the 5th anniversary of ‘Fall Into Cash’, they’re also offering a very special discount exclusively for Practice of the Practice listeners. From now until the end of the month, they’re offering new websites for only $49/month for your whole first year plus no setup fees – that’s a savings of over $200!

For more information and to take advantage of this great offer, head on over to

Meet Sara Makin

A photof Sara Makin is captured on the Grow A Group Practice Podcast. Sara Makin speaks with Alison Pidgeon about how she built a large online group practice.

Sara Makin is the founder & CEO of Makin Wellness, Pennsylvania’s #1 Rated Online Therapy Platform.

Under her leadership, Makin Wellness has established a proven track record of successfully shaping the mental health market & driving mental health transformation by executing on their mission of helping millions of people heal & become happy again.

Her successful career in mental health care began at Duquesne University, where she still serves on the Alumni Advisory Board.

She holds a Bachelor of Arts from La Roche College & a Master’s of Science in Education in Clinical Mental Health Counseling from Duquesne University. Sara will be attending Harvard University this summer to study Innovation & Entrepreneurship.

Visit her website. Connect on Instagram, Facebook, LinkedIn, and Twitter. Subscribe to her YouTube channel. Listen to her podcast.

Claim a free copy 101 coping skills sheet on our website at! Email Sara at [email protected] 

In This Podcast

  • Communicating with the team online
  • Live out the mission
  • Sara’s advice to group practice owners

Communicating with the team online

The way that you lead a team remotely is very different from how you would lead a team in person. (Sara Makin)

  • Because the staff cannot read your body cues online it is extremely important to therefore communicate your needs and wants effectively and clearly.

Even things that you consider are a given still need to be communicated and reiterated clearly, such as making sure that the team is engaging and communicating this one another so that the clinicians do not feel isolated or scattered.

Consider sending out an email or two each month that talk about:

  • Some of the things that the clinicians have been doing,
  • Team successes,
  • Posts and information to inspire the team,
  • Recognizing team members and providers for completing excellent work,
  • Reminding the team of the company’s mission, values, and vision.

When we see someone on our team do something that exhibits [one of our] values, we do give them a shoutout and we do let them know that it has been acknowledged and that we do notice [their work]. (Sara Makin)

Live out the mission

The businesses that will be the most successful in the future are the ones that live out their mission to express and embody their authenticity.

Both employees and clients appreciate companies that embody their core values, that are aligned with their principles, and exhibit integrity because they incorporate their principles into how they go about doing their work.

Your company will enjoy a higher buy-in from clients and an increased retention rate with their employees when they ensure to make progress towards their mission.

  • Treat your employees and clients in a way that lives out your company’s values,
  • Incorporate your values into your procedural systems.

Sara’s advice to group practice owners

Have someone who is a bookkeeper do your books, and become financially literate in business, and learn to read law statements and business reports. Make sure that you review your financial and business reports monthly.

You want to know where your numbers are throughout the year so that when you need to pay taxes, you understand and know how much, and so that you can have an idea about your expected income so that you can invest in and grow your business.

Useful links mentioned in this episode:

Check out these additional resources:

Meet Alison Pidgeon, Group Practice Owner

An image of Alison Pidgeon is displayed. She is a successful group practice owner and offers private practice consultation for private practice owners to assist in how to grow a group practice. She is the host of Grow A Group Practice Podcast and one of the founders of Group Practice Boss.Alison Pidgeon, LPC is the owner of Move Forward Counseling, a group practice in Lancaster, PA and she runs a virtual assistant company, Move Forward Virtual Assistants.

Alison has been working with Practice of the Practice since 2016.  She has helped over 70 therapist entrepreneurs start and grow their businesses, through mastermind groups and individual consulting.

Transformation From A Private Practice To Group Practice

In addition, she is a private practice consultant for Practice of the Practice. Allison’s private practice ‘grew up.’ What started out as a solo private practice in early 2015 quickly grew into a group practice and has been expanding ever since.

Visit Alison’s website, listen to her podcast, or consult with Alison. Email Alison at [email protected]

Thanks For Listening!

Feel free to leave a comment below or share this podcast on social media by clicking on one of the social media links below! Alternatively, leave a review on iTunes and subscribe!

Podcast Transcription

You are listening to the Grow a Group Practice podcast. Whether you were thinking about starting a group practice or in the beginning stages, or want to learn how to scale up your already existing group practice, you are in the right place. I’m Alison Pidgeon, your host, a serial entrepreneur with four businesses, one of which is a large group practice that I started in 2015. Each week, I feature a guest or topic that is relevant to group practice owners. Let’s get started.

Hi, welcome, welcome. I’m Alison Pidgeon your host. I’m so glad that you joined us today. Summer is winding down and I hope you made the most of it. I know I did. I thoroughly enjoyed spending lots of time outside with my kids and school has already started here. So we’re getting used to that whole transition. But today I have a great interview for you today with Sara Makin. Sarah is the founder and CEO of Makin Wellness, Pennsylvania’s number one, rated online therapy platform. She has established a proven track record of successfully shaping the mental health market and driving mental health transformation by executing on their mission of helping millions of people heal and become happy again. She also has a podcast called the Makin Wellness Podcast that she talks about in the interview, and she explains to us how her practice is set up and how they are going to be a total virtual practice even after the pandemic is over. So I think you’ll really enjoy this interview that I had with Sara Makin.
Hi Sara. I’m so happy. You’re here. Welcome.
Hi Alison. Thanks so much for having me on.
So I thought maybe we could just start with you giving us the overview of your practice and the number of clinicians you have and what types of specialties you offer as well.
Yes, absolutely. So our team Makin Wellness is on a mission to help millions of people heal and become happy again through excellent online therapy. And right now our team is about 30 people total, and we specialize in research backed online, mental health addiction and relationship counseling.
Nice. So tell me, all I know we were talking a little bit before we started recording that all of your folks are working virtually, correct?
Yes. The entirety of our team on every department is working remotely. This is something that we do plan on continuing to do in the future, even when everyone goes back to back to work and the rates of COVID start to go down. So this was a team decision that we made and we have really enjoyed the flexibility of working remotely but also the sort of overall improved like work life balance with working remotely as well.
Nice. So do you have people all over the state or are you in multiple states or what does that look like?
We’re currently licensed and credentialed with insurance panels in the Commonwealth of Pennsylvania and in the future, we definitely will expand to additional states. We are just focused on PA at this point in time and our providers are all throughout the state. Most of our providers at this point are based out of Philly and based out of Pittsburgh.
Very cool. So when you started the practice, was that always your plan to have it be all online or was that kind of a product of the COVID world that we’re living in now?
That’s a great question, Alison and I actually always knew, like in my mind, I was knew that telehealth and telemental health services were going to be common in the future, but when I started this practice in 2017, there was not product market that the area in which we were practicing, like the clients were not open to it at that point in time and I did not want to try to put a round peg in a square hole. So we had two offices, two physical offices instead, and we were seeing clients out of our physical locations. And then when COVID hit we pivoted to only operate online. We were always, when we started in 2017, we were seeing clients in the office and we’re also seeing clients remotely, but the challenge was that insurance was not covering for the remote services. So it was an out-of-pocket service and now the biggest difference is that many payers are paying for like the GT qualifier. So that has been very helpful for our patients and that also sort of makes it easier for clients to enroll in an online therapy service when their insurance company is paying for it.
Yes. That was a total game changer for us too, for the insurance companies to really across the board start paying for telehealth. And now, since we’ve all been forced to do it on both the provider side and the client side, I feel like it’s definitely going to be something that more people request and feel comfortable with, even though we may not have to do it forever and ever hopefully.
Yes, definitely. And I noticed too that a lot of it sort of depends upon your client bases and your teams, like sort of like what generation they’re in. Because I’ve noticed that a lot of like the older clients are not necessarily wanting online therapy as, like that wasn’t necessarily their choice. And then, but then once they started experiencing it, they really enjoyed it. I think that younger generations are more open to telehealth. So offering that if you have a practice where you’re predominantly seeing like younger patients could be a great idea.
Yes. So I’m curious about the challenge in terms of managing the practice. And obviously a lot of us went through this transition of, we had a mostly brick and mortar practice, and then all of a sudden, now we have this total virtual practice. So did you change anything you were doing in terms of how you managed the staff or how you communicated with them or I think just from that standpoint, the management standpoint, there’s it’s kind of like we’re doing the same things, but just in a different way. So I’m curious to hear about your perspective on that.
Absolutely. The way that you lead a team remotely is very different compared to how you would lead a team in person. When you are working remotely, your team is not necessarily able to see the entirety of your body and sort of your like nonverbal cues, if you were on the phone. So very clearly and effectively, verbally communicating what is on your mind is extremely important. Even things that you think are a given still need to be communicated. And what myself and our leadership team has been doing is we have been extremely mindful of the, even more mindful than before of how we communicate with our team. And we have a lot of different things in place in order to keep the entirety of our team engaged and communicating with one another.

So then that way the clinicians don’t feel like they are just seeing patient after patient, after patient, and they’re not engaged with our team. So we send out different emails throughout the month that talk about the highlights of some of the things that our providers have been doing. We talk about some of the successes that we have had as a team, and we send out different things to inspire our team throughout the month. We also have different, like an online community where we can interact with one another. We have different channels set up so that if providers are in between clients, they’re on break and they want to chat or video message or video conference with someone on our team, they could very easily do that as well. And we are constantly recognizing and praising our team and our providers for doing the excellent work that they are doing and constantly reminding our team of our mission and our vision for the future and our values.

So when we see someone on our team do something that exhibits a value, we do give them a shout and we do let them know that it has been acknowledged and that we do notice that as well. So we do a lot of things and at the end of the year we have a profit share set up and it’s contingent upon the teammates performance, the amount of impact that they’ve had, and a couple of other metrics that that are calculated throughout the year. So they do know that internally and externally are getting sort of reinforced for living out the company’s vision, mission and our values.
I really appreciate your explanation of that, because it sounds like you just have created a really clear structure around what you believe in and that carries through to how you treat the staff and they’re all aware of that. And I think it’s so important to not only write down your mission, vision and your values, which a lot of people don’t do, but also to communicate those to the staff and actually talk about how do we demonstrate these in our workplace, which can be even more challenging when you’re all working remotely. So yes, I really appreciate kind of your description of how you do that.
Yes, absolutely. The companies that are going to do the best in the future are going to be the ones where everyone is on the same page and everyone is moving towards the same direction. And the way that you do that is by reminding your team and really living out the mission and living out the values yourself. So when there is authenticity with what you’re saying and what you’re doing, your team, of course will believe you because you’re honestly doing them yourself. And for every practice and for every organization, it looks very different. Um, but ultimately if everyone on your team knows what you’re headed towards and why it is that you’re doing what you’re doing, you’re going to have a lot more buy-in, which is amazing because then you have a much higher employee retention rate.

And this is actually amazing for outcomes. I highly recommend that anyone who’s a group practice to consider the possibility of really spending some time to consider, like, why is it that you’re doing what you’re doing and what are some great values that you can instill in your team and operate off of to be able to make progress towards your mission? You want these values to be something that your team legitimately is already doing now, so meaning if like for instance, our number one value is excellent client care. So whatever you need to do to make this client’s experience exceptional do it. My team knows if someone, if for some reason there’s some billing error or some something got messed up in our billing system and a client gets a surprise bill, and they’re very upset, our team knows that our number one value is like excellent client care.

So when they call there’s an issue, we will resolve it. We’ll waive it. We’ll take care of it. So that way our team knows that this is what our values are and based off of these values, we’re going to make specific types of decisions that really embrace our values. And ultimately you would have sort of your standard operating procedures or your manuals based off of your values to incorporate that into your systems and your processes. So you have sort of the overall sort of generalized values and then you also have it specifically laid out in, this is how this value manifests in your group practice or in your company.
Yes, that’s great advice, because I feel like it’s one thing to write them down and it’s a whole nother thing to actually live them out and that’s where a lot of people get stuck. I’m curious, when you obviously took the time to write down the values of the business, was that something just you did or was that something you got other people’s input or how did that process go for you?
That’s a great question. So I sat down in the evening and I just really thought, this was in about, this was either in 2017 or 2018. So it was very early on and after I started making money. There was like me and one other persons at that time and I just really thought about the five, 10 years in the future, what kind of organization do I want to have and what kind of values are going to make a huge impact like in society and what kind of values can we set in place now where like I know in the future that clients are always going to be taken care of and that we’re always going to focus on growing and always focused on collaborating and getting things done? And so found about what I wanted in the future and then I narrowed it down to five values and I communicated with our other team member at the time to get her input and her feedback. And that is how our core values were created and we actually still have the same core values today.
Very cool.
How would you like to fall into cash this month? Every year, my friends over at Brighter Vision kick off the fall season with a month long digital conference event they call all Fall Into Cash. For the entire month of September, they’ll be teaming up with the top brands, consultants and coaches in the mental health industry to provide you with the best advice, tools, content, podcasts, and giveaways, all centered around one main theme, helping you grow your practice and make more money. Plus in celebration of the fifth anniversary of Fall Into Cash, they’re also offering a very special discount exclusively for Practice of the Practice listeners. From now until the end of the month, they’re offering new websites for only $49 a month for your whole first year plus no setup fees. That’s a savings of over $200. For more information and to take advantage of this great offer head on over to That’s
Yes, I know a few minutes ago you had mentioned about having a leadership team and I’m always curious when you have a bigger practice, how people have their leadership position structured. So would you mind giving us the overview of what yours looks like?
Yes, absolutely. So my second command is Rama and she is a clinical supervisor and she oversees the entire clinical operations and she is in charge of all major clinical decisions at Makin Wellness. Her responsibilities consist of ensuring that the clinical operations are running smoothly, that claims are getting sent out smoothly, notes are properly done and everything is properly documented and that supervisions are taking place, because we do offer several different supervision groups within our company for a team. And then we have a practice manager who’s in charge of having an excellent client experience and is in charge of the billing and credentialing and scheduling.

We have two clinical team leads who work directly underneath the clinical supervisor and they have their own teams underneath them. Essentially they are the ones that our providers first go to if they have any type of questions about a note, a client, a process or anything like that. So that is how the leadership team is currently structured. And interestingly enough, Alison, we are looking at sort of revamping that and adjusting some responsibilities. So that is what we have currently set up now but I do know that we are going to adjust in the future within the next few months.
Yes, obviously as you grow and things change, you have to adjust and potentially add new positions or change around the rules or whatever. So it’s always interesting to see how and when that needs to happen. You know what I mean? Like I felt like when we got to be a out 20 clinicians, it was like, “Oh, we really need a different structure here.”
Yes, that’s what we’re experiencing as well. And that’s something that actually Jackie, one of our clinical team leads at Makin Wellness mentioned during our leadership team meeting yesterday. It was it would be a good idea for us to consider restructuring how we have this set up just so that it is still optimal moving forward.
Definitely. I’m curious too. If you feel like there’s anything that makes your practice like unique or different or something that kind of set you apart from other practices in the area?
Yes. So we operate entirely online, which makes us very different. We have a network status with all of the major payers within our state of Pennsylvania. So a lot of clients like coming to see us and they know that they can use their insurance and still see their provider online because most of the online platforms don’t have a network status so they end up paying a lot more at other online platforms. And there’s such a huge emphasis on excellent client care, when people like search Makin Wellness or look sort of at what other people have said about their services here, unsolicited of course. We have a lot of past clients that have posted different things online. And again, Alison, I think it sort of goes back to, we serve a younger demographic and we tend to be more open. And there have been times where like I would go on Twitter and see a client who would post about what they’ve learned at Makin Wellness through their provide and like that person would tweet like after their sessions, like a glimpse of like a golden nugget that they learned from therapy.

And, of course this is not solicited, but like we would see different things like that. And I think that really differentiates us as well because we have a very huge online presence and we share a lot of information about therapy and mental health and addiction in relationships. And I think a lot of our clients really appreciate that because we invest so much time in a lot of resources into sharing valuable information. Part of what we do is education, research and advocacy in addition to the therapy component and the way that we share information and share research is online. So we do it through the Makin Wellness Podcast. We do it through our blogs, we do it through social media and in different networks online.
Nice. So do you feel like that is the main way that you get client referrals or is it sort of just a wide variety of places that clients come from? Or do you see like a real difference when you do those sort of educational content type? I don’t know what the word I’m trying to think of is, but you know what I’m saying? Like when you write blog posts and you do a podcast and it’s like educational, do you see that being like a big sort of driver for people to want to come become clients?
Oh yes. Yes, definitely. And we have a whole system in place for various ways of how we get referrals, but that’s definitely one of them. And again, it is a big time in financial investment in getting more of an all online presence set up and gaining followers and sort of doing your own research to see what kind of content people are interested in seeing. But if you stay consistent with it, there definitely is, you can definitely get clients that way, but the way that we are, our number one way is really still word of mouth. Because if someone has an excellent client experience, they’re going to tell someone about it. So we still get tons of tons and tons of referrals from clients who have had a good experience with a provider at Makin Wellness and then they hear about a friend or someone who’s going through a hard time and then they end up sharing us as a resource. So I think that’s still like the best way of getting referrals; is just do a great job and then people will refer people to you.
Yes, the ultimate compliment. Word of mouth.
Yes, absolutely. Absolutely.
Yes. So tell me a little bit more about the podcast, because I know you just kind of mentioned it briefly, but can you tell us a little bit more about what types of episodes you do and is that you’re doing it every time or you sort of rotate through your staff? Or what does that look like?
That’s a great question, Alison. So we have the Makin Wellness Podcast and we bring on different celebrities and influencers and professional athletes and just people that are sort of open to talking about their life experience and perhaps struggles that they’ve gone through and what they do to feel better. So we actually have so many amazing guests that I’m so excited to share, but I’m not supposed to share until the episodes are actually out, but it’s really interesting content and it’s very different because it’s people just being very open about what they’ve gone through and what they do to, what they do to feel better. And therapy many times is part of that peeling process for them. So our clients really enjoy it and our audience really enjoy it because it just gives them so much hope and it reminds them that they really aren’t alone. Like most people have some sort of, have experienced directly or indirectly some sort of challenge with either like mental health or addiction or relationships. So it’s educational and also very inspirational as well.
Yes, that’s really cool. And I know I’m always a big proponent of kind of breaking down the stigma of mental health. And I would imagine that that’s one of the outcomes as well, is like, oh, this kind of celebrity that I look up to had their own mental health struggles and they asked for help and like it de-stigmatizes it even more. So I think that’s really cool.
Yes, definitely. It definitely does. Like our first episode was with Fred Mitchell. He used to be on the Philadelphia Eagles and he talked about his mental health challenges, especially when he retired and his identity, his whole life was being a full football player to, oh my gosh. Now I’m retired. What am I supposed to do? And how that really affected him mentally. So when you hear about people like that going through something, it does remind you that you aren’t alone in that. It’s okay to talk about these things and the way that you heal from these sorts of challenges is by communicating and like opening up. So someone’s not ready for therapy yet, but they’re ready to like consider the possibility of maybe going to therapy. Like they start to hear about these sorts of things. It can help to inspire them and to realize that there is hope in that there are people who can help, whether it’s a Makin Wellness provider or if our team is not a good fit, then another provider because there’s so many wonderful ones out there.
Yes. That’s cool. Just switching gears a little bit, I like to ask practice owners who have kind of grown their practice quite large, or been in business for a while if they have any advice for people who are just starting out, because obviously that’s a big kind of chunk of our listeners is people who are just in the beginning stages. So if you could kind of like go back and give your younger self some advice about starting the group practice or like the first year in group practice, what advice would you have?
That is a great question. So many things come to mind and I’m just trying, I’m seeing what would be the one thing that I would’ve done differently that would’ve made a bigger impact is to have someone who is a bookkeeper do your books. Don’t try to do that yourself and learn, like become financially literate business, and learn to read a private law statement, learn about these various different types of like reports that you can run and make sure that you review these financial reports monthly. I know most therapists think or are probably thinking, “Oh my gosh, like I hate numbers. That’s why I’m a counselor. I don’t want to do it.” Trust me, it is very important. If you want to have your own practice you have to look at these numbers and become familiar with them because you have to make sure that you are not overspending and you want to know where your numbers are and so by the end of the year, you’re not like surprised by how much you would potentially have to pay in taxes and to do whatever you need to do in the beginning stages to get clients in the door.

You could do Facebook Lives, you could do like Facebook advertising, you could do Instagram ads, you could go live on Instagram. You can build referral relationships with other healthcare providers or doctors or other places that can provide you with referrals. And to really focus on that is your number one priority. Like invest in whatever you need to invest in to get clients in the door and for every practice that’s going to look very different. But that is the most important thing. You need to have clients coming in the door and making sure that you take the absolute best care that you possibly can of all the clients that do come in so that hopefully years down the road, you will, those people will then start to refer people to you. And of course we don’t ask for referrals. It’s unethical to ask for that, but if you do a great job, you’ll get those referrals and you won’t have to ask
Very good advice. I know you have a giveaway for our audience. Can you tell us about that?
Yes, absolutely, Alison. So you can go to the Makin Wellness website and scroll to the end of the page. We have a free 101 coping skills worksheet available for you. We spent a lot of time generating different ideas for different things that people can do to cope with stress and I highly recommend you to check it out.
Nice. And if anybody wants to get in touch with you, what’s the best way for them to contact you, Sara?
Yes, the best way of contacting me is via email and that is [email protected]. Again, [email protected]. If you’re on social media, I’m at Sara Makin on Facebook and Twitter and LinkedIn and The Sara Makin on Instagram because Sara Makin was already taken.
Nice. Well, thank you so much, Sara, for coming on today. Obviously you are quite busy with your large practice, but I do appreciate you sharing about your experiences and maybe we can have you on again sometime soon.
Yes, of course. I would love that Alison and I tell you what, podcasts like this were instrumental in helping me out in the beginning stages. So I’m just really happy and so grateful to be able to give back and to share a bit of information that hopefully can help some of the therapists in your audience.
Thank you so much again, to Brighter Vision for being our sponsor this week. They are having their special Fall Into Cash event. Definitely check that out over at their website, If you want to get the promotional offer they’re running right now to get a new website for only $49 a month for the whole first year, go to the special link they’ve set up for us,

If you are looking to join a community of like-minded professionals who are also running established group practices, please check out Group Practice Boss, our membership community for established owners who want help learning how to scale up, how to work less and just all around how to make their businesses better. You can check out our page at

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This podcast is designed to provide accurate and authoritative information in regards to the subject matter covered. This is given with the understanding that neither the host, Practice of the Practice, or the guests are providing legal, mental health, or other professional information. If you need a professional, you should find one.