Andrew Burdette 00:00:00 The growing Group practice podcast is part of the practice of the Practice Network, a network of podcasts to help you grow, manage and promote your business and yourself. To hear the other podcasts like The Practice of the Practice Podcast, go to practice at the practice.com backslash network. You’re 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 Andrew Burdette, a practice owner, and I love to hear from people, their stories, and real life experiences. Let’s get started. Hello and thanks again for joining us for the grow a Group practice podcast. This episode, I’m here with Carla Titus, who’s the founder and CEO of Wealth and Worth Within LLC. So welcome to the show. It’s a pleasure to have you. And like with every guest, I’ll ask you to give a little backstory about how you got to this point in your career and what prompted it. Thanks so much for. Carla Titus 00:01:08 Having me, Andrew. I’m excited about our conversation today. And yeah, my background actually started, in corporate finance. I was in corporate for, you know, over ten years just doing the career ladder climbing thing that everybody does that serves the purpose and got to learn a lot about financial management and became really passionate about small businesses. I’ve always had an entrepreneurial bug in me that said, I wanted to start one or like wanted to be part of one. And while corporate was wonderful for, you know, my growth and development, I really realized that small businesses didn’t really have access to knowledge or expertise around financial management as readily available as they do, maybe the bookkeeping or accounting side of business, which is what everybody has to do in order to comply with taxes And don’t love to do, but they know they have to keep up with, you know, the books and provide that to their accountant. Every year. A tax time where the financial management of the business is really more proactive, forward looking. Carla Titus 00:02:09 And that’s where we’re really good at dealing with the uncertainty, understanding, you know, where what are we trying to achieve, where are we going? What are the goals of the company and where do we want to go. And kind of bring in those corporate finance tools over to small business to help them make better decisions and not guess their way through growth, but actually have a plan mapped out that helps them more clearly take action steps in the right direction to achieve those goals. Andrew Burdette 00:02:34 Yeah, most of us therapists are pretty math averse. in terms of not wanting to go there, or I, I’m QuickBooks averse because I think it’s an awful piece of software and I hate using it, but I realize I have to because we need to do bookkeeping. Right. And so, it kind of sits in that price point that everybody can afford. And then also is the thing that everybody mostly uses. And so yeah, if you’re a small business, you’re kind of in the QuickBooks world if you’re going to get any useful reporting. Carla Titus 00:03:02 Yeah, exactly. And I think it’s something that we also love and hate, to be honest. Like it’s not my favorite tool. It does the job. It’s the one of the industry standard tools that we use. But making sure that you’re keeping up with it, it can be a daunting task, especially if you’re like you said, metaverse or, you know, like you really love math. It’s it’s okay. Right? Like you don’t want to look at numbers all the time, but you need to have a good sense at least, or whether your numbers are ad so you can make better decisions. And even if it’s that you get some help with it or you get someone to explain it to you, you know, that’s better than not looking at it at all and making sure you have the right partners and support in place, especially if you don’t love the number side of your business. it’s what’s also can get really exciting and fun if you do it right. And so I always tell people, maybe you don’t like the numbers because you don’t like what you’re seeing. Carla Titus 00:03:49 And once we make them better, you’ll want to check them all the time, like you never know. And we specialize in working with people who are math adverse because we understand how hard it is to just even open up a profit and loss statement and look at so many numbers and you’re just like, what am I looking at? And what does this all mean anyways? And answering those questions to, you know, get some clarity around the numbers. Andrew Burdette 00:04:13 So one of the things you mentioned kind of to start off with was, explaining the different roles within finance. And so do you want to kind of break down what a bookkeeper is and their role versus the accountant and then versus what you do, which is more the the forward thinking and projections about business planning. Carla Titus 00:04:29 Yeah for sure. So the bookkeeping side is you think of it as more like the day to day when transactions come in, you’re categorizing things in the right buckets. And I think there is such a missed opportunity here for someone that can do a right and do a well for you, because this translates into your tax return at the end of the year. Carla Titus 00:04:47 That means it captures all deductions, it captures all the benefits you can get to write off as a business owner. And by the way, it’s not 1 to 1. I know many people give advice that’s like, oh, every dollar you write off you get back doesn’t necessarily work that way. The math doesn’t exactly. you know, it’s 1 to 1, but it does allow you to capture a lot of those benefits. As a business owner, if you’re categorizing things the right way. And I see so often there is, you know, bookkeeping support out there, or maybe you’re doing it yourself and it’s not being done. Correct. And so checking and making sure things are in the right buckets, it’s an important aspect of running a business and having good solid financials to start with. And to be honest, we can’t do our job if the financials are not solid to start with. So we will always start by reviewing and seeing where we had on the books. How are things being done every month? Reconcile or not? Ensuring the accuracy of those books is such an important task, and I know sometimes it gets minimized. Carla Titus 00:05:44 So I just want to make sure we understand why it’s important is the foundation of everything we do. And ultimately that lands in your accountant’s hands and the accounting support is for tax time. Maybe there is some tax strategy or planning ahead of tax time to avoid overpaying on taxes. And like, how awesome. If we can minimize our tax liability legally and still get all the benefits for our business write offs, and that doesn’t happen by accident. It happens by keeping good books every month and throughout the year to ensure that you have the good tax return. And your accountant is in many tax returns. So they’re not necessarily checking line by line everything that’s going on because they don’t really have time. And that is not for them to do. Because at the end of the day, guess what? As a business owner, you’re signing off on the tax return too. So your accountants saying you ensure accuracy of your books I ensure accuracy of your tax return. So it’s a partnership, right? When they’re filing the taxes. Carla Titus 00:06:36 And this is something that people should be really aware of as an owner, because you also have responsibility to ensure things are accurate. And ultimately, the role that we play as CFO is a third leg of the stool. Think of it as the forward looking direction setting, like when you’re driving a car and you have a dashboard and you’re sitting in the in the driver’s seat and you have a co-pilot with you helping you navigate, say, hey, by the way, Andrew, you’re about to run out of gas. We should stop at the gas station and fill up. Hey, Andrew, you’re going a little too fast. Let’s slow down and make sure, like we don’t get a ticket like so. That’s the job of a CFO. And also the CFO sets that direction with the owner to say, what are we trying to achieve? What is our destination point and put it on the map and say, here’s the road we’re going to take and the steps we’re going to do to drive there leisurely and get to our destination point in the most calm way possible without the roadblocks, without the bumps, without running out of gas, without having a flat tire along the way, and making sure they’re guiding you along the way on how to best take the right actions to achieve those goals. Carla Titus 00:07:41 So that’s ultimately the job of that CFO is to be that active partner, helping you overcome objections and obstacles and problems that come up as well as capture opportunities and possibilities for what you might not be able to see. That could be a good opportunity in your business. Andrew Burdette 00:07:57 So for listeners out there, the bookkeeping part kind of like you were saying, it’s it’s really up to us to kind of categorize everything. And, there’s a fantastic resource. simple profit. It’s a woman named Jenny Miller. She’s an LMD and a CPA. She’s got lots of great content. I know I’m kind of jumping off to somebody else. You can go review her episode. It’s earlier. She talks about how to, like, get schooled on how to do your own bookkeeping. That’s the part that honestly, everyone should be doing because your bookkeeper is even going to ask you. Like, so was this a box of pens that you bought at staples, or was it something else? Because again, it’s going to depend on the category. Andrew Burdette 00:08:34 And one thing that she really pushes, which is partly why I’m bringing this up, is having really granular detail in your books. So, you know, you and I were talking about telehealth in lieu of disaster and those kind of things. And for listeners out there, I’m located in Asheville. So it’s been a fascinating month and a half now, almost of navigating coast. Hurricane Helene and what that looks like for things. But that granular detail does matter. It’s a big deal. And to be able to go through, you know, so software system wise. So I’ve got stuff broken down to here’s my phone systems, I’ve got my email system stuff. So there’s kind of those levels of detail or like advertising and by directory and by, you know, like you kind of have to pick by employee or by directory, but nevertheless, you can kind of lump some of these things in there and get really good detail in your reports. And you can say, hey, well, when you sit down with a CFO like you’re talking about and do some planning, great, here’s can we prune this category out a little bit? Do you really need to spend this much on these systems? If this is what it is, can we prune this out or can we prune these other things out? that granular detail really makes a big difference. Andrew Burdette 00:09:46 I think And is it is that something you find as far as the financial planning aspect as well? Yeah. Carla Titus 00:09:52 By the way, I love Jenny’s stuff too. She’s great. And you know, we’ve done a lot of collaborations. We believe in the same things. And so I think that her advice is fantastic. If you’re getting started and you want to get really good with your numbers, I highly recommend her to. And I think that granular detail, what it allows us to do is go back and look at the opportunity areas for our businesses. Where do we want to cut back on intentionally? Where do we want to double down our investment on? Maybe it’s you want to invest in the next level of system for your telephone system, because now you have more therapists in the practice, and you need to be able to manage more people getting calls or bringing in more intakes at the same time. And so it’s not always about cutting back. I think that’s one thing that with CFOs, that’s what we’re popular for, right? It’s like, oh, the no person that crushed the dreams person. Carla Titus 00:10:40 But I actually like to reframe it as in the way that we can also identify opportunity areas and gaps that we should be closing by investing more or better in reallocating resources from one place to another, to strategically drive the growth that we want to see in the business. And that’s the job of the CFO to identify through those lines of spending. Are we allocating in the right places, or should we shift based on the business goals that we have outlined with the owner on what they’re trying to achieve? And we’re able to spot trends and see over time what has changed and also identify, you know, some risk areas that maybe want to mitigate, you know, maybe it’s a run insurance, maybe the policies are not large enough. And we want to up the amount of insurance we’re purchasing for the practice, especially as we’re growing and bringing more clinicians, that liability goes up. So we want to assess for that as well. And again, making sure that we’re plugging those holes wherever possible and bringing those opportunities to the table as well. Andrew Burdette 00:11:37 So on the insurance know we can talk about risk management down the road later on. you and I were talking about it’s I have an interesting perspective because we’re six weeks post a hurricane rolling through and, I’ve had had one office destroyed from flooding with the river where two and a half football fields away, and there was two feet of water in my office, which is astounding. And then another one, just because of the rain, like it’s in a basement. So, you know, there’s water showed up because. Because. Right. there was a lot of it. Yes, exactly. Just a lot of it. Nowhere to go. so, you know, in one category, it’s flood damage, another it’s water damage. And they’re not treated the same from like, insurance. And so the, the thing that’s been consistently reflected as you kind of can’t ever have too little insurance. Carla Titus 00:12:27 I like that take away. It’s something I don’t think a lot of people think about. Right. Until, until something bad happens and then they’re like, oh, I wish I was paying for a higher deductible or a lower deductible and higher coverage. Carla Titus 00:12:39 And it’s not until they have to use that that they realize maybe how bad it is, or maybe how they actually chose the right one for, you know, what they’re experiencing. Andrew Burdette 00:12:49 Yeah. So most especially if you’re in solo practice and listening from that standpoint, even groups, malpractice is just malpractice that keeps you from going to jail, getting sued, that kind of stuff. You know, it’s not maybe not like there’s there’s actual additional writers to go along with the malpractice. It’s not just like, hey, license protection. There’s also there is license protection as well as the malpractice. And then a half a dozen other writers, that cover different parts of that whole process of, like, license defense. Right. Like, so they’ll pay attorney fees to defend you in court, and then you get the the more standard business policies like general liability, which is your slip and fall coverage. my policy has a coverage that if we accidentally set fire to the building, then my my, my, my insurance will back us up kind of thing. Andrew Burdette 00:13:40 there’s a business income protection, which is something that everybody listening needs to make sure they have. This is one of those things that, out of sheer dumb luck, last year when I renewed my policy for, you know, this year, this cycle, it was like $50 to add it on, right? So added it on. my policy is good for up to a quarter million dollars. It covers some instances, but not all instances, kind of thing of cover, cause of loss and other things like that. But listeners out there, especially if a group like find some way to have business income protection because sure, like you might have stuff in your office and I mean, my one off is flooded. So there’s probably about 3 to $4000 worth of stuff between the books and couches and stuff like that. But that’s not near as valuable as the business income protection, which covers loss. When you can’t physically use your office for how many weeks you’re unavailable to do it. So those additional coverage things really do make a difference, and it’s worth checking in to see if your existing carrier provides those and if not, or if it’s inadequate, can you then get supplemental coverage through a different company to then cover the gaps? Because there’s going to be a lot of gaps? Carla Titus 00:14:49 Yeah. Carla Titus 00:14:50 And the good news is that you can assess this at any point in time during the year. You don’t have to wait till renewal time. Maybe there’s a way that you can add something halfway through the year, especially if you’re adding insurances are happy to take your money. So just ask your person like, can we add or look into some writers that are additional coverage? The other one I will bring up, and I don’t think a lot of people know about it, is the key man policy. And I hate that the name, but it’s essentially the key person that runs the business. If you were incapacitated or hospitalized or something happened that they would still, you know, provide you some sort of coverage for that as well. And, you know, it’s policy dependent, of course. And there I’m sure there’s a deductible for everything, but it’s something to keep in mind. Also, if you haven’t saved the money for your deductible, maybe, Andrew, if this happened and you didn’t have the cash, save away to pay that deductible to get them to cover everything they need to cover. Carla Titus 00:15:40 You will still be without coverage in a sense. So like that’s another aspect, I think, of the planning that we want to have in place. As we’re growing our practices. Over time, the needs and demands of cash will become bigger, and even just having enough to cover the deductible so the policy can kick in the income, you know, recovery piece. It’s such an important aspect of using the insurance. Andrew Burdette 00:16:05 I will say to to add with that, find a commercial insurance agent to walk you through these details, ahead of time, like not post emergency, but someone that can really walk through and just clarify like the full details of your policy, because it’s going to be really convoluted and complicated and there’ll be all kinds of exclusions. And, one of the fun ones that’s in mind, for property loss, not the business income part because we’re separate criteria. But yeah, the the cover loss for water damage is kind of ridiculous for the normal rest of everything. It’s like, well, we’ll really only cover water damage if it causes a fire explosion or prompt the sprinklers to go off for like happen. Andrew Burdette 00:16:46 Right? Like, yeah. So it just be sure. Be sure you have an agent that’s not just looking at like your premium cash flow coming into them, but also just is willing to walk through and really explain details about here’s really what’s going to be covered if this actually has to be put into effect. Carla Titus 00:17:03 Yeah. And the time to prepare for this is now when something wrong happens in your business. But ahead of that be mindful of, you know, reading the policies and going through it at least once a year. Just things might change in your business year over year and you’re not even thinking about it. It might just be time to revisit those policies and make sure that everything that you need coverage is in order, and that you understand what’s covered and not covered. And if you can make changes, you know, and you caught it on time, fantastic. Then maybe this year the hope is that you’ll never have to use your insurance policies. Right? But we have them in case we need them and something bad goes, you know, happens in your practice and you need to access them. Carla Titus 00:17:39 They’re there for you. Andrew Burdette 00:17:41 A lot of times, too. Increasing your limits is really, really, really cheap. Versus if you have a claim that’s filed and then what they’re going to do once they’ve had to pay out, which I’ll be able to post people about next year, is it’s it’s going to be this time next year before I really know what’s going to change. but yeah, the upping your coverage limits is actually a really cheap thing to do. So if you’re looking at like, you know, say your car insurance has like the $100,000 cap out, you want to go to $500,000, it’s probably not going to cost you a whole lot to like, do that and to go along with that, since we’re talking about liability protection, having a good kind of umbrella liability thing is a good idea to have too, because if a scenario does show up to where whatever, let’s say you’re found liable and it’s going to cost $4 million to this claimant that you’re going to have to pay out to you, but your coverage ends at 1 or $2 million. Andrew Burdette 00:18:33 Like you’re still on the hook for that judgment. So having that kind of umbrella liability policy at the end of the day is, is that kind of extra hedge to make sure that you have as many layers in big dominoes. They have to get knocked over before it’s really going to directly impact you. Carla Titus 00:18:49 And so part of you know, as you’re building your wealth, as you’re building to practice this worth and has value in the marketplace, if you were to sell it one day as you’re generating profit, this becomes more important right. From a personal liability aspect. Like umbrella policies are super cheap anyways. Like you can get $1 million for like a couple hundred bucks a year. It’s not a lot. And I think just for the peace of mind, right, that, you know, you have that like last, last, last, last resort and that you don’t have to come out of pocket for any of those, incidents. It’s just going to let you sleep at night better knowing, you know, I’m just extra cover, even if I never use it. Carla Titus 00:19:26 Like, you know, I’m good with that. Andrew Burdette 00:19:29 So it would be fun, I guess, at some point for me. I’m just thinking of possible other guests. And like I thinking of a couple financial people, I could bring in the Du insurance and can kind of talk through this as an in-depth thing for a future episode. So I realize it’s not your forte, but this has been a good little talk through thing as well. So let’s talk a little bit about, I guess, financial planning and maybe with the the lens of at different sizes. So if you were working with like say, well first off, does a solo practitioner need a fractional CFO? Carla Titus 00:20:03 most likely now they’re going to need a bookkeeper. An accountant for sure. only if they’re trying to do some planning for ahead of time in the year to come, which does not. It’s not complex enough to merit a CFO. So I wouldn’t, you know, waste a lot of time or money getting support. You probably can run the numbers to yourself, or you can ask your bookkeeper accountant to help you with that because it’s just you. Carla Titus 00:20:26 So you should know your numbers. You know how many sessions you could do a week times. Your average reimbursement rate will give you what revenue you potentially could generate every month, times 12 months, and then subtract your current pay. And then you’ll know you know what your numbers are. You could also look at last year’s numbers and kind of get a good guesstimate put in place for the new year, so it doesn’t make a lot of sense. Obviously we’re here to help if you need help, but, it should be pretty straightforward exercise where I see the need gets more complex, especially brought in a few people because they have different compensations. First of all, let’s start with nobody’s thinking about their compensation structure when they start hiring. And that’s one of the problems is we get to a practice of like, let’s say ten people before we know it, and everybody gets paid differently. And nobody thought, oh, we should probably pause. And that says, what is our compensation strategy, both from a rewarding our people and investing in them as well as financially? What can we actually afford to do? I see that a lot of practice owners are very generous. Carla Titus 00:21:27 They like to pay top dollar for their talent, and while that is fantastic, sometimes I practice depending on the size or average reimbursement rate, might not be able to afford that. And knowing what are the key roles that deserve that level of pay versus what are some of the roles that we can maybe pull back a little bit more and, you know, looking at market data and understanding, like, where do we fall in the percentile of pay for that type of clinician and experience? And what we’re going to be able to provide them as a benefit package, it’s really important for you to kind of evaluate before you get to that first and hires. And then you realize, oh, we did not do this exercise right. And I see this often. That’s why I kind of bring it up, because that’s kind of the size where I think we’re just kind of testing things. We’re doing one hire at a time. We’ll see how we feel. You know, maybe it is working out. Maybe it’s not working so well. Carla Titus 00:22:15 You need to like, restructure halfway through and just save yourself a lot of time and effort. If you kind of start to shape that intentionally versus just react to it after the fact, because it’s much harder to change people’s pay once you told them what you know you’re committing to doing for them? Andrew Burdette 00:22:31 Yeah. I’m going to encourage listeners out there to start thinking about pay structures at the 1 to 2 higher things, so you don’t end up in the ten plus area and have to do big shifts. there’s a really awesome group of people down here, a bunch of group owners, and we’re all really collaborative, and we’re pretty transparent about just about everything. Like, I don’t know that we’re like, super. I mean, we’ve talked a little bit about marketing and referrals, but, you know, no one’s getting into their like special sauce version of how that’s all working and stuff, but pretty much everything else. And one of the things that we did at the start of this year, actually, was talk through different pay structures, because we’re all different sizes and, you know, different markets work differently. Andrew Burdette 00:23:11 Like Asheville’s not a particularly like high dollar market. it’s really expensive. So like there’s always a narrow margin kind of whatever you’re talking about. If you take insurance, like you’ve got a tighter margin because insurance dictates the rates. so as someone that did the 1099 contractor to W-2 switch this year. It was awesome to have 3 or 4 other people that were doing similar to what I wanted to kind of match for pay structures and outside of benefits, the actual like dollar amounts and kind of what that’s entitled to is probably consistent around 4 or 5, six of us probably that run different groups because it’s like, here’s what the market will do. Here’s where you can kind of do this, and then the rest of it, it gives you a little margin to kind of customize your culture and your benefits. And that was really helpful versus some of my consulting clients that come in and, you know, they throw this percentage out there and it’s like, I don’t know how you’re affording that now, and you certainly can’t go where you need to go with that same number. Andrew Burdette 00:24:05 And you definitely can’t bring anybody new onto that. Carla Titus 00:24:08 exactly. I think the commission percentages tend to put people in a bind, because there’s not much room for growth in the, you know, maybe you can get insurance to raise rates yearly if you’re lucky. Sometimes they’re decreasing. So if you have people in commission percentage, they’re going to go down and pay. And I don’t think that’s a great story. They’re probably not going to want to stick around too long because they’re seeing an impact negatively on their pay based on, you know, percentage commission. But if we can structure a compensation package that puts you at a certain margin percentage, that’s healthy for practice, and that is going to depend on the size, but we like to see it at least 50%, you know, if not 60% to the practice, because we need room to pay overhead and billers and other things like rent in, you know, the cost of running a practice and you need that room not because you need more profit, but because you really do need the room to cover payroll taxes, running payroll, you know, all this merchant fees and things that are part of running a good practice. Carla Titus 00:25:10 And they just grow over time with the more people you bring to the practice. And I don’t think we’re thinking about the math in the right way. And, it just gets you in trouble faster because you have not done, you know, that diligence around what are the margins I need in my practice for this to be a healthy business. We’ve done that. Well, this person is really good. I really want to pay them 70%. And you know, they deserve it and they’re great. And that might be all true, but the practice might not be able to afford to do that. And that’s where we have to get really honest with our numbers. And it’s unfortunate because sometimes we do have social situations that we will make exceptions for us because we know we can afford it. But if you haven’t run the numbers for all of that, then you’re just giving money out. And then before you know, you’re like, wow, this is unaffordable and you’re running payroll and there’s nothing left and you’re like, how am I going to pay rent? How am I paying all this other bills that are part of, you know, running a group practice? Andrew Burdette 00:26:03 I like that you kind of briefly mentioned some of its size dependent too. Andrew Burdette 00:26:07 So I usually am describing it kind of this way. So you start off as a solo practice here in your studio apartment. It’s just you like overheads cheap because you’re in a one room like that’s it. And some people kind of opt for opt for a little more opulence. So it’s like, hey, actually I want a two bedroom so I can sleep in one room and have a home office and do telehealth from the other and stuff, and that’s fine, but that’s that’s a personal choice. It just really impacts you and your bottom line and, and those kind of things. And then when you start contemplating group practice stuff, you kind of grow all your infrastructure costs and phases. So there’s these different kind of tiers of because I kind of think of it like a step. So you go from your studio apartment to like a four bedroom house, right? And so to make that really affordable and to kind of bring costs back into alignment with what you were paying, you need three roommates, right? The sooner you get to three roommates that are working full time like you. Andrew Burdette 00:27:00 The sooner you’re going to be back to like that same similar kind of like cost profile of things. And then when you decide to go to the next thing, if your infrastructure is not going to scale, well now you go from like a now you’ve got a triplex and everybody’s got a four bedroom, right? So now you need like 12 roommates, right? To like make it all work. And you’re smiling because like, you clearly you’ve heard this before and you kind of walk through. But this has been my, like, functional metaphor about how to think about different phases of practice and why some phases are more comfortable than others financially, because the wealth that the whole practice generates, once revenue gets spread out more evenly versus maybe it’s a tighter fit. Carla Titus 00:27:37 Yeah. And I think the other thing well, so I’ll touch on that and then I’ll talk about the marketing side of things because I think sometimes that gets missed. And so there’s like the whole capacity piece, right, where I see a lot of people jumping to getting that ten office, you know, building a once the first year that they go into group practice and we’re just like, whoa, whoa, whoa. Carla Titus 00:27:57 Like you just added a ton of overhead, add ones that might not be affordable or all you’re doing is work to pay the rent. And so we want to be careful on the size. Right. So maybe if you get a co-working space with two offices that can go to four and then that can go to five, and then at that point you’ve outgrown that space. Now you get the ten person office on a whole floor for yourself, right? So you start going to steppingstone your way to rent because that one, first of all, is fixed. It tends to be on a 3 to 5 year contract and I really get hard to get out of. And so making sure that you understand what is your roadmap for the next 3 to 5 years. And the other thing I have to say on that is you can always choose to add space adjacent or in a second location temporarily. You don’t have to commit to the Big Ten office. You could get the first five co-working offices and get another co-working space two miles down the road for two more offices. Carla Titus 00:28:48 And the thing is that you can always add gradually, but if you just go from 0 to 10 offices at once, that is a huge hit to your panel. And then you’re wondering where you’re not making money because you haven’t filled it out with ten connections that are producing that kind of revenue yet. Right? And that takes time. We know it takes time to ramp up someone to full capacity anyways. And then the other piece I see is, okay, you went for the ten office, you hire the ten and you’re like, I’m doing this and then you’ve forgot the marketing budget and you don’t have the leads to fill up your clinical capacity for those ten new clinicians that you just brought it. So oops. Now we have no one there sitting around waiting for clients. And then before you know, they’re leaving because they don’t have enough work, you know, to do. And so this is where we want to make sure all the pieces are working together at the same time, that nothing goes neglected from a budget perspective. Carla Titus 00:29:33 That’s what we plan for things ahead of time so that we know, oh, you know what? We’re going to need more SEO budget or more Google ads or whatever it is that you do to bring leads added into the budget in order to be able to get everyone up to capacity. So don’t get ahead. Make sure you’re thinking about all of this together comprehensively, and then you’re going to think about, okay, my capacity and my clinicians and how quickly can they get clients and retain clients. And now we’re talking about a whole different, you know, aspect of kind of practice management and why it gets so complex when you bring more people is because there’s all these moving pieces happening all at the same time, and they don’t all work harmoniously all in the same way, unfortunately. And why we’re, you know, why we provide some help and support in this stage. Andrew Burdette 00:30:15 If one clinicians a constellation of their own moving parts. Every clinician you bring in has that same number of things. And so if there’s to my MFT people listening out here like your systems, people see you understand like couples counseling isn’t just there’s more there’s so many more relationships. Andrew Burdette 00:30:32 So couples you’ve got, you know, Joe and Susie, their relationship in each of their relationship with you and then the collective relationship. So it’s like 4 or 5 relationships, and you had one other person and everything kind of spiderwebs together, and you’re talking some more kind of things that everything’s really interdependent. clinicians, my group of fellow colleagues, and we’re generally all trying to like, kind of have probably two thirds full before we actually bring the next person on, just so that you don’t end up having to market to three people. It’s more like just marketing one person at a time. Carla Titus 00:31:04 Yeah. And then we’ve had practices that, you know, hire ten at a time. And so like we but the level of, you know, marketing budget and like understanding of the amount of leads and things we need to have in order to fill that up, we kind of are familiar with it. So it makes it a little easier to navigate. but even if you’re just bringing one new hire, like knowing when is the right time. Carla Titus 00:31:23 At what point in your capacity journey are you ready for that next hire? If you’re not close to 70 or 80% utilization, maybe it’s not the right time yet, right? Give it another month or two. See if you can get to that. But it’s looking in the numbers that you’ll be able to tell when it’s the right time versus just kind of winging it and figuring out, well, I think we need another person. We have an empty office. Let’s go ahead and hire. And you maybe didn’t even have everyone at capacity. And that’s we’re actually I find a lot of the profit leaks in the business is where we have people that are below capacity and not hitting their numbers, and there’s not a right accountability in place to get them to hit the goals. And that closing that gap is what’s going to make a huge difference in your group practice. If. Joe Sanok 00:32:11 You’re someone with a vision for your practice, for your side hustle, and for your personal journey. But when it comes to establishing your path and how to get to where you want to be with your practice, things get a little messy. Joe Sanok 00:32:23 You’re also someone who would prefer to go in person instead of to groups and listening to everyone else’s story. To me, it sounds like you could benefit from one on one consulting with our experienced practice of the practice consultants from 595 a month and up. You can work with a consultant that will give you more direction and practical, tried and tested tips match to you and your goals. For more information, visit practice of the practice. Com forward slash apply. Again, that’s practice of the practice. Com forward slash apply. Andrew Burdette 00:33:01 The accountability piece. Because retention is challenging because people leave for all kinds of different reasons. statistically speaking and this is older data just to be fair. but a third of your clients are only going to show up for one session, and half will be gone at the end of three. That’s what the statistics about retention say. And I bring this up because as a group owner, like, you know, there’s this what do we consider retained. Right. And really eight’s a good number I think just from a clinical standpoint of did they come in and do their solution focused off, you know, patch the boat and off they go. Andrew Burdette 00:33:35 If they’re doing deeper work obviously like it’ll be longer than eight sessions if they stick around. But yeah you really need to kind of plan to have people, clients for more than five sessions and then start basing math that way, because it’s probably going to take you five sessions to just break even. Carla Titus 00:33:51 Yeah, an 8 to 12 sessions. Normally what we’ll see depending on the practice and like the goals and the type of, you know, therapy that you do, but also like helping your clinicians get better at retention, like, you know, working through those treatment plans, making sure you understand how do you get a client successfully through it and keep them coming for support because it’s needed and how they, you know, get better and make progress over time. Not everybody is great at retention, and I think that’s something we have to recognize. Sometimes we have to coach the team to hear the tools. Here’s the way that you can improve retention metrics. But again, if we’re not measuring it, how will we know if we’re getting better? So it’s all about the progress. Andrew Burdette 00:34:29 Yeah. And since we’re talking finance and accounting stuff broadly anyway, everyone listening should be getting into like as many data points for KPIs as they can, which are key performance indicators. So things like retention, like how many inquiries did you have versus conversions. How many of those conversions, how long do they stick around? This whole sequence of things makes a huge it’s really informative for one, because it’ll show you what to address and where you need to address things, and also gives you some insight about how, you know, if you are a solution focused therapist, you probably should link up with EAP because they’ll fill your caseload with people that aren’t really going to like, see you for more than 3 to 5 sessions anyway. based on coverage. And then so you, you save on the marketing, but you maybe don’t get quite the same reimbursement rate, but you know it. There’s ways you can kind of, you know, sit down with somebody like you and kind of break down the math on on how that really works out. Carla Titus 00:35:19 Yeah, we do the math for ERP conversions all the time because it’s pretty low. And you have to know what are your breakeven numbers and you know what you can expect from conversions long term to make the math, you know, solid. It depends like in a solo versus a group. but I think that looking at the metrics on the leading indicators, which is where we’ve been talking about in our intake intakes, you know, conversions like understanding how to do we ultimately translate that to revenue and ultimately profit in the business. It’s really key to understand the front end of the business. And I think we’re often talking about the back end where we’re like number of sessions, retention and such, and that’s great. But if your front end is having issues and you’re not converting, that’s a missed opportunity. You know, we could have everyone felt up if the conversion was better. And so sometimes we’ll flip to those leading indicators instead of the lagging ones, which is revenue and profit ultimately. but you have a little bit less control over those two, because unless you’re investing money into generating more intakes, then, you know, might not, you know, might see any change in the numbers that you want to see. Carla Titus 00:36:22 So it just depends on where you want to put your focus. But just know that that is ultimately funneling all the people that will convert to revenue and profit at the end of the day in your business. Andrew Burdette 00:36:32 Switching gears, and I’m kind of going this way so I don’t forget, but you had mentioned so payroll is going to be your biggest expense. Rent is probably going to be your second biggest expense. you talked about trying to keep, you know, 50 to 60% going into the business. So what kind of pay structures do you really recommend people adopt to help make that happen? Because if you’re on a percentage model like that, percentage generally stays the same if they’re seeing ten people or 25. so where do you how do you generally advise people in terms of considering pay structures. Carla Titus 00:37:05 Yeah. So what we’ve done is a bit of a mix and it depends on the practice owner. Sometimes you don’t want to rock the boat too much with your employees, because if you’ve grandfathered them into a system that works for them and that they’re familiar with and they bought into, we’re not about to just lose all those people by making a change on them. Carla Titus 00:37:20 So we will talk about grandfathering in any commission percentage based type, as long as it makes financial sense. And even if it doesn’t, just recognizing that a certain people just doesn’t make financial sense. But we’re going to keep it that way because we want to retain that talent, and it’s important for us to invest in them that way because they were here for many years. So when you started, right. And that’s okay. And then we will start to work through hourly compensation models ideally, because then we can better control what is the output to the employee. But also we can market research data that says what this type of role is currently expected in this location to get compensated at. So you’re also not lagging with competitors and other practices that are hiring. You’re much more in line with what they are also providing us the, you know, compensation hourly. Now for my more mature and highly accountable practices. we only recommend salary for leadership normally because we don’t want them tracking ours. We want them just doing the work. Carla Titus 00:38:20 They’ve demonstrated their self managed, they demonstrated they can self accountable and hold others accountable. So we just want them doing their job right. So those people we reward through a salary compensation model. And we’ve tested salary models with highly accountable practices. And what we’ve actually found is that most people in those practices that do understand their metrics are, you know, always tracking performance and progress are actually able to exceed their goals through a salary model, which is really interesting. And actually going to talk more about this, with one, other person that we tested this with. And we found that we got way better results, but it doesn’t happen by accident. I think what is happening is I see a lot of people putting people on salary, and then those people are working half as much. And so now it’s actually impacting their profit negatively because it’s actually costing them money to have this person be on salary in their practice because they’re no longer achieving their goals of clinical sessions, billable hours needed. And I think that’s where the owner needs to be very certain that the accountability has been built as part of the culture, that people understand what they’re compensated for, how and why and what’s expected of them, and making sure that they are okay. Carla Titus 00:39:33 Having the uncomfortable conversations around there is no performance. We need to reassess your compensation structure, and I don’t see that going very well most of the time, so we don’t recommend it for that reason. That’s why we can stick to hourly and kind of hold people accountable on that until we see that maybe they’ve gone into a point of maturity, that we are comfortable switching them to a salary model. But for the most part, we recommend hourly. And it’s just because of that. you know, when we get rate increases, we’re able to do increases every year for employees. We’re able to kind of manage costs Cause and I sometimes get pushback on like, well, sometimes we get insurance cuts to our rates and then we say, well, we need to reassess the numbers overall for the practice. This is not a one person problem. This is the overall practice problem. And with every new hire we bring into the practice, we are able to also assess and correct as needed without impacting our current compensation structure that we built in place intentionally to be equitable and fair to everyone in the practice. Andrew Burdette 00:40:30 If you’re a listener out there that’s relatively unfamiliar with insurance panels, you can’t afford to be on every panel because they just don’t pay enough to make that viable. So, we’re on several panels. There’s quite a few panels I’m not on. I’m going to be dropping another one in about a month or so. I just want to make sure that 1 or 2 leftover clients, like, have coverage at the end of the year. And then once the marketplace thing renews, I’m going to give notice and get off this panel. But, yeah, part of part of the overall financial picture is can I afford to take this insurance would be a question if you’re going to be an insurance based practice. Carla Titus 00:41:05 Yeah, we assess that. We look at overall insurance compensation rate for the practice. We look at 937, of course, in very, you know, fine detail, especially for those practices that are heavy therapy 101 sessions to see what’s happened year over year. We’ve seen this rate increase drop. Are we getting reimbursed what we expected. Carla Titus 00:41:23 That’s another piece I think a lot of practitioners are not as involved in their billing and they’re not asking the questions. And I’m looking at the data. And so we do that analysis and say, hey, if we notice a $10, you know, per claim drop on average, like we have a problem, we got to figure out what are what’s happening. Are we not billing right? Or is there denials what’s happening and asking the questions to understand? Or does that change intentionally, like the insurance drop does $10 per claim, you know, going forward, starting as of this date and knowing what that impact would mean for their practice? And where would we cut back and where we find the money to, you know, still make sure everybody is compensated and we’re still making profit at the end of the day. It’s an important aspect of navigating insurance, paneling and credentialing and making sure that those things don’t get in the way of you collecting. And then there’s a whole aspect of, you know, when you actually get paid and make sure you’re collecting from insurance that sometimes will take longer to pay than you expect. Carla Titus 00:42:18 And if you weren’t prepared, you know, that becomes a cash flow issue in the business. Andrew Burdette 00:42:23 Yeah. Among insurance panels, I’m no longer participating with one. The first one I actually terminated the contract with was just turnaround time. It was they went from maybe like 30 to 45 days because they were more of a reprice there. And then it got to be like 3 to 6 months. And I’m like, I know that’s a hard no, I’m out. So that’s rough. Yeah. And yeah, that was that was a pretty easy decision. Check with some other colleagues that were still on that panel and they were like, nope, we’re getting off to you because I can’t wait six months to to pay my bills. So at the end. Carla Titus 00:42:54 But at least you knew and you were able to take action and do something about it. So I would say you’re in control of a lot of these decisions, but without looking at the data, you wouldn’t have known that they’re delaying payments and it’s taking that long to receive. Carla Titus 00:43:08 The other aspect, obviously, we can manage receivables. We can always access a line of credit or something to kind of get us through the timing of all that if you choose to stay panel with them. But that is a conscious decision, right? You are now taking on debt and cost of having debt because of insurance are taking longer to pay and not necessarily a bad thing. It’s just a timing of cashflow. We have to manage delicately and balance to make sure that we feel comfortable with it. Andrew Burdette 00:43:33 Yeah. And for listeners out there too, if you want to read about how critical cash flow is, just look up the change health from 2020 for any of the news around that. which isn’t just our our field in particular. I mean, pretty much all the medical field is a fee for service type model. And so when you can’t process insurance claims and you have a whole huge part of your pie comes from insurance stuff, while your cash flow is now dead in the water until it gets resolved. Andrew Burdette 00:44:00 And that’s a big deal. Carla Titus 00:44:02 That was a scary time to navigate for sure. And I think a lot of the practices that were impacted by that. you know, we will take advantage of some short term remedies, you know, to get us through. But it was definitely stressful. And if you do not have a cash reserve at that point in time, you didn’t have time to think or react, which is the whole point of why we want to have some kind of cash cushion. It’s just so we have time to think, what are we going to do? How do we solve this problem until, you know it got resolved? Andrew Burdette 00:44:30 one of the things we haven’t talked about is benefits packages and things like that. So there’s health insurance is are going to put health insurance in its own category and talk about the rest of things first, because it’s actually surprising how affordable the rest of things like, say, dental vision, short term and long term disability life insurance, all those are really, really, really affordable. Andrew Burdette 00:44:52 And honestly, like if you’re a solo person and try to get like long term disability as an individual, it’s damn near impossible. Whereas if you go through a business like, oh, sure, like full, full income, you know, 70% income replacement while you’re out. Like, sure. It’s like, you know, 20 bucks a month or whatever. It’s no big deal. so so those are really, really, really huge benefits that have big monetary benefits to people, either in the form of they don’t have to pay the ophthalmologist to get classes and figure out what they need, or they can go on maternity leave. And the discussion around maternity leave being a short term disability qualifiers and saying that’s a whole or just I. It blows my mind that this is how we have structured our society. It’s just it’s it’s not right. It’s not. Carla Titus 00:45:36 Support mothers. Yeah. No we get it. Yeah. Andrew Burdette 00:45:39 So it it’s it’s it’s not cool. Not okay. No. but nevertheless like, you know, there’s having that enormous difference of, like, short term disability being a factor or not. Andrew Burdette 00:45:51 So, had I converted people over to W2 sooner, Like my person that’s on maternity leave that’s coming back this week would have had coverage, but she was a contract at the time she got pregnant. So that was just the way the rules are. Carla Titus 00:46:04 And yeah, there’s a waiting period. Yeah. Unfortunately. Yeah. Andrew Burdette 00:46:09 so those types of benefits really do translate to there’s more benefit than what it’s going to cost you as a business owner to actually provide for your people. Carla Titus 00:46:17 Yeah, they’re actually very affordable. Like I was just running. We’re in the middle of open enrollment for a lot of the practices, and we’re running some calculations around what it’s costing us to have ancillary benefits is what we call it for those additional ones, and then some lifestyle benefits, too, by the way, which are now more popular, I think, than people have thought of them in the past. And since we said, you know, health insurance aside, we’re talking like dental vision, long term disability, short term life insurance. Carla Titus 00:46:45 We’re talking about an FSA, d cap, you know, for daycare costs, things that putting those programs in place and allowing your employees to have access to. It does not cost you a ton as an owner, as a practice per person. It’s incredible how affordable that can be and how great of a benefit it can be and make a difference for your new hires as you’re bringing them on and incentivize them to join your practice. The other one that I think people don’t think about often is A41KA41KA vehicle for retirement savings. You do not need to match it in order for it to be an accessible, available benefit to your company. And it is still very affordable to just run the program and allow people to opt into it on their own and contribute on their own. Not no match situation here, if you can yet afford that. it’s not an expectation, but at least making it available to your employees can be a great benefit as well. And a great way to, you know, go out in the market and market yourself as a full suite of benefits for, you know, fraction of the cost. Carla Titus 00:47:48 you know, then you think it probably costs to have those ancillary benefits. And, you know, I see a lot of owners are very generous, like always. And, you know, they want to Manchester for one day and they haven’t run the numbers. And then before they know they’re like everybody signed up and everybody wants a match. And it’s it can be really expensive. So like start with like no match and then test out maybe a 1%. And you know, overtime you can also tie it to performance metrics. You can say, hey, if you hit your clinical hours you get your match. And then now we’re motivating people to hit their metrics and you’re giving them a reward in some way of matching, you know, their for their retirement and funds. But even at the basic level, having some of those, a few of those even benefits highlighted can make a huge difference for the people that are working there, showing them that you care and that you’re invested in them in other ways besides pay. Andrew Burdette 00:48:36 The health insurance area is a whole other different ballgame. my understanding is you’re required to find or pay for half the premium, which makes health insurance really expensive to offer right off the bat. There’s some ways you can kind of do reimbursements or stipends. They from what I’ve heard from people that have tried to mount, like its course or something like that, I can’t think of Sarah. Yeah, yeah. apparently it’s not the easiest system to participate in. and several people, including the guy that has done our benefits. he’s like, yeah, you just don’t want to mess with it. It’s more headache than it’s really worth the end of the day. there’s there are still options though. So in Asheville, there are a couple of different direct primary care offices. So another name you’ll kind of hear is maybe like Concierge Medical, but they’re not exactly the same or similar. But the idea is you basically pay like a gym membership to a local doctor’s office, and then you have access to them at very, very reduced or free rates up to a point. Andrew Burdette 00:49:33 And around here you can enroll somebody for between 80 and 100 bucks a month. And so they can go have a primary care go through their thing. The arrangements they have with like the local lab places, it’s like $40 to do your entire lab handle your normal physical stuff. So really, really, really good deals and probably cheaper than your co-pays would be anyway if they were using decent insurance. And so there are some other likely to be available depending on your market and your geographic area. Some other alternatives to kind of bridge that health insurance gap in a way, to where somebody actually gets real usable benefits. one of my offices is leased in a, one of these spaces. And so for my people, they would literally just walk out one door and walk in the front door next door and go see their doctor in between sessions. It’d be really convenient. So, thoughts on those other types of creative ways to provide more benefits that don’t cost as much? Carla Titus 00:50:27 Yeah, definitely. What you can afford to do. Carla Titus 00:50:30 It’s like, well, we prefer you to do as an owner. We got to be really honest, right? Sometimes we get caught up in like, we have to do this or we have to provide that, and we have to choose to provide a profitable, long term practice that can employ people for the long term. I think that we owe it to the employees to be around, and we can’t be around if we’re not making profits. So we can have that impact. But we have to have the profit first. And some of those programs are fantastic alternatives to value. But just making sure your employees know what they’re signing up for that will not cover a situation where there’s a catastrophe. And maybe they’re diagnosed with cancer, right. Like that is not for that. And so making sure that they understand what are they’re opting into, what are some of the options you’re providing them? you know, evaluating different insurance plans. Sometimes we’ll work with the insurance brokers in the benefit side to understand what are the levels of insurance we could provide, even if it’s like the worst plan, at least there’s a plan available. Carla Titus 00:51:32 So employees feel like they’re somewhat protected versus having nothing. Right. And so you could start with that and then over time get a better plan and a better plan. And sometimes what I see often practices is they go to the called the premium, the most expensive, like the corporate level plan, but they’re not a corporation with, you know, multi billions of dollars to cover that cost. And so like being realistic about where do we want to land. Maybe somewhere in the middle. Maybe it’s a silver plan or you know and running the cost for like hey if everybody participated everybody signed up with their families included tomorrow, could we afford this plan or are we just going to be out of business? Because now everybody signed up for insurance and it’s so expensive every month. So running those scenarios and running that, you know, calculation to make sure you understand, okay, what am I signing up for. Upside risk potential versus that. The more likely scenario, which is probably half your population will sign up. Carla Titus 00:52:23 We’ll cover at least a 50% because that is actually required at some point in the cycle business that you are. You know, when you have employees, there’s certain requirements you have to meet, and that is one of them. The minimum is like 50%. And then over time that goes up, depending on your size of company, and making sure that you’ve run the calculation before you sign up for it, not just while you’re doing like 1099 to W-2 W2 plus benefits. All of a sudden you just added a bunch of costs all at once in one year and you might not be prepared financially. So kind of think about the stages. And I think owners sometimes think it’s all or nothing. It’s like, oh, either we do the whole thing or we just don’t even touch it. And there’s like, I think a really nice in-between. We need to start to consider, you know what? If we added one benefit every year, you know, what would that look like? Could we afford to run our budget and then settle into that benefit? No. Carla Titus 00:53:13 Okay. It’s affordable. We can do this. It feels comfortable now. Now let’s look at another one. Maybe see your reimbursement credits in a certain amount per year, or maybe say gym membership, you know, reimbursement. People might appreciate that if that’s, you know, what your people are into. Maybe it’s pet insurance. Like, you know, we have some practices that provide that. And so thinking creative about what do people care about. And we always start to tie benefits to what what’s important to people and making sure that we’re meeting the mark with that and not just adding a bunch of benefits nobody cares about and signs up for. Maybe we need to reassess and get rid of some that are not as popular, and then invest in the ones that are actually are people care about. Andrew Burdette 00:53:53 I don’t remember the name of the episode of The Office, but it’s worth checking out because there’s a whole episode dedicated to figuring this out and part of the part Dwight’s in charge of it, so that if you’re listening and know who Dwight is, it’s already going to set the tone of how things go. Andrew Burdette 00:54:06 but basically, like, he’s kind of asking what people want and is asking very not okay to ask questions from an HR standpoint. Don’t ask that. But just yeah, if you to just understand the complexity of this. And then also just the importance of like that word culture thing. I think one of the beauties of the office is it highlights, here’s a work culture to where largely people want to be in that dysfunctional work family, even though it’s really dysfunctional. Right. And so, you know, how can we do better as business owners and, and take care of our people? So, you know. Yeah. And don’t get carried away. Carla Titus 00:54:37 I think as small businesses we have to understand what we can afford to do and what’s important for people for us to do. And don’t be compelled to add everything all at once and try to afford everything. people are choosing to work for you for different reasons than you might think. Maybe it’s the flexibility. Maybe it’s you’re close to their home. maybe they love the culture you’ve created. Carla Titus 00:55:00 And sometimes it’s not really about the benefits. And sometimes it is, right. And sometimes it is about the pay and, kind of thinking about what is important and what are we providing us, the additional value to them that’s beyond the things that we can pay for. it’s also, I think, sometimes overlooked, especially with small group practices. I see it a lot. It’s like they are just a great place and everybody loves to work with each other, and it’s just a great environment. And their last employer maybe wasn’t that. And they’re like, I’m just thrilled to be here, even if all I get is pay and no benefits. There’s just like, this is so much better, right? So just kind of keep that in mind too. Andrew Burdette 00:55:36 Yeah. There’s just so many, so many little levers to kind of tweak and adjust and things and, and I like what you’re really emphasizing to, which is do things in an incremental way, in a small way, and try it out and test the waters before you’re before you, you know, buy that castle and then need 50 roommates to make it work. Andrew Burdette 00:55:54 Right? Like, yes. Carla Titus 00:55:56 Yeah, we’ll get there. We just won’t get there. And step one right. Step one is like, let’s get a couple, see how we feel. But these are kind of the conversations. You know, we we help our owners navigate. We know it can be really complex and complicated or scary too. Even just figuring out on your own because maybe you don’t know. Right? Is this new to you? And, I find that a lot of times we come in after the fact like they’ve already made all these decisions, and now we have to kind of undo it or shift it, and it’s just that much harder. So if you think of it proactively now listening to this episode and start to think about what do I intentionally want to create, then you’ll be in a much better position, right? There might be a few things we need to tweak later, but at least you’ve thought about it now early in the process. Andrew Burdette 00:56:38 Yeah. Key takeaways listeners out there for from you. Andrew Burdette 00:56:41 Do you have any key takeaways for them? Carla Titus 00:56:43 so we talked about risk. So make sure you check your insurance policies. Action. Step number one. I think we talked about thinking about your group practice, growing stages. You know, one step at a time. Don’t try to climb ten steps up too fast because that’s where I see a lot of problems with profitability. Start to happen is when we grow too fast, too soon and we’re not managing it. looking at your metrics, right, looking at those KPIs we talked about, even if it’s just a few of them to start, like pick your top three. Like you don’t have to boil the ocean, just start with three that are relevant to you where you’re at right now, and start measuring them like, don’t even judge them. Just be like, what was it last week? What is it this week? What was it last month? What is it this month? It could be that simple. And yet you see how powerful that is in shaping the culture and the business that you want to create from a profitability perspective, when you start to look at what the numbers are telling you. Carla Titus 00:57:38 And I think Lastly, you know, we want to take care of our people, but as owners, we have to take care of ourselves as well. And I think often the owners, the last one left behind, like, well, if there’s money, if there’s profit and you’re not thinking about your compensation, what do you need to get out of this group practice for this to be worth it to you, and kind of shaping that conversation as a win win, like, my employees can win and I can win. Everybody can win, and we can all be taken care of in this environment. But not if you don’t prioritize you as an owner in the equation as well. so making sure that when you’re thinking about benefits and things like think about things you need as well, like how do I get health insurance and what health insurance would I want to have as an employee of my own practice and business? Because you get to decide and it’s great, and you get to shape what that is for your business, and then think of it as incremental over time versus all or nothing, which I think is a mentality that we tend to have. Andrew Burdette 00:58:36 What is that one quick little like addendum to that? if you’re a smaller size practice, there are minimum enrollment numbers. So at least to get started, you’re going to want to make sure you have a minimum three, usually five as a census for people that are going to participate, because maybe not everyone’s going to participate in all of it. And that would be something important to have figured out and have maybe like a cushion of extra people that maybe aren’t participating yet if needed so that you so everyone doesn’t sign up, and then somebody decides they want to move on to somewhere else, and then you go from 3 to 2. And, I’m not speaking from experience. It’s just one of those things I like because I’m at that size, and once I grow a little bit more, that’ll be something I can do. But just for the smaller practice owners out, there is things to consider. There are those occasional you have to wait and then do it all at once. Carla Titus 00:59:24 Yeah, they can think of the ancillary benefits or lifestyle benefits, you know, that don’t require minimum participation, like things that you could do, stipends and things for your people that are not tied to enrollment numbers. Carla Titus 00:59:36 And that could be a good way to start. You know, provide benefits. Andrew Burdette 00:59:40 Yeah. So if someone wants to work with you. How would we. How would one of us find you and get Ahold of you? And we’ll have all this link in the show notes to. So. But if somebody wants to look you up, how would they go about finding you? Yeah, I. Carla Titus 00:59:51 Can. You can go to our website. A wealth worth within.com. We have, let’s connect. let’s get started. button where you can book a call to talk to one of our CFOs to see if we can be the right match and support you in the needs that you have currently from a financial planning or forecasting perspective. we also provide one time project support. So if you’re like, I’m not ready to hire someone fully, but I need some support, then you’re able to access that. We also provide professional bookkeeping services. So if that’s something that you are dealing with, where you’ve outgrown your current bookkeeper and need a little bit more support, and feel free to reach out other ways. Carla Titus 01:00:26 We put a lot of free educational content. We want you to get better with finances, so make sure you subscribe for our newsletter on our website, or follow us on social media at Wealth Worth Within. We would love to hear from you and what content is resonating. And what else would you like to know about financial management and a group practice? Andrew Burdette 01:00:42 Awesome. Well, thank you so much for coming on. This has been a real pleasure, and I hope listeners out there have learned a lot and have some stuff to take away from this, because we’ve touched on several different key areas around finance. So thanks so much. like I said, we’ll have all your pluggable and everything linked below. And thanks for coming on. Thanks for having me Andrew. If you love this podcast, please be sure to rate and review. This podcast is designed to provide accurate and authoritative information in regards to the subject matter covered. It is given with the understanding that neither the host, the publisher or the guest are rendering legal, accounting, clinical or any other professional information. Andrew Burdette 01:01:32 If you want professional, you should find one.