When should I level up my rent? When should I add clinicians? How do I rank higher on Google? How do I make more money? How do I leave my full-time job?
In this podcast episode, Joe Sanok speaks about the five most common questions he gets asked on leveling up a private practice. Here he discusses rent, clinicians, Google, money and time.
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In This Podcast
In this podcast episode, Joe Sanok speaks about the five most common questions he gets asked on leveling up a private practice. Here he discusses rent, clinicians, Google, money and time.
When should I level up my rent?
When you’re starting a practice, you’ll want to keep your risk really low. Start by sub-leasing and maximize that space as much as possible. You can even start by adding an extra day.
If you’re thinking of moving into a bigger office, think about how that space fits the direction of where you’re heading.
When should I add clinicians?
You have to do it when you’re ready, and when you’re thinking about a clinician seeing people at times you don’t want to see them.
Think this decision through carefully. You want to find someone that compliments and mirrors the kind of therapy that you do. Consider someone that will mirror your brand but won’t compete with you.
How do I rank higher on Google?
Google wants its search to feel authentic and bring up the exact results the average person is searching for.
They look for regular content, specialty content, and whether or not you mirror what a person is looking for.
Think about your anchor text, SEO, internal linking and external linking.
How do I make more money?
Do the math of how many hours you need to work, and then work those hours. Level up with additional resources like podcasting. We’re here to help you with that.
How do I leave my full-time job?
It’s all about doing the numbers well again. Look at your best and worst-case scenario.
Test it out what you want to do as a side-gig. You can use our ‘how to leave your job’ calculator in the useful links section below.
- Michael Ceely on How to Hyper-Niche | PoP 398
- Simplified SEO Consultants
- How To Leave Your Job Calculator
- Podcast Launch School
Meet Joe Sanok
Joe Sanok helps counselors to create thriving practices that are the envy of other counselors. He has helped counselors to grow their businesses by 50-500% and is proud of all the private practice owners that are growing their income, influence, and impact on the world. Click here to explore consulting with Joe.
Thanks For Listening!
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This is the Practice of the Practice podcast with Joe Sanok, session number 399. This is the Practice of the Practice podcast. I am so glad that you are here. If you are new to the Practice of the Practice podcast, welcome and if you’ve been around a while, I’m really glad that you stuck around. We are the number one podcast for people in private practice. We’ve won the Brighter Vision award for best podcast two years in a row. That’s because of you, our listeners voting for us. We nonstop are trying to find industry leaders both in and out of the private practice world.
Today we’re doing a solo show, meaning I’m going to be sharing some thoughts with you about what’s been going on here in Practice of the Practice world, but also the five most common questions I get on leveling up a private practice. So, I’m going to tell you the questions now so that you know if one of them you don’t like, you can jump ahead or whatever you want to do. So, the first question I’m going to answer is when should I level up my rent? I get this question a lot. Second, when should I add clinicians? Third, how do I rank higher in Google? Fourth, how do I make more money? And fifth, how do I leave my full-time job?
So, we’re going to be talking all about that today. I’m going to grab my phone so that we can do some math, because some of these are going to involve math. So, I’m going to treat these as if it was someone in our Next Level Practice community that was asking these questions. If it was one of my consulting clients, you guys get to kind of hear how I would typically answer this. So, let’s dive right in. When should I level up my rent? And so, the situations where people are asking this question are maybe they’ve started by subleasing an office. Just yesterday, one of our Next Level Practice people in our ‘What’s working?’ meetings; so, we do these meetings once or twice a month called ‘What’s working?’ was asking this exact question. She’s subleasing and wanted to know should she expand to sublease somewhere else. Should she expand within that? What do you do?
So, people that are in this situation, maybe they started by subleasing their office, meaning they might be paying for just Mondays or they might be paying a percentage of what they bring in. They’re keeping their risk low as they start their private practice, which is really smart. They must’ve listened to the other podcasts I did on negotiating rent. So, they might be doing that. They might have a single office and they’re getting busier, maybe they’re adding a clinician or two. They want to know, like, “Should I jump up to a two or three office, should I jump to a six office? Like how big should I go when I want to level up with my rent?”
So that’s kind of the situation most people are in when they’re thinking through this question. When should I level up my rent? So, I want to start with your phase of practice. When you’re starting a practice, you want to keep your risk really low. Usually for most people, they don’t have a lot of capital, they don’t have a lot of money to put into the practice, they’re doing it kind of as a side gig or maybe they have a partner that brings in their primary income or maybe, they know that they want to grow a full time practice, but they aren’t quite there yet. So, they might start by subleasing.
I would say that you want to maximize that space as much as you can to make sense. So, I would rather you take a bigger jump when you take the jump then to go from one sublease to another sublease to a single office, to a four office. That to me, I’d rather you really kind of max it out when you’re subleasing. And so, I might push the limits with the person you’re subleasing from and say, “Hey, I’m renting Mondays. I would love to add on Thursdays for 25% more.” O, “I’d love to find out if I could rent a little bit more.” It’s not going to be perfect, and that’s part of this phase: is that you’re putting up with a space that’s not entirely yours. The furniture might be different than you want, some of the things in that building might be different than you want, but you really want to be able to make sure that when you make that jump, it makes sense.
You know, it’s never going to be zero risk, but you can do things that can reduce the risk. So some times when you might want to level it up, well you might’ve added a couple of 1099s, within your subleasing contract or you might start running the numbers on, “Hey, if I’m seeing 20 people a week, that’s clearly going to pay for my space, if I go to a single office space and just rent it completely. And then you could sublease that space or add 1099s or W2’s to your practice as well. So, you want to make sure those numbers work, but you also want to look at, how does that space fit the direction of where you’re headed? Because in most leveling up, your lease is usually going to be at least three years. And so, you want to be able to think about over the next three years, “Can I grow into this space?”
So, you may want to look at a two-office space if you’re jumping from subleasing. Even if it’s a bit of a stretch and you’re making the same amount of money, you still want to make sure that you can move into the largest space that you can afford without adding unnecessary risk; because the worst thing would be you sign a three year lease, you have a one office space, you’re adding clinicians, they fill up and then you can’t continue to grow, and you’re looking at a second location, which is not ideal to have a second location because that’s two different places. There’s two different things that can go wrong. And usually I want people to be in a larger office all in one spot. A couple of exceptions to that when you might want to look at a second office is if you want to get into a certain part of town, if you’re getting a lot of people from a certain side of your town, if there’s an underserved area and maybe your insurance-based and a lot of people have insurance in that area.
Those are all spots that you might want to increase your rent in two different locations. I’m not going to go into when you should buy a building. I think that’s a little more advanced than what a lot of people are asking. If you have that question, we have some great resources for you and Alison Pidgeon, one of our consultants, she did that. She bought a building and she’s done an amazing job with that. And so, we can definitely talk with you about that if you have that question. But what about when do you upgrade from, maybe you’re renting a space already. You’re not subleasing, but you want to make a jump. I would say get again the largest space you can afford because if you’re growing a group practice, you definitely want to be able to continue to expand.
A lot of people think, “Well, I just have a single office. I can’t have a group practice. If you look at how many hours in a typical week that are billable one-hour sessions back to back, you’re looking at about 72 hours in a typical week of 72 billable hours. And that doesn’t even include if you’re doing 45-minute sessions that are back to back. So, you could squeeze in some extras. So, if you are at 80% occupancy, 80 to 85, you’re looking at about 50 sessions. So, if you’re doing 20 sessions a week as a full-time clinician, you could add another full-time person and a part-time person and still not max out that space. So, if you’re looking at adding clinicians, which we’re going to talk a little bit about that in the next question, one thing you really want to look for is people that will see folks during times that you don’t want to see folks.
So, for example, when my wife had our first child, when we had our first child, I wanted to work fewer evenings. And so, I was just working one evening a week. So, I looked for 1099s that specifically wanted to work evenings because that’s where it was easiest to fill for our counseling practice. So, I looked for people that wanted to work evenings and filled that up, maximize that space. And then when we were busting at the seams, went from that single office to a four-office suite with a view of the water. So, I made a big jump. It was a huge financial decision. I think my rent was around $500 for that single office and bounced up to around 2100 a month. So big jump. But I knew it was necessary and made sense at that time.
All right, second question. When should I add clinicians? Well, adding clinicians is one of the best ways to diversify your income, to keep those referrals that you’ve worked so hard to get in-house and also to optimize your time. So, when you’re looking at working less and making more, or even working the same and making more, or wanting to have vacation money or to be able to go on vacation, still make money, adding a clinician is such a great way to do that. Alison has started group practice mastermind group that is such a good resource for people that are doing this; that are adding clinicians. Seeing the people get kind of structured help between that and her e-course around that is just an amazing way for you to learn those skills over practiceofthepractice.com/apply. You can connect with Alison to talk about that if you’re interested.
But when should you add clinicians? Probably before you’re ready. A lot of people say, “Oh, I want to have X number of referrals coming in,” or “I want to make sure that we’re getting this much web traffic.” The thing about adding clinicians to your website and adding them to your practice is that they are a multiplier. It’s more people out there talking about your practice, it’s more people out there serving different specialties. Even just the image of a group practice really helps you to be able to be more and more professional, to be seen as a group practice. So, these people may only be doing two or three clinical sessions a week as they first get going, but the general public doesn’t know that. They see that you’re a group practice, that you’re adding clinicians, that you’re adding specialties. You really want to think through who mirrors the specialties that you have.
So, if you’re a couple’s therapist, it might be helpful to have an EMDR therapist that if one of those individuals has been through trauma, that they can do some individual therapy outside of the couples work or maybe a play therapist for the kids. Find things that mirror your brand but don’t compete with you. And then at a certain point, you’re really going to be looking at replacing yourself so that you can put more time into the admin of the business and do just the clinical work that you want to do. So, I’d say sooner than later, you want to start adding clinicians. I mean, if you’ve got 10 clients a week, or more, you’re definitely in a position that you can start adding clinicians.
Now the other thing you really want to be aware of in adding clinicians is know your state laws, especially your employment law around 1099s and W2’s. So, my current information is that California is almost impossible to have a 1099 contractor. You almost always need to do W2’s and in a number of States that’s more and more true, especially with kind of lawsuits around Uber and Lyft and, you know, people that have misused 1099 contractors. The intent of a 1099 contractor is really that they’re a business within your business, that they have quite a bit of autonomy, quite a bit of freedom, that they’re more like a colleague than someone that you’re micromanaging. So, if you really want to create a specific culture and you want people to blog for you and go to networking and follow a bunch of rules, you’re probably leaning towards a salary- plus commission-based W2 whereas a 1099 you’re looking at probably more of just a percentage-based clinician.
All right, next question I get all the times. How do I rank higher in Google? Well, Google doesn’t release their exact formula. IT folks are always trying to figure out how to rank higher in Google. Google basically wants their search to be as good as if a person asked a person. So, if I ask someone, “What is the best French restaurant in Traverse City?” I might get a variety of opinions, but those three or five restaurants, that’s what Google wants to have to be the three or five kind of top things in my search. So, they really want to mirror what kind of the average clinician or average person is searching for, and to make sure it feels authentic. So, what they’re looking for is they’re looking for regular content, they’re looking for very clear specialty pages with your practice, they’re looking to say, “Well, do you mirror what this person’s looking for?”
I was just doing a website evaluation recently and this person, they helped folks with eating disorders and on their main page, they had a lot about self-image, they had a lot about eating, they had a lot about nutrition, but the word counseling was nowhere on that whole front page. So, if someone’s looking for counseling and the word counseling isn’t on the page, that’s a big red flag to Google. And so, you want to make sure that it’s super clear right away who you serve, what’s the transformation people go through and that you’re creating content on a regular basis that points to who your main specialty area is.
Also, you want to do little things like have Yoast installed on your website. That’s why [YOAST], Yoast and I got to give a shout out to simplifiedseoconsultants.com. Jessica has been on the podcast. Let her know that I mentioned her if you connect with her. She has worked on doing meta descriptions and ranking higher in Google for a long time and actually taught at Slow Down School and is teaching at Killin’It Camp. She is just a regular clinician who loves helping people rank higher in Google. So, she’s someone I would highly recommend connecting with. I do get an affiliate link if you work with her, but just, I mean, she’s awesome.
So, how do I rank higher in Google? I would say, work on the meta descriptions, work on the SEO and work on regularly putting out content. Another thing is you want external links pointing back to your website. So, if you write an article for your local newspaper, make sure that they give you a back link that goes to your website, preferably using what’s called anchor texts. So instead of just saying, “Here’s the website,” you know, if what you’re wanting to rank for is couples counseling Traverse City, you want that text to hyperlink to your website. That’s going to let Google know that couples counseling Traverse City, that that specific practice is one that that does that kind of work.
As well, you want to be doing internal linking; that’s linking from pages on your own website to other pages on your website. So, for example, if you write a blog post about depression and you have another blog post about anxiety, don’t say, “Here’s another blog post about anxiety,” and then just put, you know, practiceofthepractice.com/anxietyblog. You want to again, use that anchor text of anxiety symptoms to go to that website or to that blog post. So, you’re doing the internal linking as well.
All right, fourth question. How do I make more money? Well, it again kind of depends on the phase of your practice. So, when you’re first getting going, you’re going to wear lots of hats. You’re going to keep your costs down. Time is one of your biggest assets because you know you aren’t seeing 40 clients a week, you’re not seeing 20 clients a week. You want to work the number of hours that you plan to eventually work. So, if you want to eventually have 20 clients and you’re at five, you know that 20 clients plus probably five hours a week in admin is 25 hours a week you should be working. So, if you have five clinical hours, you need to be working 20 hours a week on your business. Don’t go grocery shopping, don’t do other things while it’s slowly growing. Work the hours that you want to work, you’ll get there faster.
Now, if you are in that kind of just under a hundred thousand dollars, you know that’s 60 or a hundred or so, that’s going to be where we’re really looking at starting to take off more hats and adding clinicians to your practice, adding multiple services that are outside of your time. And so, as you do that, you’re going to want to free up your time. That’s the low hanging fruit when you have a practice that’s going well. And then when you’re looking at the scaling, you’re really looking at investing in additional clinicians while also looking for opportunities to take that clinical expertise and level up. So that may be through a podcast or an e-course or through some sort of keynote speaking.
Those are all ways that you can continue to level up, make more money, and work fewer hours. Later on, this year, as you may have heard, we’re launching Podcast Launch School where we’re going to be training you and a whole bunch of other people on how to launch a podcast around a certain specialty. So, say you’re awesome with anger management; man, it’d be awesome if you had a podcast. It is still the early days of podcasting. It may not feel like it because you’re an early adopter. You’re someone that listens to these podcasts, but honestly when you look at the majority of the people, when you look at the stats, we actually have a workbook for you with a bunch of those stats that you can get for free over at Podcast Launch School. It’s, I think 27 tips, stats and tricks on kind of thinking through some things before you even consider starting a podcast.
But there’s 600,000 or so podcasts right now compared to 5 million YouTube channels. I mean that is nuts. That means that for every podcast there’s probably two or three or four depending on kind of what stats you look at of YouTube channels. So, it really is still the early days and there are very few people doing kind of clinical work and doing it well. I think the average, where they call it a pod fading is when someone starts a podcast and then it just kind of stops. Pod fading is a real thing. I think the average number of episodes is 10 episodes. So, it doesn’t take much to just kind of keep with it. So that’s another great way to continue to level up and take those clinical skills higher.
All right. Lastly, how do I leave my full-time job? So those of you that are still working full time jobs, you’re in that situation. I’m with you. I’ve been there. A little bit of my story when I was, let’s see, my very first private practice job, I was, it was child and family psychological services in Kalamazoo. Dr. Larry Beer owned the practice. Started that as like a side gig in 2006 as a 1099 contractor while I was working at this residential facility and then community mental health, and then, kind of I did that on the side, didn’t know what I was doing in regards to marketing myself, but saw three or four clients a week, helped pay down student loan debt.
Then, when we moved back here to Traverse City, we knew this was going to be home or at least our home base. You know, we were planning to do some travel next year in a camper and go see the nation with our kids and probably rode school for a year, but Traverse City was a base. We knew that. And so, I got a job as a foster care supervisor, lunch and evenings and sometimes before being a foster care supervisor during the day, I would do anywhere from 6-10 sessions a week and then got a job at the local community college. While I was doing that same sort of thing, kept going, added clinicians to the practice.
But then in 2014 when our second kid was born, I used the Full Family Medical Leave Act to be able to work about 20 hours a week so that I could just pay for our healthcare and really test out this private practice and podcasting stuff. Every month was the best month. So, doing this kind of how to leave your job numbers is really important. If you go over to practiceofthepractice.com, just type in the search bar ‘how to leave your job calculator’. We have the calculator, that was the exact numbers that I used to determine when to leave my job. So, what you can do is you can take your pay stub from your full-time job, entering your benefits, and then it’ll say, here’s about, it’s kind of a rough sketch. “Here’s about how many clients you’ll need,” and then you put in how much you’re charging based on this rate. So, if you’re charging $120 per session, you need X number of clients, and it’s usually a much smaller number than you think.
Another way to do this is to just take your job. So, let’s do some math here. If I pull out my calculator on my phone here, so you’re making $60,000 a year in your job. If we multiply that by 1.5, that’s going to give us enough money for our taxes and a little bit of overhead and all of that. So that brings us up to $90,000 a year. Now if we divide that by how many weeks we want to work; so, let’s say I want to take a month off over the course of a year. So, I want to work 48 weeks a year. So, I’m going to divide that by 48 weeks. That’s $1,875 per session, per week. Excuse me. Let’s say you’re charging 125 per session, private pay, or you’re averaging that with insurance, multiply that by 125. It means I need 15 hours a week that I’m clinically seeing people in order to make that up.
So, I’m going to multiply that 15 back by the 125 to get it to our 1875. Now let’s play with some numbers. Let’s say that I charged 175 per session for private pay. That brings it down to 10.7, so 11 sessions a week. So that’s a lot fewer. So, one of the reasons in private pay practices that you really need to be raising your rates is that you then keep attracting people that can pay those rates, but also you can specialize more and you can offer more of those boutique services. So, running those numbers to replace it also running some worst-case scenarios. So, let’s say that, you know, I know that I could live off a 60 grand a year, but if I actually look at my family budget, if I look at our mortgage, look at, you know, if you have car payments or student loan payments, and if you have a partner who brings in some money too, what do you actually need?
It’s usually not as much as what you’re making. But like let’s say it actually just takes, you know, say $40,000 a year. So, we’re going to do 40,000 multiply that times 1.5. So that’s $60,000. Divide that by, if we’re in a worst-case scenario, maybe I work 49 weeks a year instead. And then, let’s say worst case scenario, I’m only charging $100 a session. Well, that’s only 12.2 sessions a week I need to do, if I lower my budgets. That’s worst-case scenario. But now I always like to look at, “Well, what’s the best-case scenario?” So, let’s just say that, and we’ll reverse engineer this a little bit. Let’s just say that, I really fell up fast and I did like 19 sessions a week and say I’m able to charge that 175, and say I work only 47 weeks.
Well, that ends up being $156,000 growth and so, when you have that worst case scenario, best case scenario, and most realistic scenario kind of in the middle, it helps you feel a little bit better about, “How could I get 20 clients a week if I really hassle, if I put that extra time in and actually kept working 40 hours a week?” And if you’ve been working a full-time job, partial practice, you’re probably working 50 hours a week. So, what if you did that for two months, you kept that same pace up but it was just after you left your full-time job and you are networking 30 hours a week, and you are working on your website, you are blogging; do you think that you would have 20 people a week? In most situations, the answer is yes.
So, it’s really worth thinking through these questions of, “When should I level up my rent, when should I add clinicians, how do I rank higher in Google, and how do I make more money and how do I leave my full-time job?”
So, thanks so much for listening. We have tons more coming up throughout this month and next. As you can tell, we are doing more podcast episodes than just once a week. So, especially in October, I think we have planned out to do eleven podcasts episodes in that month. So, you’re going to want to check that out.
Thanks again to our sponsors, Brighter Vision. If you head on over to brightervision.com/grow, you can try that Social Genie. It’s so amazing. It’s helping so many different people with their practices and their social media.
Thanks so much for letting me into your ears and into your brains. Have an awesome day and I will talk to you soon.
This podcast is designed to provide accurate and authoritative information in regards to the subject matter covered. It is given with the understanding that neither the host, the publisher, or the guests are rendering legal, accounting, clinical, or other professional information. If you need a professional, you should find one. And thanks to the band Silence is Sexy for your intro music. We love it.