Joe Sanok 00:00:00 Hey there, practice of the practice community. Are you ready to take your private practice to the next level? Then mark your calendars for September 16th through 19th, 2024, because Level Up week is back and bigger than ever. Insert rocket emoji here. Join us for four days of live webinars, interactive panels, and exclusive resources tailored just for counselors, therapists and private practice owners. Whether you’re looking to fill your caseload, hire your first clinician or scale your group practice, we’ve got you covered. This is your chance to level up while others give up. Don’t miss out on this game changing event. Register now at practice of the practice. Com forward slash level up and get ready to transform your practice. Remember September 16th through 19th level up week your ticket to practice success. Register today and let’s level up together. Practice of the practice. Com forward slash level up. Speaker UU 00:01:06 This is the. Joe Sanok 00:01:06 Practice of the Practice podcast with Joe Sarna. Session number 1064. I’m Joe, sound like you’re hosting. Welcome to the practice of the practice podcast. Joe Sanok 00:01:21 I am so, so excited to have you with me today. we actually, in the next three episodes, are going to be having a really amazing conversation about scaling a mega practice, and I’m super excited because we’re going to be covering a few different topics. And I just want to give you a sense of the next three days, what we’re covering. So we’re going to be talking about today where you open kind of how zip code matters, talking about competitor analysis, things like that. Tomorrow we’re going to be talking about should you take insurance, how do you survive an insurance audit billing those sorts of things. And then we’re going to talk in the third episode about keeping and finding amazing therapists, knowing that, you know, retention things happen, that people move on, that there’s turnover. How do you handle that? How do you plan for that? And you know what? I am not just talking about this stuff on my own. I have the amazing Melissa Schneider with me. Melissa was actually on this podcast in late 2023 as part of our seven figure practice series. Joe Sanok 00:02:21 She now has over 60 full time therapists on staff, and they provide 5000 therapy sessions a month. So Melissa Schneider’s a therapist, a practice owner, business consultant. She has just joined the practice of the practice team. They have three offices in North Jersey, over 60 full time therapists, as I said, and just doing a ton of different things with their practice. So, Melissa, welcome to the practice of the Practice Podcast. Melissa Schneider 00:02:50 Thanks so much, Joe. I’m so excited to be here. Joe Sanok 00:02:52 Yeah, and welcome to the practice of the Practice Consulting team. I’m so excited to have you joining our team. Melissa Schneider 00:02:57 Thank you. Joe Sanok 00:02:58 Yeah. You know, when I did that, interview with you back? it was before December. It went live in December. And you had said you hired 13 people in one month. I’m like, 13 was the max I had in my group practice. and you did that all in one month. So. I mean, and I don’t remember how many you had done. Joe Sanok 00:03:14 I think you had 40 or 50 clinicians. So you just keep growing. And to just see that systematic way that you do it is so impressive. Yes. Melissa Schneider 00:03:21 And we’re, it’s funny that you say that because we’re about to bring in ten new people, kind of between August and September of this year, including a couple of interns. and our admin team is like, okay, we’re planning it better than the last time, right? We’re going to paste this out. yeah. But we it’s an industry where you have to keep growing and, bringing in new people. So we’re excited about that. Joe Sanok 00:03:41 Oh, that’s so awesome. Well, I want to just start with that idea of where you open your practice matters. Now, you’re the first person I’ve heard really say this. And to talk about zip code, to talk about being strategic, to think about kind of looking at competitors, Take me back to, like, was there a time that you realized this was important? Or was that something you kind of always had as a posture towards opening your practice locations? Melissa Schneider 00:04:04 Yeah. Melissa Schneider 00:04:05 So I did not have this in mind at all. I did what probably everyone does. I was like, well, I live in Jersey city. Maybe I’ll open here. I only later, as we were starting to do competitor analyses, to think about opening our second office realized that I had just happened to be in an amazing place to open a therapy practice. I realized that if we’d like, if I’d been in Brooklyn or, you know, somewhere where there’s, like, a lot of therapists, you know, people on every corner, we probably never would have grown. Like, I might have just had a solo practice and been happy with that. we later learned that downtown Jersey city was one of the most underserved, like, cities in the area. and that had been gentrifying and growing, like, just hand over foot for about ten years. And there were 300,000 people in downtown. And I was the only couples therapist marketing myself and taking Aetna. And so the phone just never stopped ringing. Melissa Schneider 00:05:03 And that was how the practice started. But I just thought like, oh, that’s what business is like. And you’re not realizing how extremely fortunate we’d been just to be here. Joe Sanok 00:05:12 Wow. So at first it’s just kind of accidental. You’re taking the right insurance. You have the right specialty. Just people are coming in like crazy. and you just initially think, okay, this is just how it is. Wow. Practice is really easy. Yeah. Melissa Schneider 00:05:25 I used to be a therapist. Joe Sanok 00:05:28 When when you decided to open your second location. was that where things got more strategic, or was it by the third location, like, take us through kind of both of those openings? Melissa Schneider 00:05:37 Yeah, yeah. So when we were ready to open our second location, it was like nerd level strategic. and so I’ll kind of walk you through our story. Right? So my husband and I were like, all right, you know, we have 8 or 10 people. we have some really promising thing. Leaders were ready to open another location and this was 2021. Melissa Schneider 00:05:58 So this was in the middle of the pandemic. Basically, everyone we knew had just moved to the suburbs of North Jersey, and we were like, they can’t possibly have enough services. You know, like towns are growing like six and 10% a year. You know, a lot of income is coming in like everything about the town is changing. And so we were like, let’s figure out like what would be a good place to go to. and so we did a lot of things. Right. So we, kind of two principles we had in mind is like, we want to find the sweet spot where there’s a high population town, decent income, and the fewest number of people doing the things that we’re good at. So that was our sweet spot. And then our second thing was we want to do like smart, free, pilots experiments. before we open somewhere, like to really prove the concept. So I’ll kind of walk you through our story there. but those are kind of the big things to keep in mind. Melissa Schneider 00:06:49 It’s like finding your sweet spot and then testing before you spend a dime. Okay, so why does this matter so much? Right? If you’re going to open a group practice, right, you could easily spend 2 or $3000 per session room or lobby area. Just like buying furniture, you know, getting the laptop, getting the printer, getting whatever you need. and so if you’re a group practice owner and you want 2 or 3 session rooms, like you could easily invest $10,000 just in, like getting your office ready, you know, not to mention, like your lease, your security deposit renovations, like the whole thing. Right? So it’s it’s not something to roll the dice on. And there’s like, zero reason to do that. so what we did is we got out a spreadsheet, because we love numbers and we just sort of googled, like populations in the towns near us that everyone seemed to be moving to and just kind of got like ten places on the map that we’re like, we could drive to these places, you know, like, we feel like we like they’re reasonable places for us to open in. Melissa Schneider 00:07:44 so that was like our first column, right? Town names, population. Then we went to site today and just found out, like how many people just total with no filters are in each of these towns, right. And there’d be somewhere between like 12 and 300. Right. And so we’d write down the number of directory listings. then we developed a ratio. And this is just like one measure, right. You could count directory listings in Etna, or you could count anything that you know, anywhere that like people find therapists in your area. But it’s like today is big for us. So we sat down and we made a ratio. Right. So like, divide your population by your number of like today listings. And that helped us figure out our sweet spot. So just to give you like a comparison, right. A town in new Jersey called Montclair, at the time the ratio was 120, Jersey city the ratio was 2231. And so you can sort of appreciate that like the opportunity was 20 times greater, meaning that there’s like more people and fewer people doing what we do. Melissa Schneider 00:08:45 and so we did not open in Montclair, you know, we were looking for towns in new Jersey that kind of matched our profile in Jersey city. And we found a couple, you know, so we were looking at Bloomfield, we’re looking at Clifton, we were looking at, Maplewood and Millburn. and so that was kind of where we started. so any questions so far on like, number crunching and just kind of finding some sweet spot leads? Joe Sanok 00:09:08 Yeah. So when you’re looking at kind of total numbers for a zip code, are you using census data. Are you using like how like what numbers are you pulling from to do some of that. Melissa Schneider 00:09:18 Yeah. So I mean Google pretty much has all of this at the fingertips. So we would just go in and be like population of Clifton new Jersey. You know, they’ll just pull up census data for you, census data for you. It’s sort of you can kind of tell it’s coming, you know, to link back to the census report. Joe Sanok 00:09:35 Yeah. Joe Sanok 00:09:36 So, so doing that side of it. And then, are there any ways with that? And I know this was a while ago that now you’re using AI to help with any of this. Melissa Schneider 00:09:45 That’s a good question. I actually haven’t tried that. but I’m sure you could pull up ChatGPT and say like list the, you know, ten towns by population density that are within a 30 minute drive of wherever you’re starting at. Right. And it would probably be able to tell you that just much more quickly. Joe Sanok 00:10:02 Okay. What else goes into a competitor analysis. You start to look at kind of that ratio. so you’re looking at the population and it’s like today, what else are you looking at then. Melissa Schneider 00:10:12 Yeah, exactly. So so we kind of did this just to start getting an understanding of what towns could be a good idea. Right. Kind of working toward finding that sweet spot. so after we did that, we also added in, like, median income in the towns. I feel like we might have looked at like, is there a Trader Joe’s? We were just thinking of, like, whatever marketing research Trader Joe’s is doing, we can just ride their coattails. Melissa Schneider 00:10:34 and so we kind of got it down to two towns that we thought, like, I think one of these two is the place for us. and so that was kind of how we used that research. So once we had our two towns that we were like, it’s probably one of these. That’s when we really did what I typically think of when I think of a competitor analysis. So we were like, okay, Bloomfield, new Jersey, let’s go to the internet and just type in like best therapist in Bloomfield, new Jersey. You know, we looked on psych today. We just kind of found 20 practices that were doing decent marketing, you know, showed up online. We’re easy to find. and then we sat down and called them all. We pretended to be looking for couples counseling. And we have Aetna. My husband has horizon and we can only do Saturdays. And our team might want someone. And so we just we would just ask things to kind of understand like how this practice does onboarding, how they work with people if they’re insurance savvy, etc.. Melissa Schneider 00:11:27 and we were astounded. And this has happened in every competitor analysis I’ve done since then. 50% never called us back. No reply. another like third, don’t answer live, you know, so like maybe you’d hear back in a day or two. The final third did answer live, but in almost every time, like there’s not any way to book online. Like maybe one Everyone practice has a way to book online. And so we were like, is this book up against I think we can we can win here. and so, you know, the both towns, like nothing really stood out in the competitor analysis. We were like, they’re both doing, you know, similar things. They both have practices. I think Bloomfield had fewer group practices. So we were like, okay, we’re like leaning toward Bloomfield. so now we were down to that, like free experiment that I talked about, right? That we were like, okay, this is this is all theoretical up until this stage. Right? It seems that the internet and like today and like general intelligence would point toward this town, but like, what if nobody there wants therapy? Or what if there’s something just going on culturally that we’re not aware of because we don’t live there, right. Melissa Schneider 00:12:26 so we what we did and you can do this to most likely using your free code, Joe, as you just go and make two news like today pages totally fresh. And they’re exactly the same, except for one thing the address. Right. So you just go in both towns, Google like a co-working space or a medical office building. Like something plausible, right? You make your site today page and you just wait for 30 days, right? You see, you know, as people reach out, you could be like, oh, you know, that office is full now, but we can totally see you over here, or we’re starting with telehealth. How about this person, you know, so you can still, like, serve the clients. It’s not like fake, but that way, at the end of 30 days, we sat down and we were like, wow. Like a lot more people reached out in Bloomfield, then reached out and are like other town that we were thinking about. Melissa Schneider 00:13:10 And so we felt really confident. We’re like, this center is going to get calls. People want therapy in this town. The population looks right, the income looks right, the competitors are low. Like we were like ready to sign leases and pay money. It didn’t feel like just the hope, right? It felt like a reason to be confident that the business would work. we later learned that the densest population in new Jersey is where we opened in Bloomfield. just another another tidbit to think about that even your zip code can matter. You know, if people are starting with the zip code instead of typing in Bloomfield like they might not find you if you’re listing isn’t related to that zip code. Joe Sanok 00:13:54 Whatever stage your practice is at, we know using great resources with patients is crucial to helping them get better faster. As a practice owner, I never compromised on this, but finding the right materials was a constant challenge. It’s so time consuming, especially with everything else to juggle. That’s why I recommend Psychology Tools, an online library of over 500 evidence based resources for whatever problems your clients are facing. Joe Sanok 00:14:21 Choose practical exercises, handouts and worksheets, audio therapy, treatment manuals, and loads more. They’re even available in multiple languages and formats developed by highly qualified psychologists. Resources can be downloaded with therapist guidance to enhance skills or client guidance, helping patients make the most of each tool. It’s a game changer for saving time when delivering more effective therapy, as well as a great resource. Library Psychology Tools is also a smart business tool, boosting productivity and efficiency. Focus on growing your practice while your team feels better prepared for every session. It’s a win win for you and for me and for the client. Visit Psychology tools.com/joe to find out more. Use code Joe 24 for 20% off new subscriptions. Again that psychology tools. Com slash Joe to find out more. What are you doing October 1st through third. I want to hang out with you just south of Nashville, Tennessee. Down in Franklin. I’m going to be key noting the Mental Health Marketing Conference, and I would love for you to be there. We are also sponsoring the clinical track, where there are going to be tons of amazing trainings, all for you in private practice. Joe Sanok 00:15:39 This is the national gathering for marketers and clinicians in mental and behavioral health. You’re not going to want to miss this awesome conference. It’s the one conference I’m keynote this year, and you can read more over at MH marketing. Org. Also, Steve over at Mental Health Marketing has given 25% off to any practice of the practice. Listeners that want to come to this, whether you’re coming in person or online, you’re going to want to use promo Code Joe at checkout to get 25% off. I would love for you to come in person for my closing keynote on Thursday, October 3rd at the Mental Health Marketing Conference, but if you can come online, that works as well. Can’t wait to hang out with you in Tennessee again. That’s MH marketing. Org and use promo code Joe at checkout to hang out with me October 1st through third, 2024. Now, is there anything with Psychology Today or with those addresses that you need to be aware of just in regards to, like using those addresses if you’re not necessarily like practicing there yet. Melissa Schneider 00:16:39 Yeah. So I always want it to be a location where I could plausibly go and meet you for a session. So I usually am going with a co-working space or like a therapist hotel ING service, you know, so that no one could be like, but you don’t even operate there. I can be like, sure I do. I can meet you Tuesday at one, you know, you know, Regis, something like that is just a good way to do your marketing test. Obviously, eventually you’ll have a real office that you’re going to use there. Joe Sanok 00:17:05 Yeah, I love that. So it’s a place that, you know, does allow co-working and you just say, here’s where we would meet. And, you know, maybe in some towns, if you don’t necessarily have those kind of spaces, you could have an agreement with someone or something. awesome. Okay. So you do that market research. Yeah. So you do that market research. then, you know, you’re looking at the numbers and what happened when you did that experiment in your second office location when you did this Psychology Today experiment? Melissa Schneider 00:17:34 Yeah. Melissa Schneider 00:17:35 So we, you know, the outreach was definitely stronger in the location we went with, a Bloomfield, new Jersey, and so we just felt like, okay, wow. Like real people are reaching out. They’re interested in the practice. They’re finding us online, they’re contacting us, and then even we took it a step further. So we started to look for offices. But we we like, hired to telehealth oriented therapist who knew an office was coming so that they could actually start like building a caseload before we were paying rent. and again, this was the height of the pandemic, so that was easy to do. it won’t work in every town these days, I would say. But it was another way for us to, like, start when we had some income as well as some expenses. Joe Sanok 00:18:16 Yes, you’re keeping your risk really low by filling those people up before you even rent the space. How long do you recommend people are kind of doing virtual as they’re thinking about opening a second or third location? Melissa Schneider 00:18:28 I think we were doing it for like two months, tops. Melissa Schneider 00:18:32 but we, you know, usually like the first month in a location, we’re still coming out in the black as far as, like the actual expenses of the month. You know, you might be in the red as far as, like a security deposit or something like that, but we really try to, to be low risk about opening new locations. Joe Sanok 00:18:50 So then what else needs to be factored in when you’re doing competitor analysis, when you’re thinking about zip codes, think about locations like what else do you need to be thinking through as you’re making that decision before you sign up for a new lease? Melissa Schneider 00:19:04 Yeah, definitely. So I would say a few things that I get questions about a lot is like, what if I’m telehealth only, right? Like I really don’t want to have an in-person office. Does it matter? Do I need a location? so I would say that even if you don’t plan to open, like a physical office location, you want to think about the fact that, if you don’t have a location, then you can’t really be present on Google Maps. Melissa Schneider 00:19:29 You know, you wouldn’t have a Google business listing because you need an office address. Your local SEO might struggle. And if you’re telehealth, only without a location, then you’re just competing with like BetterHelp, thrive works, life sync. You know, like kind of these these giant telehealth only services that are putting in a lot more advertising dollars than, than you would be. And so I think it’s really worth figuring out how to have at least a plausible office location so that you can show up on a map in a town, like have a physical presence so that local people could find you, even if they’re happy to do telehealth. And again, then it also would give you the option, you know, if you’re connected to some kind of co-working space or a sublease type of thing, maybe you have an office for four hours on Saturday once a month, right? But you still can get mail somewhere. You can like, you know, put credentialing addresses. You can be in directories if you’re taking insurance. Melissa Schneider 00:20:21 So I think it’s worth even if it’s like extremely small, as you know, as part of like part of your business, that you still have a location just for all of those kind of marketing and online SEO options. another thing I get asked about is like does the zip code actually matter? Like, if I’m in a town, why would the zip code matter? so super interesting research I did with a consulting client just a couple months ago. You know, they were in like a major city in the US, you know, kind of like the second city next to, like, a giant, you know? And they were in a zip code, you know, that they had been. That’s where they lived. They were happy to open an office there. But when I did some research, the other four zip codes in town, like that ratio we were talking about, the zip code they had chosen was like the lowest, like the worst ratio I’d ever seen. And when I was asking them about it, I was like, how is this possible? it was they were in a university town, so like median income was low because it was students. Melissa Schneider 00:21:16 They had a counseling center. There were a bunch of people there like kind of, you know, sort of a hip area. One zip code over the ratio was like 700, you know, two zip codes over it was 1200. And so we really kind of looked at that and thought like, I think you might be missing out on a lot of marketing eyeballs, because the population in your zip code is really small compared to like, you know, just want like one mile over. And so they were like, wow, that’s really compelling. Like, we might want to think about doing that little AB experiment. And then we were kind of off to the races to see if people would actually call, if they moved to a different zip code, or just change their address online to that zip code. Right. And then they could be like, oh, that location is full. We’re seeing people at our this office. And so that was something they were able to to kind of sink their teeth into and really test in the real world. Joe Sanok 00:22:06 Now once you open the location, like what are the things that you got to be thinking about as you’re opening that up. Melissa Schneider 00:22:12 Yeah. So that’s a, that is a probably a whole episode in and of itself. Joe Sanok 00:22:17 But yeah. Melissa Schneider 00:22:18 Exactly. Exactly. I would say like the, the short answer is that before you are like paying a dime for your office space, you want to kind of be looking at leases where they’re going to give you a month to, like set up and paint, or they might even give you a couple of free months to get your business going. You know, these deals are probably changing these days, but we recently, moved to a larger office in the city we’re in. They gave us ten free months and did the renovation. We were like, are you serious? But they were, you know, it was like a booming part of town. They, you know, they were trying to kind of, you know, level up as far as, like who was there. Melissa Schneider 00:22:54 They had a huge office building to fill and it was worth it to them. So like, commercial real estate is different than renting an apartment, you know, so people there are people willing to give you like some cushion to get going business wise. So that’s important to think about. We also didn’t want to have to do any major renovating, you know, like if we have to replace the carpet or paint or something, that was fine. But we didn’t want to be like, you know, demoing some ugly office from the 80s to rebuild because it just felt like too much investment in the early days, like do that, you know, a few years in when you need to move in the building to have more space or something. So I’d be thinking about those things, like, how can I give myself a cushion so that when we ramp up You know, we can be ready to go. I would also, like I said, be launching online a couple months ahead of time and getting your therapist started with a telehealth caseload. Melissa Schneider 00:23:42 you know, they can still come in for training at wherever. You know, they can still meet you in person and have in-person supervision and all that sort of stuff while the office itself is getting ready. and that way is just another way to, like, cushion your expenses. and then I would also just really be thinking about, just making sure that you’ve done the, the basics online, right, that you have a Google business profile that you have, not just ones like today page, but like a page for every therapist, a page for the practice. You can have a page for couples there, but you could have a page for kids and teens. Like when people get to your town, they should see like seven, like today pages just about you so that you’re hard to miss. make sure everyone has intro videos and then think about any other directories that are big in your area. So I would always be like, okay, if I want to open in Bloomfield, let’s Google like best eMDR therapist in Bloomfield and see like what’s coming up is, you know, second is it Zach doc is it grow therapy, something like that that can help you figure out where else you might want to list. Melissa Schneider 00:24:39 and then just, you know, do your regular networking, tell the local school, tell the outpatient hospitals, tell the psychiatrists, you know, just think about who needs to refer to your practice. you know, all of that takes time to build. But that’s what I would do to open in, like, the best position you can for a new business. Joe Sanok 00:24:57 so. Joe Sanok 00:24:57 Awesome. Melissa, the last question I always ask is if every private practitioner in the world were listening right now, what would you want them to know? Melissa Schneider 00:25:05 I would want them to know that I really think the therapy space is changing. I know I just read a, press release that BetterHelp is going to start taking in-network insurance. there’s a lot of telehealth only competition. I think that the way for smaller, you know, just mom and pop therapists, like, like us to survive is to have an in-person office and to have at least like a hybrid workforce. You know, people don’t have to be in five days a week. Melissa Schneider 00:25:34 But I think that one of the only ways to stand out anymore is that you see people in person that they can come meet you, that you’re not trying to connect with their kid on a screen. So I would really think about that upside that we can offer that some of these giants haven’t invested in. Joe Sanok 00:25:50 So awesome. Melissa, thank you so much for being on the practice of the practice podcast. If you are hearing this and thinking I want a competitor analysis, I want to work with Melissa. I want to scale and grow and continue to get to that next level. You can apply to work with Melissa over at practice of the practice. Com forward slash apply. thank you so much for being on the show today Melissa. Melissa Schneider 00:26:12 Thank you so much. Joe Sanok 00:26:22 All right. Tomorrow I’m going to be interviewing Melissa about should you take insurance. Is that going to help you scale. How do you survive in audits? You are not going to want to miss that episode at all. We have three in a row with Melissa and this was just day one, so make sure you sign up, and listen to the show for that two. Joe Sanok 00:26:40 Also, we couldn’t do the show without our amazing sponsors, and today’s sponsor is Psychology Tools. Whatever stage your practice is at, I know that using great resources is what you need. I know that when I was practicing, I would just go find different behavior charts or different, you know, ways to think about cognitive distortions, all those things. I would just find them on Google psychology tools is what I wish I had been using. It’s an online library of over 500 evidence based resources for whatever problems your clients are facing. it’s an amazing resource, but it’s also a good business tool for you because it boosts your productivity and your efficiency at your practice and helps you focus on just doing the counseling. Visit Psychology Tools com slash Joe to find out more and use code Joe 24 for 20% off new subscriptions. Again, that psychology tools dot Com slash Joe use Joe 24 for 20% off of new subscriptions also. I can’t wait to hang out with all of you down in Franklin, Tennessee that is just south of Nashville. Joe Sanok 00:27:38 That’s going to be October 1st. The third. I’m doing the closing keynote there at the Mental Health Marketing Conference, and I’m also doing a clinician workshop. We are sponsoring the entire clinical track at the Mental Health Marketing Conference. So head on over to MH marketing. Org. You can get 25% off your ticket for being a listener. Just use promo code Joe at checkout. Thank you so much for letting me into your ears and into your brain. Have a great day. I’ll talk to you soon. Special thanks to the band Silences Sexy for that intro music, and this podcast is designed to provide accurate and authoritative information in regard to the subject matter covered. It is given with the understanding that neither the host, the producers, the publishers or guests are rendering legal, accounting, clinical or other professional information. If you want a professional, you should find one.