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. This is the practice of the practice podcast with Joe Sarna, session number 155. I’m Joe Santa, your host, and welcome to the practice of the Practice Podcast, where we help you build a thriving practice you absolutely love. Joe Sanok 00:01:25 You know, we want both sides of that. We want it to thrive. We want you to just be killing it. and we also want you to love it. There’s so many ways that you can make money. let’s make sure we do it in a way that you really enjoy and that you are able to get to that next level. you know, when I think about my business practice, the practice or my former business that I sold mental wellness counseling, when I think about scaling, that’s not something I had a lot of mentors around. That’s not something that I knew how to do. I knew that, you know, I heard, like, you know, build a team. I heard, you have the ideal team player. You know, I need to put profit first. All these books that I would read. But then it was like, how do I bring that all together to just help things go a little bit smoother? and I am so excited to have Rob beer with me today. Joe Sanok 00:02:15 Rob is the author of Smooth Scaling 20 Rituals to Build a Friction Free Organization. Rob’s an expert in building high performance organizations for over with over 20 years of experience, and he’s helped so many companies scale, and he’s had notable clients like Crypto.com and tons of other ones. So Rob, welcome to the Practice and Practice podcast. Rob Bier 00:02:37 Thanks, Joe. Pleasure to be here. Joe Sanok 00:02:39 Yeah, well, before we got rolling, we were just kind of talking a little bit, which I always like to do with guests. And one thing you said right away, I got hooked into. And you said there’s a difference between scaling and growth, and I just want to start there. There’s a difference between scaling and growth. Tell me more about that. Rob Bier 00:02:56 Absolutely. So I don’t know why, but it seems that we as a as a people have a tendency to come up with new names for old ideas we used to talk about. We would agree on something, and now everybody seems to use the word align. And I feel like in the in the growth business world, scaling has simply become the cooler way of describing growth, but they actually mean very different things. Rob Bier 00:03:23 And so I think that’s been a bit unhelpful. Growth I think everybody understands what that means. More revenue, more people. Pretty clear. The technical definition of scaling is that you preserve the essential qualities of the thing as you enlarge it. So, for example, if I blow up a photograph and it becomes all grainy and dotty, then I’ve grown it, I’ve enlarged it, but I haven’t scaled it. But if I make it bigger and it’s still as high resolution and clear as it was when it was small, that’s scaling. So in an organisation, what that means is that your organisation was great when there were two of you and still great when you’re five of you, and should be just as great. We can talk about what great means when there are 50 of you. Joe Sanok 00:04:13 Yeah. So what are things that maybe like get in the way of that happening. Rob Bier 00:04:18 Well that is a very good question. And I’ve had the privilege of working with a lot of companies as they grew from very small, when the organization just seemed to work kind of naturally, everything just fell into place and then see how things fall apart as the organization grows. Rob Bier 00:04:36 And I’ve come to a few conclusions, which is that when you’re a very small organization, you do a lot of things that are very healthy, but you don’t do them consciously, they just happen unconsciously. What are those things? You build trust. You get to know each other as individuals. You spend a lot of time talking about what is the direction, what is the strategy, who’s going to do what. Everybody understands what each other person is good at and what their strengths and weaknesses are, and you try to play to those. If there’s a disagreement, you can’t really hide in a 4 or 6 person organization. So it tends to get surfaced and sorted. But when you are, let’s say, 30 people, none of those things is still true. You don’t necessarily get to know all your colleagues well. You don’t have that face time with them. You don’t necessarily know exactly what they’re up to or how they spend their time, or what their strengths and weaknesses are. And if there’s a tension, it’s very easy to just kind of let it go and bury it because we’re all conflict avoidant. Rob Bier 00:05:41 And so that all leads to what I call frictions in the organization and frictions over time compound and make the organization less effective. Joe Sanok 00:05:53 What are what are some of those frictions that you’ve seen be just like super common in maybe the counseling space or when people have smaller businesses and I don’t I know your book goes through 20 of them, but I just love to hear maybe one of them that for you, most likely our audience is like, oh man, that’s totally me. Rob Bier 00:06:12 Well, gosh, there are many. I think the root cause of many, many organizational problems is simply misunderstanding, right? We we hear something and we jump to a conclusion about what the other person intended. And and of course, mental health professionals are expert at helping people, you know, think through and dissect whether their interpretations of reality are legit and correct and valid and but but we all make those same mistakes. And so I would say one of the most common problems is tension building up. Because I think you’ve said something that I didn’t particularly agree with or appreciate, but rather than testing and slowing down, saying, Hey Joe, can you tell me more about what you mean by that and where you’re coming from and what’s the problem you’re trying to solve? And just listening, giving lots of space for you to fully explain yourself. Rob Bier 00:07:14 My experience is that when people do that 90% of the time, they may not agree with the other person, but they at least see that they’re coming from a good place, that their intentions are positive and that there’s some rationale for their point of view. So jumping over that step is very unhealthy. But we all do it. Speaker 3 00:07:38 Yeah. Joe Sanok 00:07:39 Now, so I’m thinking about practice, the practice. And, you know, we were just over ten years old. We have a team of probably 25 at this point. I was just talking with my coach, Sam, and, you know, as she and I talked, you know, we’re talking about different staff hires. And, you know, how much you have that balancing act of, okay, we’re paying this much for whatever that position is. We want to either give raises or expand or scale differently. There’s kind of the maintenance side of running a business of making sure that we do good consulting, we do good podcasts, we do good membership communities. Joe Sanok 00:08:15 Those are kind of core three things that we do. and then there’s there’s opportunities to grow in either within those three areas or outside of that. So you know, our IT team continues to grow and we’re helping people with websites. We’re helping people with social media management or implementing AI. And there’s always in a business this kind of balance between what you’re currently doing and where you could go. What would you suggest for me in regards to mindset, in regards to thinking through those things with the team, if we were to have a scaling lens instead of a growth lens, what would that look like? Rob Bier 00:08:48 That’s a great question. I think it sounds like you’ve already crossed the first chasm, which is there is a strong tendency for many people to hire people who look like themselves, who have similar skill sets. Right? Because that’s what they know and have confidence in and trust. And if you’re going to hire an IT person and you don’t know anything about it, that can be scary. and that can go wrong. Rob Bier 00:09:15 But the reality is there’s no alternative if you want to scale your business other than to hire people who have very different skill sets, than yourself. So early on, I’m a big believer this is not part covered in the book, but I’m a big believer in what I call try before you buy type relationships where maybe you hire somebody as a contractor or a consultant, and you make it very clear that if that goes well, you would like to bring them on board full time. But just being transparent, I don’t know a lot about it. I haven’t hired IT professionals before. I’m not sure I would even know what good looks like. So would you be willing to work with me for three months before we commit to, let’s say, getting married? So I think asking employees early on to share the risk of building the enterprise and not treating it as a, you know, parent child paternalistic thing, but saying, hey, you’re an adult. This is the situation. Help me to help you right by by taking a little risk and seeing if we can’t build an effective team and partnership together. Rob Bier 00:10:23 But definitely overcoming that fear of hiring people whose skills are very different than your own is is, I would say, one of the challenges. What’s your experience been to that. Joe Sanok 00:10:36 Yeah I think that for me we’re continuing to really look at, you know, the numbers side of it to have clear budgeting, to have clear like what does growth look like. What is scaling look like. So to know okay, if consulting is up 6% this year, if our memberships are up or if podcasts are up, like how do we know from data how to like when to hire and scale instead of, you know, my intuition or the team’s intuition. But to really go back to, okay, we want to get to this level. This is what’s worked. This is where we it’s an unknown. We don’t know, or we’ve outgrown our current team and need to bring in an expert. so I think getting even more data driven than maybe we’ve been in the past, which, helps, but it’s also not as sexy as, like, you know, the new flashy thing that you’re launching, right? Rob Bier 00:11:27 Well, it’s interesting, different people have a very different orientation towards running their business by, quote, the numbers or the data. Rob Bier 00:11:36 I do a lot of work with tech entrepreneurs and just, I guess, by the nature of their mindset, they often get very, very deep into that. And of course, there’s a very important and legitimate role for data to play. But my experience is that ultimately systems are dumb and humans are smart, so the data only tells you what you ask it to tell you. You know what you mean, what it what you’re looking for and And and having a group of people who can sit around and have intelligent, challenging conversations about what is that data telling us and what does it imply and how do we move forward. And building alignment and commitment as a group, I think, is ultimately the more important skill than just being able to, let’s say, collect and interpret that data. Does that make sense? Speaker 3 00:12:32 Yeah. Joe Sanok 00:12:33 And you mentioned kind of bringing in contractors on a part time basis and then maybe moving them into employees. Is there a danger to being too W2 heavy or a danger to being too contractor heavy? Rob Bier 00:12:45 I’m afraid I’m not really an expert in that. Rob Bier 00:12:49 obviously in the end, you want to get real commitment. I mean, I’m not sure about the legals because I don’t haven’t lived in the US in a long time. but in the end, you’re looking to get, you know, long term commitment, and it’s hard to build a practice, without that. So I do think if you were to contractor heavy, that can be very tiresome. And we can talk a little bit about what is, let’s say, the social contract, the implied social contract between a partner and yourself, somebody you bring on to help you run and build the practice. or a just an employee, right? A W-2 employee and a contractor. But I think as you move up that scale from contractor to employ to partner, one aspect of the social contract is I’m no longer asking you to just do a job right with narrow technical parameters. I’m asking you to help me build this business. Right. And that may involve all kinds of things that we haven’t anticipated. That means you’re thinking, what’s next? Not just what do I have to do? What’s on my to do list, but what is the company have to do that maybe we haven’t thought about. Rob Bier 00:14:04 And ultimately it’s fatiguing to be the sole founder of a business, because you’re the one who’s always waking up in the morning and going to bed at night thinking, oh, what about this? What about that? Should we do this? Should we do that? And as soon as you can get somebody who takes at least a little bit of that burden, that load off. my experience is that that makes the whole thing a lot more resilient. Joe Sanok 00:14:41 As a therapist, I can tell you from experience that having the right EHR is an absolute lifeline. I recommend using therapy notes. They make billing, scheduling, note taking, telehealth and e-prescribing incredibly easy. Best of all, they offer live telephone support. It’s available seven days a week. You don’t have to take my word for it. Do your own research and see for yourself. Therapy notes is the number one highest rated EHR system available today, with a 4.9 out of five stars on Trustpilot. Com and on Google, all you have to do is click the link below or type promo code Joe on their website over at Therapy notes.com and receive a special two month trial. Joe Sanok 00:15:24 Absolutely free. Again, that’s therapy notes dotcom and use promo code Joe on the website. If you’re coming from another EHR. Therapy notes will also import your demographic data quick and easy at no cost, so you can get started right away. Trust me, don’t waste any more of your time and try therapy notes. Just use promo code Joe at checkout. Now, most of our listeners at some point would love to work less, make more, take more time off while still doing really good work in the world. So you know what that sometimes looks like. It’s not always exactly this roadmap I’m about to do, but I’d say most commonly is someone starts a solo practice, they start to grow. They realize they need to hire an assistant so they have someone answer phones, do intake, scheduling, things like that. They start to grow so much that then they add their first clinician to the practice. and they launch that group practice, and then they, you know, going from 0 to 5 is really a struggle because that old mindset of wearing multiple hats and kind of just learning to be a CEO instead of just a clinician. Joe Sanok 00:16:30 Like, that’s a struggle. And then, you know, really when people get to about ten, they start to realize, oh, I need to, you know, really delegate a lot more. when you think about that flow. if someone says, I really want to start working less, making more, being more of a business owner, not as much, a clinician that is working in the business, say they’re in solo practice right at the beginning. Like what mindsets would you have them think through? And then we can kind of move into when they’re launching that group practice and then when they’re moving into that mega group practice, like in each of those phases, what what mindset should they be developing? How should they be working through what scaling looks like? So we’ll just start with the solo practice. what should that person be thinking about when they’re first getting going? If they know they want to eventually scale? Rob Bier 00:17:15 I’m going to sidestep that, but I will come back to it. There’s a great scene in the TV series Yellowstone where the the son, of Mr. Dutton, who runs the ranch, who’s the most involved in running it, say, is, you know, the father is talking about stepping back and retiring. Rob Bier 00:17:32 The son says, you know, I can do it. I’ve been doing the most. And he said, and the father says, you’ve been working the ranch, but you haven’t been running the ranch. Right. And I do think that there’s a difference. Other people use the phrase working in the business or working on the business. And indeed, as you move from solo to small group up to ultimately a business, you have to stop working as much, maybe not entirely in the business, and really focus on working on the business. So I, I would say from, you know, from the 1 to 2 stage, it’s really about is this somebody that you trust that you think has the same values that you can rely on? we can talk a little bit about delegation because there are I see people struggling with delegating effectively, and I think I’ve cracked the code a little bit on why they struggle. we can come back to that. But I do think that when it’s very, very small, whatever the person’s role is, you really need that strong personal alignment. Rob Bier 00:18:48 Whereas when you’re growing from, you know, 5 to 10, you’re not going to have the same intensity of relationship and interaction with each person. So then you start looking just more for, you know, role fit, professional competencies and role fit. but I do think that I actually asked when I coach CEOs, I asked them to draw what they think about all day as a pie chart. How much of your time are you thinking about marketing? How much of your time are you thinking about managing people in the organization, coaching and feedback, and hiring? How much of your time are you thinking about the numbers? How much of your time are you thinking about, doing? Maybe you’re still a practicing clinician and and then just asking them to reflect on, does that look like the right balance? Right. It will change over time. What does it maybe need to look like a year from now? And if the marketing side or the organization side needs to grow, where is that going to come from? And very often in the early stages of scaling, as you know, it just comes from our weekends and evenings. Rob Bier 00:20:01 We sort of don’t give anything up, and we end up working even harder when that was never the intention. So I do think that that that it’s an excellent practice to always map where is my mental energy going? It may not be the same as your hours. I think of this as more of a mental energy exercise. And where does it need to be going to get you to the next step? Joe Sanok 00:20:26 Yeah. One thing that I talked about in Thursday is the new Friday, is the idea of Parkinson’s law. And there’s two parts to Parkinson’s law. One is often reported and the other side isn’t as much. And the one side that’s often reported is that work expands to the time. Given that if we give ourselves, you know, two weeks to do something, it usually takes that long. But the other side that Parkinson discovered was the natural bloating of an organization. So he was looking at the British Navy, and he found that if something was added into that system, a sign off, a checklist, whatever, it was near impossible to pull that thing back out. Joe Sanok 00:21:01 And so I think that when we limit time on tasks and we limit how much we’re involved. Kind of what you’re just saying, if I have 20 things to do in the next week, but I only give myself time to do seven, I’m going to do the seven best things. You know, I’m going to do the clinical work. I’m going to make sure, you know, the billing is done. I’m going to, you know, do some marketing that makes sure that things come in and those things that are not the best use of my time fall by the wayside. And then I have to ask myself, well, why am I doing those if they’re not important? And, you know, maybe we need to eliminate it. Maybe we should delegate it. Maybe we should have some automation in there. Maybe we just shouldn’t be doing it. And so I think that that idea of getting leaner and leaner by you stepping back is such an important idea. what does that look like when someone starts to grow a group practice? When they’re growing into a mega practice? Like, what are other mindsets that maybe are more unique to those phases? Rob Bier 00:21:53 Well, I think you know what you describe. Rob Bier 00:21:56 Can we automate, can we not do it? And so on and so forth. is a very good mindset to have. But the reality is that any of those, you know, to automate something takes time and takes expertise. And that’s probably not going to be the founder. So I think the first step is always to delegate, right? If you are doing something which is taking up too much of your time and is not critical to the future success of your business growth, then you should find somebody and delegate it to them. And I mentioned that that is an area that I’ve had some insights into. Here’s what I notice. Kind of nobody wants to be a micromanager, but some of us may be by nature. And so that is a kind of form of under delegation, right, where you’re not getting the leverage that you need. At the other extreme, people often will hire somebody and say, oh, you’re brilliant, I empower you, I trust you, and they give them actually too much autonomy. Rob Bier 00:22:59 And that leads to a phenomenon that I call flail and then fail, right? They kind of flap about and eventually you lose confidence in them. And the point is that we need a more nuanced way of thinking. What is the right level of autonomy for this person at this time? And it will change over time. If I bring you in and you’re new, I need to be a bit of a micromanager. That’s actually quite justified because maybe you don’t understand our processes. You don’t understand our ethos. I need to give you quite regular and and and tight sort of feedback in order for you to learn. But maybe three months later, that would be totally inappropriate. And so the, the the key is to I would say there are two keys. One is to think about autonomy as a dynamic process and set targets together. So if you come to work for me, Joe, I might say I want you to work at this level of autonomy in 12 months where I don’t have to quality control your work, I could just tell you, give you broad direction, and And I trust that you will come to me if you need any guidance, etc., etc. but it’ll take us two three steps to get there over the course of the year. Rob Bier 00:24:14 And I’ll be giving you feedback not just on your work, but on whether I see you progressing towards that target level of autonomy. So the two keys are one make it dynamic and two, make it discussed. Don’t just have all this in your head, because then you might create misperceptions and misunderstandings. If I start out by micromanaging you, you might think, oh, I’ve made a terrible mistake joining Rob’s outfit because he’s a micromanager. Whereas in fact, all I’m doing is de-risking your early onboarding. Joe Sanok 00:24:47 Yeah. Now as people look at really kind of removing themselves from the day to day operations. what are some scaling principles or actions that that help them really step back at that point? Rob Bier 00:25:01 good question. So, I mean, scaling principle one is always shared vision, shared goal. And I don’t write a lot about this in the book, because I think it’s already been written. I think other authors have covered it well, but I think the experience of almost every business owner is that you can never spend too much time repeating the core message, who are we trying to be? What do we stand for? What are our values? What is our Northstar? What is the vision? What is our goal? To make sure that there’s truly alignment, but also not just talking about it, but listening and asking people, you know, is that resonating with you? Has the situation changed? Do we need to adapt that in some way? And so having an ongoing dialogue about where are we trying to get to? And does everybody understand how they can contribute to that direction. Rob Bier 00:25:59 So ultimately I am a big believer in dialogue as more powerful than, let’s say, systems. So of course there are systems you need to implement accounting systems and budgeting systems and work tracking systems and all those things, and those are all necessary. But the best performing organizations aren’t the ones with the best systems, in my experience. They’re the ones with the best and most open and constructive dialogue amongst the key people, because things change and the whole setup of how you’re going to run your business today and what systems should what we should measure and focus on might be very different, let’s say, in Covid post-Covid. Right. All these changes that we’ve gone through. The only way to be continuously adaptable to the changing environment is to have a continuous dialogue with your key employees. Joe Sanok 00:26:56 So awesome. we could go on and on. But the last question that I always ask is if every private practitioner in the world were listening right now, what would you want them to know. Rob Bier 00:27:06 Well, I would want them to know that the problems of scaling are highly predictable. Rob Bier 00:27:13 They’re largely a numbers game. And the reason I wrote my book is that I noticed that there was nobody describing these problems, and so founders were bumping into them over and over again as if these problems had never been discovered. So I would say honestly by my book, and read it, if only to get a sense of what’s ahead, what are the bumps and roadblocks and stumbling points ahead as you scale so that you can start to anticipate and plan for those and hopefully avoid them. Joe Sanok 00:27:49 And Rob, if people want to connect with you where should we send them. Rob Bier 00:27:53 my website Rob beer.com. Rob beer or of course you can find me on LinkedIn. I’m based in Singapore, but I spend a lot of time in both London and California. Joe Sanok 00:28:06 So awesome. Well, thank you so much for being on the practice of the Practice podcast. Rob Bier 00:28:10 Thank you Joe. Joe Sanok 00:28:20 Well, if you are looking to scale more, we have Level Up week right around the corner. That is going to be September 16th through 19th. Joe Sanok 00:28:29 We are doing 16 live webinars that week, bringing in our favorite experts, having all sorts of focus groups and people that are going to be sharing what they’ve been learning for every phase of practice. So whether you are just getting going in solo practice, maybe you’re considering launching a group practice or you have a group practice already going, we have something for you that week. You can read all about that over at practice of the practice. Com forward slash level up again that September 16th through 19th. Also, don’t forget that I’m going to be at the Mental Health Marketing Conference giving their closing keynote on Thursday. That’s in early October. So make sure you check that out as well. And we could not do the show without our amazing sponsors. Therapy notes is our sponsor. They are the best electronic health record out there. They are amazing. They help you with your transition from wherever you’re coming from. And they have live support. They have telehealth built right in. They automate the billing. It makes things scale so much easier for you. Joe Sanok 00:29:28 All of our friends that are billers are like therapy notes is the one to go with, so head on over to therapy notes. Com use promo code Joe at checkout to get a couple months for free. 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 silence 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.