Joe Sanok 00:00:00 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. You’re also someone who’d 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 matched 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. This is the practice of the practice podcast with Joe Sarna session number 114. Welcome to the practice of the Practice podcast. I’m Joe Santos, your host, and I am so excited you are hanging out with me today. Today we are giving you behind the scenes in regards to our membership communities. Joe Sanok 00:01:16 And so a lot of our consultants are doing teachings every single week. every Tuesday, Wednesday and Thursday we have live teachings going on in our membership. So we wanted to give you a little behind the scenes. So we’re going to be hearing from Nicole Ball talking about what to do when referrals are slow, our basics with Andrew, client retention with Ashley, scaling with Nicole Ball, choosing the right project management systems and all sorts of other things over the coming weeks. I can’t wait to dig into this with you. If you want help from one of our consultants, please head on over to practice of the practice.com/apply. I’ll chat with you for 30 minutes to determine if one of our membership communities or consulting might be right for you. Now let’s get started with this episode. Nicole Ball 00:02:02 Hello everybody. My name is Nicole Ball. Very excited to see all of you. I’m seeing lots of new faces I haven’t seen before, so this is wonderful. I’m going to be hosting a three week series on what to do when referrals get slow. Nicole Ball 00:02:14 And today is going to be our first, our first little dive into some discussions surrounding that. If you’ve never been to one of my webinars, before, you know that I like to make them fairly interactive. So sorry. Not sorry. I’m also a university that that’s where that comes from. So, forgive me for my Socratic questioning, and my seeking involvement from you. There’s certainly no, obligation to participate if you don’t want to, though. but because we do have so many new folks today, I love to introduce myself and just tell you a little bit about me, especially for those of you who are going to be continuing to follow along with the series. So my name is Nicole and I have been with Practice the Practice for just a little while now, but I’ve also known Joe for a very long time. So, I actually purchased Mental Wellness Counseling and Joe in 2019, and since then I’ve taken it to be $1 million practice with relocations in over 28 clinicians. And as I’ve grown and grown and grown, I’ve had my bumps and I’ve had my two steps forward, one step back. Nicole Ball 00:03:24 I’ve had my hardships and I’ve had my successes. And so, being a part of the practice of practice, community has been great because I’ve gotten to share those and share them in a community, that is supportive, but also a community where I can, give back to and share those experiences and hopefully help others grow in their experiences. I talk a lot about money because that’s why we’re all here, right? And sometimes it’s uncomfortable and we don’t want to talk about it. But I think when it comes down to it, you have joined at the practice of the practice community because you want to see those numbers higher for yourself. And I like to share what’s worked for me and from other practice owners I’ve worked with, what’s worked for them. when I’m not running my practice or seeing clinic or seeing clients, I also provide supervision for my limited licensed social workers in the area. I also teach full time for Ferris State University in their graduate and undergraduate social work program. And I also got two kids in three dogs and live in the middle of the woods an hour away from everything. Nicole Ball 00:04:30 So when I’m not, doing all of this, I’m trying to relax and enjoy Northern Michigan. For those of you who’ve never been to Northern Michigan, I encourage you to give it a try. It’s beautiful up here. And, it’s a great place to, to get some relaxation time in, so. All right, so that’s my little intro. I think we have too many people for me to go around and do intros. But if you’ve been to some of my webinars, you know I like to meet everybody and see what everybody’s all about. But I think we’ll save that for another time because we have a lot to get to today. So this is going to be a three part series. And in this first part, I talk a lot about figuring out first why referrals are slow. And I, I think the really, really important thing to remember is that it happens. There’s a lot of ebb and flow that happens. And I’m sure as practitioners you’ve seen that you’ve seen, I don’t know about you, but, you know, December is always a really slow month for us. Nicole Ball 00:05:30 July is usually really slow month for us. And then we have those peaks about three weeks after kiddos have been back to school, after the new year. And people are setting their, you know, New Year’s goals, and after the holidays have kind of messed up some, you know, family dynamics. So traditionally, I think that there is going to be some ebb and flow that just inherently happens in the work that we do. But one thing that clinicians and practice owners do tend to do is they panic. And so you’ll notice in my little, blurb about this, about today’s webinar, you’ll notice I said we don’t want to panic. So I think that, there’s a few things. For those of you taking notes today that I would like to highlight. And number one is going to be don’t panic. Because with that ebb and flow, even if you do nothing, chances are it will come back up. And so even if you say, wow, we’re really seeing a low number of referrals, the phone hasn’t been ringing as much. Nicole Ball 00:06:31 I wonder what’s going on. our tendency as practice owners is to protect our livelihood, and our practice is our livelihood. And so we automatically go into protection mode and we go into save mode, and we go into Mama bear or Papa Bear mode, and we tried to save our little baby, which is our practice. And sometimes we make snap decisions that could hurt us financially or snap decisions that are just simply unnecessary. So number one is don’t panic, because what you will often find is even if you do nothing when referrals are slow, it’ll pick back up. Eventually something will bring it back up because I think that’s again the natural ebb and flow of the work that we’re doing. Sometimes when we panic, not only does it hurt us financially because maybe we purchase a marketing package, or we dump a bunch of money into Google that we don’t really need to. Or maybe we, I saw practice owner once think, well, I need to hire a marketing manager now. And they went out and they hired a marketing manager, and they were really doing the exact same thing that she was able to do, with an hour a week of her time. Nicole Ball 00:07:42 And so point being is panic. Not only does it cause you undue stress? But it makes you not able to be there for your clients, or for your clinicians or for your families the way that you need to. So don’t panic. Number two, and basically the theme of today is going to be, well, let’s talk data so we can get data from lots of different places. Number one, we want to collect data from just anecdotally. And usually this is either from you if you’re answering your phones, hopefully you’re at the point where you’re not answering your phones anymore and you’ve delegated that to somebody else. But I always the first thing I do, if I feel like referrals are getting low enough for me to take an interest, is I reach out to my intake coordinator. Now for my practice, my intake coordinators, the person who answers all the phones, all the website submissions, and she is the one who decides and makes that executive decision concerning which client needs to be put with which clinician at the practice and at the three locations. Nicole Ball 00:08:50 So the first thing I do is I just just very casually reach out to her and say, hey, referrals have been low. What have you seen lately? That person who is answering the phones every day, and again, that may be you. If you’re still at that point, that person has a lot of insight into why the phone isn’t ringing and maybe why, you know, they’re not seeing those website submissions. What they also might have is a little inclination as to what the calls are that are coming in and maybe some changes that need to be made, which I’ll talk about in a moment based on the calls that aren’t coming in. The other thing that your intake coordinator can do is they can track that data. And I know that I’ve worked with a few of you here who we’ve talked about that before, the importance of who’s ever answering the phone to track data, to know where these referrals are coming from. So if I reach out to Emily, my intake coordinator and she says, yeah, usually we get about 5 or 6 referrals a month from the pediatric clinic down the road. Nicole Ball 00:09:51 And this this month we’ve gotten nothing. That tells me something about the pediatric clinic. Either, you know, they don’t have clients right now or they don’t need referrals or referrals sent out. Or maybe they have another practice they’re coordinating with now. Maybe they’ve forgotten about us. And maybe we need to make another little, you know, coffee date, or we need to send over some of our information. Or maybe we just need to make a quick phone call to tell them, hey, we don’t have a waitlist anymore. We’re accepting new clients. maybe when Emily looks at the data that she’s tracked, she says, wow, we’ve gotten a lot of referrals for United Health Care. And because we don’t take United, I’m sending those clients right out the door just to another practice. Rather than panicking when I get that information from Emily or from whoever it is who’s answering the phones for you, I can identify what moves I’m going to have to make next without panicking and making moves that are unnecessary. So speaking with your intake coordinator is the very first thing that I’m going to be doing. Nicole Ball 00:10:51 You might call them your receptionist, your administrative assistant, whatever name you have for your person who takes those phone calls, that is always my step one for data collection because they in themselves, they they have the power to hold on to that data. And it may just be very anecdotally, I might call and she says, yeah, we’ve gotten a lot of calls for couples counseling this week. I don’t know, is it a full moon or something? I don’t know what’s going on. We’ve gotten any phone calls for, you know, kids or adults this week. It could just be a fluke. And that’s okay too. But hearing that from her makes me feel good. Makes me know that. Yep, the phone is still ringing. It’s just not ringing for what we need right in this moment. another thing that often happens when I reach out to Emily is and this actually just happened to us recently, she will say, well, Nicole, We’re getting a lot of calls, but the only therapists that have openings right now are virtual therapists, and everybody who’s calling wants face to face. Nicole Ball 00:11:49 That’s another bit of anecdotal information that’s useful for me, because that tells me, okay, you need to hire more face to face clinicians. So you can see here from the data that I’m collecting anecdotally, or maybe if she’s tracking it from my, from my intake coordinator is with that information, I can then start looking to see, number one, is there a pattern. And then number two, do I need to start making some decisions as a practice owner? Do you want me to bring on more face to face clinicians? Do I need to bring on more virtual clinicians? Do I need to reach out to the pediatric clinic and let them know, hey, we’re still here and we’re accepting new clients? Do I need to, you know, do I need to maybe consider accepting UnitedHealthCare because their insurance company we’ve decided not to work with? But wow, if we’ve gotten three calls this week and we’re sending them off to other practices, Maybe I need to reevaluate my insurance strategies and my decisions there. Nicole Ball 00:12:44 So rather than jumping the gun and panicking and making decisions based on fear, me talking to the person who’s answering the phones gives me a lot of information that is going to help me to determine where to go next. So that’s my number one, is talk to the person answering the phones before I go on to number two. What questions? I’m always happy to answer questions and rather than waiting till the end, I like to do it as we go, because I do tend to break these things up into manageable pieces. So does anybody have any questions specifically about reaching out to your intake coordinator? Sabrina. Speaker 3 00:13:22 Other than the things that you’ve already mentioned as far as like data tracking points or anything else, as I’m in my dashboard right now that I should be adding to track insurance. Nicole Ball 00:13:33 So face to face virtual insurance, children, because we go through a lot of ebb and flow with kids. Sometimes we get tons of calls for kids, sometimes we’ll go, you know, weeks without a call for kids. Nicole Ball 00:13:45 couples, I have her track specific insurance. So, for example, we don’t accept Medicaid or Medicare, but I want to know, even though we don’t accept it, I want to know how many people were turning away so that if I ever do get to that point where I’m like, you know what? I’m ready to accept Medicaid. I can, you know, look at, you know, years worth of data and say, okay, this is how many clients we would have had if we would have kept it. So I have it by specific insurances that here in Michigan are typical insurances that we accept. the other thing that I have for track is, clients from out of my region because we, you know, we’re if you’re familiar with Michigan. So here’s Michigan, we’re right up here and our three clinics are kind of in this circle here. But sometimes we get calls from up here. Sometimes we get calls from over here. sometimes we get calls from up here in the U.P.. And so I have her track location. Nicole Ball 00:14:45 simply because if I notice. Wow. We’re getting a lot of calls from, like, way up here by, like, let’s say Gaylord, Michigan or Mackinaw City, Michigan. Then maybe I need to consider opening up a fourth location. If I’m getting enough calls, maybe that’s an area that I need to go because people are not calling the clinicians in their area. They somehow found me. So that’s another one. Is, geographic location. and again, some people, you know, she can’t catch it all, but she certainly does a great job for me doing that. So tracking that is important. I also like to track. How did you hear about us? So, it’s almost always our website, but sometimes it’s from a friend or from a school or from another social worker. or sometimes even another practice, you know? So I always like to have her track that as well. when she can squeeze in that question, which sometimes she can’t because people call in crisis. But, sometimes she’s able to. Nicole Ball 00:15:42 So hopefully that’s helpful. Anybody else have a question about tracking that data or speaking to your intake coordinator? Okay. So the second thing I do, if I have decided I’m not going to panic, and then I’ve talked to my intake coordinator to collect that, tracking that she does or to collect that anecdotal information that she has. The next thing I do is if you go to your Google business page, and most of you should, if you have your, you know, your Google Business page, you should get monthly reports. So they email you a monthly report and they tell you, you know, how many people visited your website, how many clicks you had, how many people ask for directions, how many people click on the call, the phone number. And the great thing about that is they give you the data when they email you that, they’ll tell you what percentage the calls are up or down, what percentage? The clicks are up and down and so on. So that’s the next thing I check. Nicole Ball 00:16:39 If I haven’t gotten that email, I’ll go right to my Google Business page and click on the analytics and I’ll identify, okay, clearly people aren’t clicking now if people are clicking and they aren’t calling or aren’t scheduling, something’s going on, right? So somehow they’re finding me, but they’re deciding I’m not the best fit. So that’s when I need to start thinking, okay, do I need to update my website? do I need to make it more user friendly? which interestingly enough, is something I did a couple of years ago. I had a lot of fluff on my website, and I had a lot of click here, click here, click here. And I cleaned it up a lot. So it’s just very streamlined and simple. And that did make a difference. And I made that decision based on the Google Analytics is people were coming to the site, but they weren’t following through. But what I did is I had, you know, at that time, 25 clinicians all on one page that people had to, like, click on. Nicole Ball 00:17:35 And it was kind of confusing. point being, though, is that those analytics gave me a lot of information as to what I could be doing differently. they also tell me a lot about what’s changed from the month before. So they will the analytics will tell you whether your calls are up, your clicks are up, your people looking for driving directions is up or down. and that information is really helpful because I think, those clicks matter. And for any of you who want to have that million dollar practice, I will tell you your website is your biggest asset. and, you know, we’ll talk about that in another webinar. But if you want to put your money into anything, I always recommend putting your money into SEO. because that search engine optimization is definitely going to get people to your website and get you the clicks when people type in counseling in your area, you want to be the first that pops up. And so that Google Analytics makes me sure that I’m still staying on top. And if not, if I’m not getting those clicks and that’s the reason I’m not getting referrals, then that tells me, nope, I don’t need to reach out to the pediatrician. Nicole Ball 00:18:47 I don’t need to hire another clinician. I need to work on my website. Maybe I need to bite the bullet and pay for a Google boost, which I hate doing, by the way. But those of you who’ve been with me before know that I hate doing that. but maybe I’ve got to pay for a Google boost just to get things up a little bit. You know, maybe I need to do a couple of blogs to get my SEO up a little bit. Maybe I simply need to move a keyword around on my welcome page, so that my welcome page, is more attractive to the keywords that people are typing in. Other great thing about Google Analytics is it’ll tell tell you oftentimes what the keywords are that you’re being clicked for. something that I never thought of is, couples counts. That’s what it was. Couples counseling in Traverse City, Michigan was something that people were googling, but my site wasn’t coming up first because my couples page was so far down the line. But if somebody just typed in counseling in Traverse City, I would come up first. Nicole Ball 00:19:45 So again, that tells you what it is that you need to fix in your website. So number one, speak to the person who answers the phone and collect that data. And then number two is look at your Google Analytics. it is very, very helpful. And there’s some months I don’t even look at it. They send me the email, I’m like, okay, whatever, things are going good, I don’t need to worry. But when I dive into it and I really look at where those clicks are coming from and where those searches are coming from, that gives me a good, good idea of where I need to put my money and my time and my energy. All right, so before I move on to the next thing, what questions do you have about number two, the Google Analytics. Any questions? Speaker 4 00:20:31 Sorry. Yeah. When you say Google Boost, do you mean paying for a Google ad? Yes, yes. I was just like, is this a thing that I don’t know about? No, I can’t, I call it a, I call it. Nicole Ball 00:20:41 A boost because I never, ever use it unless I need a boost. Speaker 4 00:20:44 Yeah. Okay. Nicole Ball 00:20:45 I really I try to really, really focus on my search engine optimization. So I want people to type in counseling in northern Michigan, and I want to come to the top every time. And if I’m not at the top and I’m coming like third, fourth, fifth, six, 12, then I’ll do a Google boost, if necessary. And then if I don’t feel like I need to do the, you know, Google ad, then I will take a look at my website and I’ll find out what is it that I need to do to get that back up there. Speaker 4 00:21:15 Yeah. That’s interesting. I just want to just share a quick I turned off my Google ads at the very end of March. And actually it did not affect the. Yeah. So I don’t I mean it’s only April 9th, but I feel like I have to like look around and like you’re saying about the SEO, like maybe I should just be focusing more on that. Speaker 4 00:21:35 then if, you know, if that’s the data for the rest of April. So. Nicole Ball 00:21:41 Yeah. And it can get pricey, you know, doing the Google ads. And another thing that I find is sometimes and this is again, it’s just anecdotally, what I’ve heard from people is if they see something that is an ad, they’re like, no, I want to go to the ones that are actually up here. I don’t want to go to the one that somebody paid for. One is the actual top. And it might be because they have lots of five star reviews. It might be just because of their, you know, the collaboration that they have with other agencies, it might be because of the, the blogs that they have could be because of keywords. But whatever it is, you know, people are interested in who’s at the top without having to pay for it. Speaker 4 00:22:20 Yeah. Thank you. Nicole Ball 00:22:22 Yeah. No shame in paying for it though, if you have to. I’ve had to do it before. Nicole Ball 00:22:25 I just try to avoid it. I try to pay nothing for marketing. That’s always my goal. Build relationships and they will come as kind of my motto. Okay, so number three, I want to I want to know what decisions I may need to make about my future. So the data that I have, the data that I’ve collected. I think we always have to start with, well, where are the referrals coming from? Because if referrals are low, right, you’re still getting something. So where are those ones coming from. So we talked about where they might not be coming from. But I think it’s also important to look at where they are coming from. And if you notice that, wow, a lot of referrals are coming from and I keep using the pediatric, you know, clinic as an example. But if you’re like, wow, we’ve gotten a lot of referrals from the pediatric dentist or I’m sure the dentist, but we’re not getting any referrals from like our website. We’re not getting any referrals from wherever. Nicole Ball 00:23:29 Maybe that’s an inclination for you to consider reaching out to other pediatric dentists or other pediatric clinics in your area. if I notice that I am getting a lot of referrals from, our sleep study, we had a sleep, our sleep study clinic. We were getting a lot of referrals from them, and I was like, wow, I’ve never thought about referrals from a sleep study clinic where other sleep study clinics are there that I could be getting referrals from. So when we know where they’re not coming from, it’s also important to know where they are coming from, because then we can identify what additional outreach opportunities they are. I don’t really reach out to the schools very much, but there was a point last year where we were getting a lot of referrals from one particular high school in our area, and I thought, wow, we’ve gotten like 3 or 4 For referrals this month from this one social worker in this school. Why don’t I have a relationship with all of the schools? So that’s when I started reaching out to all the social workers and saying, hey, I know the work you all do is hard. Nicole Ball 00:24:32 And I, you know, I’d love to see how we can collaborate and help out and kind of, you know, provide some of that back and forth. And now we get steady referrals from all social workers. But if I didn’t know where those referrals were coming from, then I certainly wouldn’t have been able to make that decision to reach out further. So that’s number three. So where are they coming from and what does that mean to other branches of that same kind of collaboration that I could be reaching out to? Okay. Number four, I, I know that I already talked about the data that my intake coordinator collected, but I kind of use this as number four simply because it provides me with comfort to know that I have, opportunities to grow more than I have grown already. Meaning, if Emily or your intake coordinator is tracking insurances that are calling, that tells me that I really, really should consider taking those insurances. I’m going to give you the example of priority health. a few years back, we were not accepting priority health because of their low reimbursement rates that we had heard through the grapevine. Nicole Ball 00:25:50 And I see some head shaking. So, yeah. And, I thought, you know, wow. Like, I don’t want to I want to get paid what I’m worth. And because of that, I’m gonna have to make some hard decisions on which insurance companies not to, credential with. But when I first started having our intake coordinator tech track data, she’s like, wow, Nicole, we are we’re sending a lot of people with Priority Health away a lot. And I said, well, what do you mean a lot? And I don’t remember the number. I’m not going to make up something, you know, extraordinary. But it was a big number. And I thought to myself, wow, if I said yes to each one of those clients and they stayed on weekly with a clinician, the potential to gain even though the loss from what my usual, you know, service fee rate would be, would be astronomical. And because of that data that she was tracking, I decided to accept priority health. Nicole Ball 00:26:45 And now we get a lot of money from Priority Health every month. A lot. Now, are we getting paid? What may be Blue Cross Blue Shield pays us? No. But the great thing about insurance companies is they give you a little bit more every year. So now that we’ve been with them for a few years, we’ve seen that little bit of an increase that makes it worth it. Not only does it make it worth it, but again, the amount the volume of clients that I get now from Priority Health is so high that it really doesn’t matter. You know, it really does not matter what they pay. They could be paying $20 less than I would still, as a practice owner, be making money and my clinicians would still be making decent money, simply because of the volume. So that’s my you know, that’s my next one is just making sure that in that data, you’re looking at the things that you’re not doing in an effort to make those bigger decisions down the road. Nicole Ball 00:27:40 Because if you want to get to a certain point and we’ve talked about this before, my other webinars, if you want to go watch them, but if you have a number in mind, I want to I want my practice to make this much money this year. Or as the practice owner, I want to walk away with $400,000 this year in my pocket. You can reach those numbers, but you have to identify how many clients do you need to see and how much money do you need to bring in, how many clinicians do you have to have, and so on. And the only way that you can reach those numbers sometimes is by making those tough, longer term Decisions. It would be beautiful if we could all stay private pay. And for those of you who are rock stars and private pay, I just it’s just so cool that you’re able to do that. But I knew for me that to get to the growth that I wanted to see, to be able to retire by 50, to be able to do all those things that I want to do down the road. Nicole Ball 00:28:31 I knew I would have to make some of those tough decisions, and accepting insurance was one of them. Now, I’m not trying to sell that to you today. What I’m trying to sell you is tracking the data will help you decide what’s going to help you grow long term. Joe Sanok 00:28:51 Something always comes up when you’re running a private practice. Well, Augusta’s payroll and HR services can make it a little easier. Gusto was designed for you, the small business owner. They take the pain out of running a business, automatically calculating paychecks, filing payroll taxes, setting up open enrollment. Gusto does it all. Want more time tracking health insurance 401 K onboarding commuter benefits. Offer letters, access to HR experts. You get the idea. With gusto, you can focus on the joy of running your business. It’s super easy to set up and get started, and if you’re moving from another provider, gusto can transfer all the data for you. It’s no surprise 99% of businesses said the value they get for gusto is worth the price. Joe Sanok 00:29:39 And here’s the best part because you’re a listener, you get three months totally free. All you have to do is go to gusto comm forward slash Joe again. That’s gusto comm forward slash. Joe, I’m telling you, you’re going to love gusto. Get started today. Nicole Ball 00:29:58 Last thing. And then we’ll kind of open it up to dive in a little bit deeper. My last thing, and this is simply I don’t want to say this as a panic move, because I told you in the beginning not to panic, but let’s say that you’ve gotten to the point where you’re like, okay, Nicole, I’ve done all of these things and I’ve talked to the intake coordinator, I’ve looked at the Google Analytics, I’ve tracked my data. You know, I’ve done all this. and I will talk about this next week as well. But sometimes I do an email push, I email my old clients, I email the clients that maybe I discharged six months ago and I just do a follow up. I do not have a formal follow up, procedure. Nicole Ball 00:30:41 And so when I discharge a client, I usually just tell them, hey, you know, if you don’t mind, I’ll just do a follow up or I’ll do a check in, you know, down the road and just see if you need anything. Oh, yeah. Great, great. And I will tell you every time I do an email blast to my former clients, I get at least three of them that say, oh my gosh, thank you for reaching out. I’ve been wanting to get Ahold of you. I would love to schedule something. some people consider that a little bit unethical, but what I want to tell you is that I’m not reaching out to my clients from years and years and years ago. I think that would be pushing it a little bit. And so I don’t reach out to my old, old clients. They know where I am if they need me. But the clients that I’ve discharged, usually within the last year, I will reach out just to do what I call my follow up, and I will just check in. Nicole Ball 00:31:26 I hope you’re doing well. If you need anything, let me know. I’m not currently currently accepting new clients, but I’m willing to. Or I am accepting old clients as needed. Whatever you want your wording to be. I kind of use that follow up strategy as a way to boost when things get low. and that does happen sometimes, where things just get a little low and, you know, your timing is everything. And so that’s something to consider. I don’t call it a panic move because it’s more of like my follow up, procedure. But I guess if you’re looking at it, you know, analytically, you could say it’s a little bit of a panic move. But when worse comes to worst, that is something that you can. certainly, do and it it works every time for me. I at least get a few clients, and the clinicians that I supervise. Same thing, you know, when their referrals are low and, you know, we’re just having a hard time. Nicole Ball 00:32:19 I say, you know, why don’t you just do a follow up with your clients and check in? And every time they get at least one client that says, thank you so much, I would love to get scheduled. Life has been crazy lately, so sometimes clients just need that little boost to say like, hey, I’m still here if you need me. And they take up that invitation strategically when you do, that is up to you. but, you know, I think that that’s something that can be helpful. So questions questions about that okay. Now I always save time because I want to hear from all of you because chances are there’s something that’s on that’s not on my list here that has helped you when referrals get low and I would I you know, I’m always about sharing the wealth and sharing our wealth of information that we have as practice owners. So is anybody willing to share what’s worked for them? So something that they’ve done at their practice when referrals get low and it worked for you. Speaker 5 00:33:17 so, Nicole, before we get to that, actually, I had a question. I just couldn’t find my, my camera, so. I’m sorry, but, so. Yes. So I wanted to ask the question, I guess, to you. To you and also to the group about, like, SEO, you know? so I definitely feel like I’m a late bloomer when it comes to that because I’m, I spend a lot more time focused on, like, social media analytics when it comes to social media. So do you have any recommendations on how to get started with, like prioritizing on the SEOs or a company you work with or anybody that you guys work with when it comes to SEO or where should I? What should I do to start off? Nicole Ball 00:33:53 Anybody want to grab this before I do? Okay, so it depends on how much money you want to spend. So if you have the money and you want to put your money into SEO. There’s lots of great companies you can do. Nicole Ball 00:34:05 Jo, I don’t remember the company that Jo was working with now, but I know that there’s a discount you can get on practice. The practice? Com or a company that he works with. So I’ll. I’ll look that up for you and find that. so if you want to put the money in, you can look for, you know, local companies in your area that do that, you can look for, you know, there’s people who can do that for you. And I think that if you have the money. But it is a lot of money. I mean, you can spend anywhere between 5 and $8000, you know, you get your money back. Yes, you will absolutely get your money back, because that’s the power of search engine optimisation. You will get your money back eventually. but you can hire a company to do it. The way that I did it is I watched the heck out of YouTube videos, and I just learned how to do it myself. And the way that you’re going to do that is with keywords, with blog posts with separate pages for each clinician, separate pages for each. Nicole Ball 00:35:08 you know, the clicks matter. So however many clicks you’re going to get is going to keep your Google boost. And I usually tell people, do a little experiment. Have all of your friends and family click on your website in a 24 hour period. Just just as a little experiment, have everybody go click on your name on it a little bit. What you will find is that if you check where you’re standing is in Google, 48 hours later, you’ll see it boost up. So it’s all about how many clicks, and the more clicks you get, the better. So how do we get people to click? We get them by having key search terms. you know, we have blog posts like five things to do when you’re feeling anxious, right? by having specific pages to specific needs. So if you need marriage counseling, here’s a page on my website about marriage counseling. If you need substance abuse counseling, here’s a page here. And so on. So I can’t tell you how to do it because I’m not an expert at all. Nicole Ball 00:36:07 But I will tell you that if you spend enough time listening to podcasts and Jo Jo has some really good podcasts with SEO folks. one of his early ones from a long time ago really helped me out years back. But, but yeah, I just watched YouTube videos and listen to podcasts, and I just tried to figure it out myself. If I had the money back then, I definitely would have hired somebody. But I think that comes down to like the, you know, what’s the word I’m looking for the like if we just everything’s figured out all right, like everything is figure out, even if it’s not in your realm. So that’s kind of the the attitude I came with is I am not computer tech savvy at all, but everything’s figured out a little. And if I watch enough YouTube videos, I can do it. I fixed a toilet last week because of a YouTube video. If I can fix a toilet, I can boost my SEO. So hopefully that’s helpful. Does anybody else have anything that’s helped them, move up in Google before? Speaker 4 00:37:07 I would just add this, that, I think just like an easy thing that I know that I went and made sure I did, is that anywhere that I like, whether it was an Instagram page or in my emails, like, make sure you’re make sure your website link is there. Speaker 4 00:37:21 so that people just from random places are like, you know, if, you know, if you have an Instagram page, even if it’s not like pop in, like if someone’s on your Instagram page and they think, oh, I’d like to learn more about this. If you’re, if your website is right there, they’re just going to click it. If they have to leave the site, they’re going to forget. And so they’re never gonna my email address is like attached to like, any type of thing I send or, anywhere I’m visible. if I’m, if I’m in Facebook and I’m responding to something like about a referral rather than put my email like if it’s like, I’m looking for a couple’s couples counselor in Pennsylvania. Rather than put my email and say, email me, I just put my website. So then it’s just like people are clicking it constantly. So that’s something that I like prioritized, and I think it’s probably had a positive impact. Nicole Ball 00:38:08 Oh for sure. Thank you. Farai I forgot to mention that because those are called backlinks. Nicole Ball 00:38:13 anytime you have a backlink to your website. So this is when your website link pops up somewhere else Facebook, Instagram. I write an article in our local newspaper every month and the digital copy of that, I always have my link to my website. if it is, if somebody does an article about me or I’m a, I’m, you know, a guest on a podcast or I do collaboration with somebody no matter what, I have my website link there because anytime somebody clicks, member clicks matter. But anytime they click from another website to go to your website, that’s called a backlink. And those backlinks are going to boost you on Google as well. I don’t want to get into five star reviews today because I know that’s controversial, but five star reviews get you up there too. Speaker 4 00:39:00 Are you going to get into them in in part two? I’m not. We all know clients. Nicole Ball 00:39:05 Can’t leave us reviews and we can’t ask client. I mean, clients can leave us reviews and they usually do when they’re angry, right? but, we can’t ask clients to leave reviews. Nicole Ball 00:39:16 But what we can do is we can ask the people that know about the work that we do to leave us reviews. So I can ask, you know, I can ask another social worker in town that I collaborate with like, hey, if you like the collaboration that we did, you know, feel free to leave me a Google review and everything helps. And she’s like, oh my gosh, yes. So she gets on and says, Nicole was great to collaborate with. we did this project together to serve, the folks in our area experiencing homelessness. would recommend she’s not a client. She’s never seen me as a clinician, but she knows me as somebody in the community. And even though somebody might never click on that or they might click on it, I still get a five star review. So I know that some people have some ethical concerns with that. And I could see those concerns, especially as a researcher. but I will say I, I’m getting feedback and I, I don’t encourage them to lie. Nicole Ball 00:40:12 Right. I don’t say, oh, say you’re a client and that you were great. And I always double check to make sure they don’t do that. But if somebody says, hey, I’ve worked with Nicole before, she’s great. or hey, I’ve worked with Amy before, you know, at this other agency, and she did great work. you know, it’s not a lie, right, about the work that they’re doing, and it gets me a boost, so. Yeah, but we can’t ask clients for reviews, and we can’t coerce clients into reviews, and we can’t, we can’t joke about it with clients. I had one clinician say, well, can I just, like, joke about it? And then whatever they do after, I’m like, no, that’s coercion. Don’t do that, please. so we do have to be very careful there. But there are ways that we can do that, and I feel like it does offset the angry reviews because not many people hop on to say, oh my gosh, what a wonderful clinician. Nicole Ball 00:41:03 But when people are angry because we overcharge their credit card on accident, or we, you know, they happen to get a clinician who didn’t stand up for them in court, whatever, right? Whatever reason, they’re angry. They’ll leave reviews about that. so some of those other reviews that we get from collaborators and from other clinicians in the area do tend to offset some of those angry folks. So, I don’t know, just a little trick, something to think about. So so yeah, that that’s I think the biggest thing that I want you to take from today is not to panic, because like I said in the beginning, sometimes what we tend to do is we, we make split decisions, that are going to cost us money, when really it might not be necessary or split decisions that are going to cause us to not be, you know, the parents, the friends, the children, the clinicians that we want to be because we’re so worried about our livelihood and you know, where we’re going to get those referrals from, they will come. Nicole Ball 00:42:08 So remember, even if you do nothing, they’ll pop back up. But hopefully today I was able to give you some ideas, on what to do. So track the data, get anecdotal information from the people answering your phones and answering your website submissions. If you haven’t started tracking your data, I would encourage you to do that. know where your referrals come from. And then, you know, remember, number five is nowhere. You’re not getting them from, you know, so know where you’re getting them from and where you’re not getting them from. and I mean, I know I didn’t mention this, but just kind of popped in my head, if you have clinicians who are friends in your area, find out where their referrals are coming from. Not that you want to head hunt and steal their referral sources, but if they’re like, oh yeah, I’ve got a great relationship with the local community college and we get a ton of referrals from them, it’s not going to hurt to drop off a business card, you know. Nicole Ball 00:43:02 So some things to consider there. and then the email blast, can be helpful as well. keep track of your Google Analytics work on your SEO. Those are all great things that you can do to boost your clients. But I think the biggest thing is just not panicking and knowing that they will they will come back. and all of the data that you collect and all the data that you start tracking will help you make decisions down the road. If it wasn’t for the data that, Emily tracks for me, I’m hiring three, three new clinicians right now, and I wouldn’t have known. I didn’t know that we were getting tons of calls for people who wanted face to face, not virtual. I thought, well, we’ve got six virtual therapists all over the state of Michigan. All of them are accepting new clients. There’s plenty of people to take clients. And she’s like, no, these people want face to face. Nicole. Okay, time for me to kick it into gear. And I’m hiring three people now. Nicole Ball 00:43:56 If Emily wasn’t tracking that data for me, if I didn’t have her to do that, then I wouldn’t be able to make that decision. I’m also considering accepting UnitedHealthCare again because that’s another one. We get a ton of calls for that. We just turn away. I know, I know, I know, we’ll see. I gotta get some more information about reimbursement rates and stuff first. But but my point being is that that data helps me make those decisions. Because if you keep doing things just because, well, this is the way we’ve always done them, well, this is the way we’ve always done them. You’re not going to grow. And if you want to retire at a certain age, if you want to leave a legacy to your kids, if you want to pay for the vacation, pay your debt. If you have those big things that you want for yourself, you know, making some of those moves are going to help you. And tracking the data will help you decide which moves to make. Nicole Ball 00:44:41 So I am all done. That’s all I have for you today. I am here though. I am excited to be here. I’ve got 14 more minutes before I have to run away, so I’m happy to answer any questions about what we talked about today, about my practice, about other things, all, you know, practice related. So if anybody has any questions, stick around. Happy to chit chat for anybody who doesn’t. I hope you have an awesome day. Thank you for being here. The recorded version of this will be back on soon. And thank you so much for being here, and hopefully you’ll be here next week where we’ll continue the discussion. Elizabeth, you had a question. Speaker 6 00:45:18 I do. I know you have three sites. I’m curious, when you knew it was time to add the second site when you stretched? Nicole Ball 00:45:28 Well, interestingly enough, for me, the second site is in the same town, and so the reason I knew it was time to add the second site is because we were busting at the seams in our office. Nicole Ball 00:45:41 Really, it was simply it was out of need for space that we opened up the second one, because if I want a building with 20 offices, I’m going to be in this area, I’m going to be spending $2 million and I just do not have the money. I did go look at an office building a few days ago with 20 offices, but they wanted, you know, ten grand a month for it. So the point being that it would be more efficient for me to have two locations, and more cost effective for me to have two locations than have one. And so that was why I opened the second session or excuse me, second, location. So we were busting at the seams. I had, we had seven offices, actually, we only had six. We had six offices and a reception space. I turned the reception space into an office, boarded up windows like makeshift MacGyver style, and made it work. And it was it was awesome. But seven offices. Speaker 6 00:46:41 With. Nicole Ball 00:46:42 at the time 14 I think 12 clinicians just wasn’t working. Nicole Ball 00:46:46 It just wasn’t working people. I mean, I’m all for office sharing, but it was just, you know, are you in this office? I want to schedule a client here. Do you have an office? Everybody’s texting each other, and it just got so messy. And I wanted to bring in more clinicians. We had enough calls where I knew we could grow bigger. And so that’s when I decided to, to open the second one. So I have seven offices at one location, seven at the other one. We call our East side campus, and one we call our West Side campus. opening a third location is in a city about 50 miles from where we’re at right now, and I don’t really know when. I knew it was time. I just knew I wanted to make more money. And that was my goal, is how can I if I know I want to, for example, retire at 50? I know I have to have this much money in the bank, this much money in investments, this much money in retirement. Nicole Ball 00:47:39 And I was never going to reach that number unless I got bigger. And so that’s when we opened up the third location. Deciding on the third location was actually a project that I put on my intern. So I had a clinical intern who needed just like a little side project just for like, you know, busy work, extra hours, things like that. And I said, okay, I’m going to give you I think I gave her like eight northern Michigan towns. And I said, I want to open a third location. and I want you to, you know, do some digging for me. So she found out who the biggest employers were in each of those towns and insurances. Those employers offered their employees. And she also got demographic data on, you know, a cost of living population, average income, things like that, which is all public knowledge. Right. It’s all there. Sure. And then she also collected information, on what practices have waitlists. So she called all the practices in that town, and she just said, hey, I’m just wondering if you’re accepting new clients. Nicole Ball 00:48:45 and if so, what is your wait list look like? And based on that data that she collected, we decided to open up the third location. I decided to open up Manistee, Michigan. I’m looking at opening up a fourth one this year, maybe in the fall instead of spring, because I’ve done it spring every year this year to look like fall. But I’m looking at Gaylord, Michigan, way up here. simply because, it’s one of those towns where we see a lot of people virtually. They don’t want to make the hour and 20 minute drive to us. but we have a lot of those folks who see our virtual therapists. And so, again, just with that anecdotal data, I’m like, oh, clearly there’s not enough therapists up there, or they have waitlists or whatever. And so yeah, so that’s the process there. Okay. Corey, you had your hand up. Did you have something else? Speaker 4 00:49:37 yeah, that that just made me think of a different question. so I’m like, something’s out. Speaker 4 00:49:42 I’m just curious for you when you say that you track where where you are in Google. like, are you going into, like, a new browser that’s like that you’re not signed into? Because I’m always like, you know, if I’m if I’m like, you know, counseling in Redding, Pennsylvania, if I have my business link, is that impacting? So you like I. Nicole Ball 00:50:01 I get on my husband’s computer. Speaker 4 00:50:03 Okay. Cool. I just was like, expecting that. I’ll be like, I need. Nicole Ball 00:50:06 Your computer today. And he’s like, oh, you need to track where you are on Google. Speaker 4 00:50:09 Yeah, I love that. Okay. That’s that’s great information. I have a husband too that I can do that with. but then based on Elizabeth’s question, I’m just curious about like, in having a second location that’s potentially an hour and 20 minutes away from where you are, like, how do you mentally, you know, kind of like, how do you manage that? Because I it’s I’ve never really wanted a second location, but now I’m like, well, maybe I do. Speaker 4 00:50:38 And I’m kind of like, oh, but how far away? And what would that be like? And I’m a control freak and all that. Right. Nicole Ball 00:50:43 And that’s I think that thank you for saying control freak, because that’s exactly what I was going to say. I have had to let go of control of a lot of things. one of the beauties of having 1099 and I know that not in every state you can, but one of the beauty of having 1099 is all of my clinicians have the autonomy, and I don’t have to micromanage them. I bring on people who can do their job, do it well. I can give them a key to the office. They can open, close, come and go as they please, when they want, when they don’t want. And I don’t really have to manage it much. Right. I may be in Manistee, I may be pop over once a month to check in. I have a cleaning person that comes once a week, so I do have a cleaning crew that comes in every Sunday and they, you know, fill the cups and the, you know, clean the coffee. Nicole Ball 00:51:24 They do all of that. so that person is kind of checking in on the logistics. But I also just feel like I have a good relationship with my clinicians. So if they need something, they can tell me right now in Manistee we’re having because it’s an old historic building from like the 1800s, right. Downtown. it’s like a Victorian city. they’re like Nicole, the soundproofing is getting to be a problem. Like, we can hear what’s going on in the hallway. awesome. Thank you for telling me. And I can take care of it. Right. So I might not be there, but my relationship with all the clinicians is so that they feel safe coming to me. One of them emailed me yesterday. She’s like, there is a terrible smell in the elevator. Like, can you hop on that? Sure. I texted the building manager. He was on it. Right. So I think we can do a lot when we’re not there. Just by trusting that people will be let you know what their needs are. Nicole Ball 00:52:16 and, you know, if I had employees, I think I could still do it the same way. I might just have, like, an office manager. So maybe I would pay a person, like, an extra clinical hour or something just to, like, be the go to person, you know, for keeping up on, you know, are we out of cuffs in the lobby or something like that, or do we need a new vacuum? So, I think if I were to grow more, that’s something I would consider. but right now, it’s manageable. You know, ask me in a few years when I have three more locations and we’ll see. But, it’s going good so far. But but you’re right, Corey, I think letting go of the control has been huge. but it’s also taken so much off of me because it’s helped me grow as a person because somebody who has generalized anxiety disorder. Right. Like, I am always going to be worrying and letting go of that control has taught me a lot of distress tolerance within myself as a business owner, that I don’t have to be worrying if there’s a problem, it’ll pop up and I’ll deal with it. Nicole Ball 00:53:15 But I don’t need to anticipate all the possible problems if I have a good relationship with the people in those buildings. So hopefully that’s helpful. All right. Well, I look forward to seeing all of you next week. feel free to reach out to me. I am accepting new consulting clients for any of you who maybe don’t have a personal consultant that you work with. I’ve got a couple more slots left. but otherwise, thanks for being here and I will see you next week. Bye. Joe Sanok 00:53:51 Well, thank you so much for listening to the practice of the Practice podcast today. These trainings are available in our membership communities. 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And because you’re a listener, you get three months totally free. Head on over to gusto.com/joe again. That’s gusto.com/joe. And I’m telling you you’re gonna love it. Thank you 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. Joe Sanok 00:55:22 If you want a professional, you should find one.