STP 19 | When Turnover Interrupts Your Scaling Plan

April 23, 2023

In this episode of the Scaling Therapy Practice, David Hall, a therapist and practice owner, discusses the topic of employee turnover in a group practice. James Marland, the host, asks him to share his experience with the issue. Hall talks about his history of turnover in his counseling practice and how it impacted his scaling plan. He discusses the effects it had on him and how he felt when two people quit unexpectedly. He shares that he had a closer relationship with one of the two employees, and looking back, he was not surprised that this person left. The unexpected departure made him question his plan for scaling and how he should deal with employee turnover.

The Effects of Employee Turnover on a Manager

Hall's experience with employee turnover in his counseling practice led to the realization that it can be challenging to handle, both emotionally and operationally. The two employees' unexpected departures caught him off guard and made him feel like he was throwing hand grenades behind them. He shares, "I felt like somebody was leaving and kind of throwing hand grenades behind them as they went." The situation was personal, and Hall found it hard to separate business from the personal aspects. He discusses how managers can become emotionally involved in their employees' lives and take it personally when employees leave. He shares, "as the manager, as the people who are responsible for this, I think some of the feelings in there and taking it personal make it much harder than just, oh. You know, uh, they're making a business decision to leave."

Effects of Employee Turnover on Scaling Plan

Hall's experience with employee turnover impacted his scaling plan. He had a plan to grow his practice to a certain size, and the two employees' unexpected departures disrupted his plan. He was forced to question his plan for scaling and how he should handle employee turnover. He shares, "It interrupted my plan, and I didn't want it to happen." Hall realized that employee turnover could disrupt his plans, and he needed to have a plan in place to manage it. It's important to note, we often do not have plans in place until something bad or unforeseen happens. The therapy practice owner that anticipates turnover and who has a plan before this happens will be able to weather the storm of turnover better than the practice owner who is surprised.

Tips for Managing Employee Turnover

Hall shares some tips for managing employee turnover in a group practice. First, he recommends having a plan for managing employee turnover. This plan should include a transition plan for departing employees, ensuring the transition is smooth and not disruptive to the practice. Second, he suggests having a policy in place for exit interviews, which should be conducted in a professional and respectful manner. Third, he recommends setting expectations for employees' roles, responsibilities, and performance to reduce employee dissatisfaction and turnover. Lastly, he emphasizes that managers need to remember that turnover is a natural part of running a business, and they should not take it personally.

Employee turnover is an inevitable part of running a business. As a manager, it is essential to have a plan for managing employee turnover, as it can be emotionally and operationally challenging. The experience of employee turnover can disrupt a manager's plan for scaling, and it is vital to have a plan in place to manage it. A transition plan, an exit interview policy, setting expectations for employee roles and responsibilities, and remembering that turnover is a natural part of running a business are some of the tips that can help manage employee turnover.

Resources and Links

Psychraft Network
Email James to talk about questions or problems about scaling: [email protected]
PsychMaven - Find more resources here
Builder Type Assessment - grow without the grind
Scribe How - Make Easy Guides for people to use and follow

Action Steps:

Have a plan for managing employee turnover, including a transition plan for departing employees.
Establish an exit interview policy that is conducted in a professional and respectful manner.
Set clear expectations for employees' roles, responsibilities, and performance.
Remember that turnover is a natural part of running a business and try not to take it personally.

Episode Transcript

Copy of STP #18 | Dissapointment In Scaling
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James Marland: So you, you're a group practice and you've hired and had some turnover. Yes. Let's just start there. What's been your history of turnover? Um,

David Hall: You know, just talking about it for my counseling practice. Um, and, and cuz I think that's where I've, I've kind of felt it the most, uh, I had in, in previous episodes I've talked about.

I, I had a psychiatry practice, um, and we had different sort of stuff. We had admin and, um, psychiatric providers and, and there was turnover there for different reasons people would move or things like that. But the, um, Uh, for my counseling practice, uh, I managed it a while without turnover. Uh, we started the counseling practice in the iteration that it is now, more or less in 2018.

And it was myself and an initial two other therapist, and then it, uh, we grew to over the next two years. To, I think we, we hit over 10 within that time. So we more than doubled, more than tripled within that time without anybody leaving. And it was just an addition process. And then we went into covid. Hmm.

And, uh, for the first few months it, no interruption all that. And then within a few weeks, in the fall of 2020, I had two people quit on me, unexpected. And that was a hard process for me. Uh, it was what, what made it hard? Uh, for one, it, it interrupted my plan, my scaling plan, because I had a plan to grow the practice of a certain size, and I was just looking to add people and Yeah.

James Marland: What, what's going on? What is this

David Hall: people leaving thing? I'm just, yeah. And it inter it interrupted my plan. I didn't, I had not, and uh, and I didn't want it to happen. The, the one person quit, the first person that quit it didn't represent a huge thing financially. Uh, they were pretty new with the practice and they didn't have much of a caseload at that point.

And that was, and. They had identified that it wasn't a really good fit for them. They felt, uh, that was difficult because they were easier at the beginning when they first said they were leaving. Um, their exit interview process was not pleasant. And part of it was, is for those Seinfeld fans, if you're familiar with the Seinfeld, holiday Festus, which is kind of the airing of the grievances, and I, I felt like there were lots of things that were unarticulated until the door was closing.

And then, so I felt like somebody was leaving and kind of throwing hand grenades behind them as they went. Stuff that I, I felt was hurtful. Even just kind of a non businessy sort of way. Stuff that was hurtful and not necessarily fair, but mm-hmm. That's my own perspective and kind of whatever. Uh, and so that was hard cuz it was, it felt personal and the, the other person that left was unexpected because, I, this was somebody who I, I felt closer to and felt more of kind of a, a kindred relationship.

Uh, I had a more ongoing relationship with this person, and looking back, I'm not surprised. Um, and part of it was that this person clearly was ambitious to wanna start their own thing, and that's what they ended up going to do was start their own thing. And I, I was surprised in the timing. I thought that this was the sort of thing this person might wanna do in a year or two, but I was wrong.

So, and

James Marland: the, the other thing, one of the things, um, like your timetable was messed up, but one of the things I've, I've felt when you, when you said it felt personal, I've like, ugh. Yeah, I felt that too. When people leave and I feel like I've done my best to take care of them and to just even some sacrifices and then.

You know, they, they leave mm-hmm. With without much notice or consideration for what happens behind. Mm-hmm. So that's the manager's side of things. Mm-hmm. I'm sure there's the, the, the employee side of things for that, but as the manager, as the people who are responsible for this, I, I think some of the, the feelings in there and taking it personal, make it much harder than just, oh.

You know, uh, they're making a business decision to, to leave. Mm-hmm.

David Hall: Well, and sometimes too, it wasn't always a business decision. Sometimes it was just like, I don't, I don't, for them it was, it would be like, well, I don't like this, or whatever. Mm-hmm. Um, and I, I, you know, when in the context of that, I was really bothered and had to take some time to process.

Fortunately I had some good mentoring, um, in that. And one of the things that had helped me re. Was basically how to plan for it. And because at that point I did not have a plan for turnover. Turnover. My thought was is every hire I make is going to be a great fit and everyone is gonna be happy and wanna stay forever.

And that's my plan for growth and scaling is that I just keep on going.

James Marland: I've been there, I've

David Hall: been there, and it was it. Some of this interruption to realize like, that is not a good plan. It's not a sustainable plan, it's not a realistic plan, but more than that, it's just not good.

James Marland: So before people left, did you have a plan for, for that?

Like how did you No, not really.

David Hall: No, no. It was, it was the, I just thought like, I'll, I'll, you know, I want to make this such a great practice to work that people don't wanna live. Yeah. Yeah. They'll stay forever. Well, and one of the things you, you said James, uh, in a previous episode that I've thought, because I, I've had some interviews I've done recently and, and it was a, it was a mindset change for me was this idea of when you interview people, you've gotta look for reasons not to hire them.

Absolutely. And for me, I usually go in, in the hired until proven, not hired in the interview process like it is, I'm inclined to think that you're gonna be a great. And I'm looking for that to be a fulfilled expectation. Yep.

James Marland: Self-fulfilling. Yep.

David Hall: And I look back now and that there were certain things that I, I could have seen differently in different people that would've affected their long-term fit.

And you know, I, when you wanna scale it, it's. You know, in a, in a group practice, this is the idea of claim, the more the merrier, kind of bring them in. And depending on what sort of practice you have, depending on your expectations, that can work more easily than than others. But, you know, it was, for me, fit really matters.

And I am both, I've, I've, from feedback, this is what I've learned, uh, my style of leader. Is either goes from the continuum to like awesome, to horrible, depending on who you are to a lot of degrees. Mm-hmm. Not, not that I don't have certain objective faults or even uh, uh, virtues that, that are fairly objective across the board, but there are lots of things in my style that certain people will do a lot better with.

And part of my job is how to make sure that anyone that's coming on board. I'm not doing a disservice to by Right. Putting them in a situation where they're not gonna thrive.

James Marland: What I, what I, uh, how, how I kind of interpret this in my head is if I see red flags in the interview process, I don't make excuses for them.

Mm-hmm. And as you're, as you're talking about your, your hiring process for, you know, you could, you know who's gonna fit in your. But you might see something that's a red flag and you say, well, I'm a good manager, or I have the process, I can overcome this. Uh, or will I know it'll take extra training, but we can go through it.

And, um, the, here's what, here's one of the, the big secrets of looking for reasons to say no if you hire the wrong person. Well, if you, if you pass on the right person. So that's an outcome of an interview. If you pass on the right person and, and a few months later, a few years later, you figure, you see that they're an awesome employee and they're a rockstar and you missed on a good employee, you have the pain of regret, like mm-hmm.

It's you, it's there, but it's not. It's not as bad as the pain of hiring a problem employee. Mm-hmm. Like the other outcome, let's say the other way is you hire somebody who's not a fit and then you have a year of da, like daily eating the cake that you made, that you made it with Ash. You know the, there's a book manager tools that says you bake your own cake and you, you choose your own ingredient.

And if you say yes to the wrong person, instead of feeling regret, you're eating, uh, the terrible cake that you made day after day after day. So anyways, which is worse. Yeah. Its, that is much worse than regret.

David Hall: Yeah. I, I've had in, in looking at, for me it's also, uh, another thing to consider is where people are in their developmental journey.

And I'll give an example of this from. I used to work as a, as a food server in, in a restaurant. Mm-hmm. As a, as a, and I was, I mean, I did that in my early twenties, uh, when I was in college, beginning of grad school. And I noticed something then as I'm like 22, 23, working in that setting, that there were only two sorts of people in it that I found people similar to me.

Who were younger and this was what they were doing while they were preparing for a different career. And then those who were kind of the lifers that they were in their thirties, forties. Mm-hmm. And, and it was a different sort of person. And I realized that, um, and, and there were, there were people who, succ were successful and unsuccessful in both categories.

I remember one of my coworkers who he was like in his early mid thirties at the time, which at the time felt super old to me, and I'll tell you, my early forties now doesn't feel that old, but he still worked as a, as a server and probably still doing that. And it, he wasn't that, he didn't make a good living at it.

I, I know, you know, we would share shifts. You know, I made good money doing that at the places I worked. It took me a while as a, as a therapist to match it. I didn't match it what I was making as a server, uh, as a therapist for the first year or two. Mm-hmm. And, but his, his, um, his life was kind of calibrated differently than where I was on a trajectory leading my life.

Like, he, he wasn't the sort of person to pick up a shift because he didn't, you know, he. Work as a server long term to take on all this extra responsibility. You know, for him the appeal was, he liked, he liked the flexibility and the freedom. Mm-hmm. And, um, but I, I, I bring this up as an examples cuz you might be the, a great fit as a place of work or as an employer for somebody in a certain phase in their journey as a professional, but not long.

And I've, I've really believed in this idea of seasons, uh, for myself and for others and to try to hold onto somebody past the right season because I've had, since the first turnover, I've had lots of different turnover and some of it's, it's people, some of it is just as simple as somebody moves though it's funny.

The, the one staff member I had that actually moved far away didn't quit, or at least hasn't, so far, they're now just working remote full-time and, and because they fit and, and we fit for them even when they moved away. But,

James Marland: so that, that leads me to, to ask, you know, what are the, what are some of the big things to think about for your plan for turnover?

Like, it's gonna happen. Mm-hmm. Because people are at different stages. Things grow, people move, things happen. We try to mitigate it, of course, but what, what is some of the big points of a plan for managing turnover?

David Hall: Uh, some of it is policy in your employment agreement or contract. And, and, uh, the disclaimer that James and I often have, we are not attorneys and so this is.

I can speak anecdotally as a business owner Sure. Where I am, so Tennessee, where I am is a right to work state. And so it's really hard to put in and to enforce, uh, non-compete sorts of things. Hmm. Uh, and so I, I try to limit that. Some people will do that. Some people, I've seen people that will do things that by agreeing to work for me in this practice, you, you, you cannot.

Be in practice within five miles of this location afterwards. And I see people do that. I'm not a big fan of that. Um, for one, it's a hard thing to enforce, at least where I live and work. Mm-hmm. Um, but it's also, I don't think a good, you, you wanna let people go that you, you, uh, particularly in this business, uh, in mental health, you don't wanna try to hold on to people that don't wanna be there.

I do think there are ways that are important to mitigate it. Um, so for me, in my employment agreement, um, and this is how the practice is structured, the clients belong to the practice, not to the therapist. Okay.

James Marland: Do you

David Hall: spell that out in the policy? You spell that out in the employment agreement. That's a policy.

Now, if you are running independent contractors, you can't do that in most places, in most states, but, um, but it's part of how we manage the practice. It's part of where the record like it all belongs to the practice. Now that being. When people will leave. I generally don't have any issues in releasing clients too, because in the end, clients are gonna want to typically go through therapist.

Sure. And I don't want to, but I have that as a policy, more as a protection because I, if I have a situation where somebody leaves and it's a much more acrimonious thing and there may even be, um, client wellbeing considerations. I, I, I want to have it spelled out that like, these are not your clients. The, they're the clients of the practice.

The practice. Um, and that, that's some leverage that in considering of, of where people go, um, I have a thing as a policy that people can leave it, it spells out like how people give notice. Like they, they give notice of 30 days and, and I've flex, you know, I don't really like a minimum of 30 days, but at the same point, I considered longer for a required notice.

But then I also realized that that would be a hard, that would be very burdensome to someone leav. More than 30 days. The, the

James Marland: hospitals I've worked for, anyone with a, a master's degree level or a manager gave 30 days. Everybody else was two weeks. So,

David Hall: yeah. And, and that seems 30 days felt. Yeah. I, I would love three months to, to plan, but I understand why someone doesn't wanna do that.

James Marland: Well, sure. But it also, it kind of, Two weeks I think would be too short for the clients. Oh, absolutely. Yeah. To figure it out. And 30 days is

David Hall: still tough. 30 days is reasonable for us too cuz that's our payment cycle is, is true. We do monthly payment cycles and, but I understand. And as an example, so my wife, she told, uh, an employer that she was leaving sooner than she had to, and there was issues with.

Not like hostile work environment. But a practical thing was, you know, she was working as a therapist and, um, they, they took her off new clients, which I understood why they did that as a practice. Like, well, why are we gonna give you new clients when you're leaving? Right. But she had gave, given significant, uh, notice.

As a consideration. And so in some issues penalized for it, which I, I get. And, but on the other side, I also understand that if someone gave me three months notice, am I gonna feed them more clients realizing that, right? Yeah. They're going.

James Marland: So there's a consideration there. So I'm

David Hall: not, seems about, yeah. So, but that's a policy.

But one, another policy I have is, People can leave the practice, assuming everything is above board. People can leave the practice and go on their own if that's what they choose to do, but people can't leave and then hire people away from the practice. Like if you leave. Mm-hmm. James is a therapist working for me.

Oh, right. Yeah. I do have it spelled out that like you can quit and start your own practice assuming everything else is above board, but you can't recruit anybody else to go with you. And like there's a thing of like, you are barred from employing or contracting with anyone else that works for the practice.

I think I have it for a year. Mm-hmm. Mm-hmm. Um, cuz I wanna give people flexibility, but part of it is, you know, not wanting to create this bandwagon of Mm. People leave in a trove together. Right. And now how enforceable that is. How, like, you know, I haven't, fortunately I haven't had to deal with that, but so how do you plan is, you know, what is your agreement and what are you legally allowed to do if you have contractors versus employees knowing kind of the employment laws in your state?

Because there's certain things you may wanna do that are not legal to do. Uh, so consult

James Marland: your lawyer.

David Hall: Yeah. Cons, sort. Yeah. Mm-hmm. And. But you, you want to have, in your policies, you do wanna be thinking of what are the things I can do that protect myself or the, the business, but also what is fair and equitable to any employee?

James Marland: What if, what if they're not? What if they leave and they don't like finish their billing or their paperwork or their notes or things that they're required to?

David Hall: Well, we have a policy in place. This is, uh, one of our friends inspired this because, uh, she was a coworker of ours. She never worked for us, but, uh, it was notorious in like, her notes getting behind, like really bad.

James Marland: If you've ever worked, if you've worked longer than a year, you know, somebody you can point like,

David Hall: so we actually have a policy for just, this is normal. Like people don't get paid unless their charting's up to date. Okay. And,

James Marland: uh, so it's a, it's a policy that's not. Not just for the one time event. It's like for the, yeah.

David Hall: Every, every month practice, people get paid once a month and if your charts aren't up to date, uh, then you don't get paid until they are. So if someone left without getting charting done, then they just wouldn't be paid for that, um, that pay period until it was completed. Uh, but that's not, that's not a termination policy.

That's just an internal policy. But again, it's good to have these. I did that just as a form of accountability. And I will say I do have staff that are oftentimes, like the last day of the month are scrambling to to mm-hmm. Get caught up in their charting and it can be, uh, attention thing. But most people have given me feedback that they appreciate it as a policy cuz they like that accountability.

Well, it does. It

James Marland: keeps it. Oh man. Have you worked with people who didn't do it for months? Oh yeah, yeah, yeah. And, and then they, they miss Billings and I, I worked with. Psychiatrists who would never do their train, their mandatory, you know, safety trainings and they had to take off like two days to catch up.

And, and also their, their notes, they, they wouldn't, they, they had stacks of charts every, every day to, to finish their notes that were going out of, you know, time for billing. Mm-hmm. So, yeah. Uh, yeah. And, and if you had the policy that kept you up to. In a manageable amount of time. There wouldn't be those days where they had to just stop everything and stop

David Hall: billing people.

Yeah. Have policies and enforce them, I think. Yeah. So that's, I think sometimes people will have policies but not enforce it. And you create a problem for yourself. Mm, because, because it, it's hard to enforce stuff. Like I, I've, I've had to withhold pay from people for a certain time because of. Maintaining boundaries and I don't like doing that.

No, but it's important to kind of hold to the hold your, your lawn. So one is the policy. Okay. The other thing is, um, a healthy ecosystem has a front. What do you, what do you mean by that? Um, Mm. It's a good, I was thinking of it as a metaphor, but I'll use, so a healthy environment of a work environment, and I'm gonna use an example like in nature.

Okay? But you need inflow and outflow. You need both. So going back to how, like I pictured growing to practice with just inflow and no outflow. But if you look at this in nature and we'll, we'll talk about bodies of. You know, a river typically has the same inflow and outflow. It just keeps on go. You know, it just moving through.

But let's say you have a Lake Lakes will have inflows where water's coming in, but they also have outflows, most of them because you need that for the water to stay vibrant and healthy and fresh. Like because either otherwise you end up with like a stagnant bit of. I'm thinking of like a pond or something like that.

Yeah. But even in like larger scales, like the great Salt Lake in the United States has no outflow. It's in this basin and between the, in the ro, between the Rocky Mountains and Sierra Nevadas and the, you know, in the United States, most rivers and lakes eventually kind of go out into the ocean, but the rivers that make up the space and all go into the great Salt Lake.

Which is a beautiful spot, but it's not like thriving with fish because it's, it's too, and cuz there's no outflow. And what happens? Water comes in it, water evaporates because there's no other way for it to leave. And the mineral and salt content just gets more and more concentrated over time. Yeah, yeah.

And, but for, you need turnover. It's a weird thing to say, but you need turn. And you need a, not only do you need a plan for it, you, it needs to happen because it's hard to keep a healthy practice unless there's now you don't want a lot, but you need some. Mm-hmm. Because people will reach a season where it's no longer a fit.

For whatever like it could be cuz their family life has changed. They have different financial needs. We hire in our practice both pre-licensed and fully licensed people, so people that are working towards their hours for full independent licensure cuz we provide supervision and, and a setting for people to do that.

And then we have people who are already licensed. And some people, their journey is, they need a place to, to work and, and thrive while they're still getting license. And when they get licensed, they wanna move on. Now, maybe not immediately after they get licensed, but at some point. And that's not bad. It doesn't mean that you're necessarily a bad boss or running a, a, a, a practice that isn't good, but it's just part of their journey.

Maybe they're part of their on their own entrepreneurial journey. Or it could be that the vision of what you have for a practice, it could be like treatment oriented. I'll give an. I have a, I have a friend who, he runs a very niche practice. He's the co-owner of a practice that specifically does couples e f T, which is a emotionally focused therapy.

Mm-hmm. It's a, it's a type of therapy and it's a specific clientele, like they will see non couples, but that's their focus, that's their niche, and he and I had some discussions. Several years ago where he was dealing with some turnover where he, he was needing to encourage somebody on, which is, uh, my father who's a business owner, owner, he talks about blessing people on, which is, uh, his term for firing people.

But he means that it's not euphemistically. He does mean it in the idea of like, they need to be encouraged in their next thing and I don't need to hold them back cuz this is not, this is clearly not where they need.

James Marland: Yes, it's not, it's not good for them to stay because they're not going to be successful where they.

So it's neither good for you or them.

David Hall: But giving the example of my friend, he had some people in the practice that weren't really, that EF, F T E, weren't really that niche. And part of his turnover process was it was allow him to really focus in on what sort of practice do we want? This is the sort of work we want do, this is the sort of clients we wanna see.

This is the method we want to treat them in. And it allowed him to really refine his brand. By having turnover. So you want a back door, but you want a, a larger front door. And so part of my way of managing it is I'm always thinking about recruitment. It doesn't mean I'm always recruiting. Mm-hmm. But I had one of my staff just last.

Come to me, one of my long-term people and she said, Hey, I, I get asked by friends if you're hiring or you're considering things, and like, what should I say to them? And my response was, and, and this is my personality, I go, I'm always happy to talk to somebody, even if we don't have a spot. I'm always happy to talk to somebody, not to lead them on, but I sometimes, cuz I'm friends with other practice owners and so I like helping direct people.

I'm like, well, we're not hiring right now. Sure you should, you could, should consider these other places. I like being that kind of matchmaker and I like being in that current because when I'm in a place where I'm looking to hire, I've got my ear to the ground enough that I kind of know and, and people are the communities in the, in the habit of sending people to me.

Um, I've learned to get, I've, I've learned to become chewier over time. Uh, I've. Some interviews I'm currently looking at, and I've already, in my mind, of people that have reached out to me, ranked them a thought of based on other certain information I have of like, this person seems like a stronger candidate than this person, and I want to have the freedom to say no.

Not just to th but to myself to say like this, this is clearly not a good. I need a, I've, as, as James was saying, I, I'm working on having, I need to have my know more ready early on. Yeah. And not be too optimistic. I think, uh,

James Marland: this, this, uh, topic of turnover has opened up some other topics like hiring and we're, we're mostly talking this, this episode about voluntary, voluntary turnover, you know, But there is probably a whole series on non-voluntary.

I've been

David Hall: very, uh, I appreciate that. I've been, I've had the, the, the benefit I've, I've not had to let anybody go. Yeah. As a therapy practice owner, now I've, I've let people go in other businesses and. I learned some hard lessons in that. I've not had to do that so far. And I, I, and as far as turnover goes, I would like not to have to do that.

I don't assume I, I need to have a policy, I need to have plans. And, but I, I feel that, you know, to, to be open in your outflow, I think kind of allows things to naturally happen. And not always, people don't always do you that favor, uh, But yeah, I mean, I, but in the natural turnover part of growing is, is there's constantly pruning.

It's like a tree. Yeah. Or like a, and that's okay. And it doesn't mean that you shouldn't assess your functions as a business leader or a manager, whatever. Like, I don't like receiving negative feedback, but mm-hmm. I do want to be open to hear it because there may be wisdom that I need to. Uh, imbibe and to, to implement.

But, uh, but yeah, it's, um, it's a learning process, but yeah, it, it's always going to happen. And so if you're, if you're doing anything on scale, uh, I will say the smaller the practice, the fewer instances of turnover you're likely gonna have. But that's just a statistical.

James Marland: And as you're, as you're growing it, it happens.

It, it always seemed to happen in stages. We, the, the, the company we, I was running, we got to a point where we needed to hire people and we had that idea, oh, if I hire people, we can see this many more clients. And then the, you had to develop new things changed. And some of the original people, it, it jarred them a little bit.

And so, Uh, you might lose something or somebody might leave, and then, then you have to go through mm-hmm. That learning process. I remember, you know, the, the company was new, it was a startup. We didn't have any transition policies in place. And, uh, I remember just making some really big mistakes, uh, with the, the, it was a service industry, so were providing virtual assistance for people, and when their virtual assistant left, it was like a crisis for the.

Not, and, and the answer is, I'm gonna figure it out, was not good enough for them. And so there that we learned quickly to, um, manage the expectations of practice owners with, Hey, we have this plan in place and we're gonna take care of this for you, and this is how easy it's gonna be. And I'm sorry that, you know, your virtual assistant is moving on, but we have this other person who's already trained on your practice.

And, and even further, Then we started having cross-training. So even before people got, uh, you know, moved on, the people were cross-trained in new practices and, uh, we made people write down all their notes and policies so that we could pick up just what, like you said, with the paperwork stuff, we, we made sure that they had regular meetings with their practices and so somebody, Um, slide in, not, not without a disruption, but with minimizing the disruption.

Mm-hmm. Because any change like that is a big disruption. Uh, but it, it, it wasn't easy. And the first time we made a lot of mistakes and we, we, we made those policies to make it, uh, smoother. So, uh, I guess, uh, What, uh, what if you don't wanna deal with

David Hall: employees? What if you, what if this feels like too much?

James Marland: Yeah. What if, what if you wanna do contractors, I guess, and do 10 90 nines instead of W2 employees? Uh, what, what does that do for you? Oh,

David Hall: it's just, it's a recent episode and I realize not everyone's listening to episodes in order and kind of things like that. But one of the things that James and I have talked about recently is, um, you, you're always gonna have a problem.

So it's deciding which problem you want. Oh yeah.

James Marland: I like that. I liked

David Hall: that one. Yeah. And you end up with different problems if you don't have people that work for you, if you have a different relationship or kind of things like that. But you also save yourself from certain problems. And so it's just deciding and um, For, I think if you have contr, I, I, I think for group practice owners, here's where I think people get in trouble and will get themselves in trouble more and more long term.

I know of practices that run their therapists that work underneath them as independent contractors, but they have a mindset to treat them like employees and uh oh, in tax law sorts of things. That gets more difficult over time, but it also. You can't have it both ways. One of the reasons I have employees versus independent contractors Yeah.

Is because I want to set policies and culture and things much more directly that I could not in a technical sense, legally be allowed to do. Right. If they were in, if they were independent contractors and the, you know, You are going to, and, and part of when you set policies, I'm, I'm, this is slightly tangential, but it, it's related.

When you set policies, you will create your turnover in some ways. By, by setting boundaries and limits, you'll create kind of where your turnover will go. And I'll, for example, for me, the way my practice is set up financially for therapist is it, uh, rewards full-time. Because the more full-time you are, the, the more money proportionally you keep per hour.

Like what you make per hour is more, the more hours you put in a month.

James Marland: And and it also benefits the, the practice because you don't have to hire as many people. Mm-hmm. The, the, the room is used, you know, the space is used at a higher level. Like, it just, it's an easier. From what I've heard anyways. Yeah.

You can correct me if I'm wrong. It's just easier to manage one person instead of three

David Hall: part-time people. I, I find that so, and that's been my choice. And so I've created a practice that incentivizes full-time people. Yeah. But what that has meant practically is that. My practice financially is less appealing to people who are less than full-time.

And that's been where I've seen Choosing your

James Marland: problem there. Yes. You're choosing your problem.

David Hall: Yeah. Yes. And so where I've experienced more turnover is people that are part-time. Mm-hmm. Because they, when they look at their options of part-time with me versus somebody else. There are other options sometimes for them where that the, they're less, I, I don't like the word penalized cuz it's not, I'm not trying to penalize people, but I am ch I am rewarding full-time people more.

Yeah. And so what that means is that I am more inclined, my retention is, is designed to be higher for full-time people than part-time people. I don't want anyone necessarily to be unhappy and leave. I, I choose, but, but I've seen practices that have done the other bit. Like I, I've, I've seen practices where inadvertently usually that they give, they way more power to part-time people even.

Mm-hmm. Not, not necessarily like truly, but it's, they, I, I think of one of my friends who had a practice where they voted on everything but the part, everyone had an equal vote, whether they were part-time or full-time. And so there was kind of this disproportionate veto power that people with pretty low investment had.

And it hurt the practice, I felt.

James Marland: Yeah. I dunno, I dunno about that.

David Hall: Yeah. And, and anyway, but to your, back to your question James. What happens when you don't wanna do this? Say your expectations and set like what you're doing. So as a, as a different example, my organization, uh, that does teaching psych ma.

Mm-hmm. Is mostly independent contractors. Mm-hmm. Uh, I've, at this point, there are no employees for it. Like, there are people that teach that I, that I contracted to teach and they get paid as independent contractors. But the benefit I have is I'm not managing them in very, like, there's, it's, and it truly is an independent contract where there's expectations of, it's usually them creating a course.

Or some offering. And so there's set things of this is what you deliver, this is what you create, this is how the finances of it will be handled. And it's a very easy exit for both sides. I I, one of the things I learned over time was initially I tried to make it a little bit more strict in like non-compete sorts of stuff, and I've over time done away with a lot of things.

Hmm. I used to have a policy that if you did a course for me, You could only teach it for me while you're wi, while you're in this. Yeah. And, and not another like, and right now the only rule I have is that you can't, you can't duplicate the course in another setting. Um, word. Word for word or slide. Word for word slide.

Yeah. But at any point you can say you have an out at any point to say like, Hey, I, I, I wanna move this course to another platform. Okay. Like, I'm not necessarily happy if someone wants to do that, but I've set up my expectation that people can do that at any point. And I've set up the expectation that for me, if I reach a point where I don't wanna keep a course going because I feel like it's, it's kind of aged out or it's, it's for any number of reasons that I can say like, Hey, we're, you know, we appreciate the work you've done for this, but you know, we're taking it off our, out of our catalog.

And everything reverts back to you. I've really made it simple and really try to do it where it incentivizes people to, uh, I, I wanna make it financially, uh, advantageous for them to be with me. Mm-hmm. But I also want to keep it super loose cuz I enjoy that freedom of, if you left. It's not, um, it's not hugely disruptive.

Now that's a different sort of business. I'm dealing mostly in that case with asynchronous for prerecorded material. Um, it's not an ongoing service like psychotherapy is. Sure. But you might be a place where it's just not one of the things we talk about in the scaling journey. Not all scaling is for all people and growing group practice is not, you know, it's.

Yeah, that if, if you don't wanna deal with a whole bunch of employees, there are ways for you to scale that don't involve, you deal with a whole bunch of employees,

James Marland: which, which, uh, reminds me. Um, take that builder quiz. It's in the links. Uh, take the quiz to see where your next stages of b scaling your practice is.

It doesn't have to be at a team member. It could be something. And the tip, the quiz has lots of tools and tips on, um, how to do that, and then some more free resources at the end. So it's a, it's a good thing to do for just exploring what are some of the options out there. Mm-hmm. So David, uh, great conversation on managing turnover.

Uh, what is one thing you want people to remember from the episode?

David Hall: You need a back. You need a like front door and back door. You need inflow and outflow, and you have to have a way, kind of a, a release valve. You have to have a way to allow turnover to happen. And as James highlighted earlier in the episode, we're not even talking about termination of, of letting people go, but you need to let people who want to move on, move on.

You can have policies to, to help mitigate it, to encourage retention, to protect yourself, and particularly where you have investment in them. But if you try to hold on to people that aren't it, it's not good culturally for your practice. Yeah. You create more and ultimately any, any therapists who doesn't want to work with me, I, I, I, that may be hurtful or that may be disappointing, but I need to be able to let them go because that won't, will not be a thriving work relationship for me or for them.

And

James Marland: it's, it's almost like the good neighbor policy, you know? Mm-hmm. You're, you're a good neighbor to them, and they can, uh, if they're in the same town, you're gonna be working with each other at some point mm-hmm. With passing customers, uh, back and forth. So be a good neighbor. Great. Uh, my, my one thing is have a plan.

Uh, but just recognize your, your, your first time. You're probably not gonna have a really good plan. Like if you follow some of the advice from this show and from other people, you're gonna have something. But there's gonna be things that you're just gonna be blindsided by. Like, for, for me, mine, mine was just like how much of a crisis it was.

Even when we had plans for our clients of how much of a crisis it was, it was for them, and I needed to work. Like really being specific about what we're doing and how we're managing this to manage their sense of loss. And for, for you, you are gonna come up with something you have a plan for, but it's gonna, there's gonna be a new wrinkle and you just get better at it.

Like we mm-hmm. Our, our exit plan was so robust. It was very robust. Uh, after three years of learning, taking the lumps, that I felt really good. When somebody was decides to leave, we had a plan in place for them that we took care of everyone, we took care of the, the leaving the, the assistant that was leaving.

We took care of the clients, we took care of the staff that was taking over. Like, but that didn't happen day one, day one was a mess. Mm-hmm. So, uh, just, um, just have a plan and just be willing to keep growing. As you have that plan, it's gonna feel. But that's just, it's part of the growing process, so, mm-hmm.

That's my, uh, my one thing. All right. So, uh, thank you everyone for listening to the podcast. If you wouldn't mind, please like, and share it with your friends and review it. Uh, we have four reviews now and, uh, I'll start reading some of those coming up. Uh, this is James Marlin with Dr. David Hall. We'll see you next time.

One of my favorite cartoons growing up was Garfield the cat. So in honor of that, I had AI write me the podcast, disclaimer, as if I was Garfield the cat. So here we go. Hey there, folks. Thanks for listening to the podcast. I Garfield the cat. Need to lay down some ground rules. First and foremost, I want to make it clear that I am not a lawyer or an accountant. I'm just a cat who knows a thing or two about lasagna and taking naps.

The information presented in this podcast is for educational purposes only. And should not be a substitute for professional legal advice or accounting services. Also, I want to remind you. That everyone's experiences and situations are different and what may work for one person. Or cat. May not work for another.

So take what you hear with a grain of salt and use your own judgment. When deciding what's best for you. Lastly, I want to emphasize that this podcast is meant to be informative and helpful, but it shouldn't be considered for professional counsel. If you need personalized attention, please seek a lawyer, accountant or therapist. All right. That's all for now.

Now that that's out of the way, let's get back to scaling therapy, eating lasagna, and taking naps.

The scaling therapy practice is part of the psych craft network.