STP 25 | Solo Practice
Hello and welcome to the Scaling Therapy Practice. This is James Marlin with Dr. David Hall. Hello David. Hi James. This week we're gonna be talking about scaling as a solo practice. It's very exciting to talk about, but first we're gonna get into our tool tech or tip of the week. David, what, uh, what tip do you got for us?
David Hall: Um, a podcast episode. I wanna share that. I was, I was, James and I were talking offline. Uh, I shared it with him at the end of last weekend. It's a podcast that I've talked about before on this show. I'll probably continue to talk about it because it's one of my favorite podcasts, but it's called The Online Course Show with Jacques Hopkins used to be called the Online Course Guy.
And I, he rebranded it at some point and, but it is episode 1 94 and it comes out at the end of January of 2023. But it's titled, if I were starting an online course business in 2023, here's exactly what I would do. And it's one of his shorter episodes. It it's, I think it's right at like 30 minutes or something like that, or close to it, 34 minutes.
And cuz he usually runs about an hour and a hour and a half. And, you know, part of his story is he started his podcast in, I think it was like 2017. Talking about his process of, of doing online courses. He has a piano course called Piano in 21 Days, and that's how he makes his living. And it's just been one of my favorite podcasts is somebody who creates a lot of online content and sells online courses, even though I'm in a very different niche than he is.
Uh, I've gotten so many great ideas and I, I just, I, I kind of really like these kind of back to basic sorts of things. Mm-hmm. And it's really kind of this quick overview of, because he started his online course, I think in like 2013 and had, has done several updates as different technologies have, have become available.
And, and that's the neat thing, even since I've been doing things. I started really putting things online in 2019 and the tools and platforms and things that are available and how I understand how to use them has changed so drastically. And so if I was starting what I was doing over again, I would have some different angles I would approach.
Anyway. I just thought it was really for anyone with any interest in exploring online commerce. Uh, And whether you have an online course or a membership or digital product or whatever it is, um, it's a great, and podcasts are great because it's a free resource to be able to, to get some other perspectives.
So yeah, was enjoying that this last week and so wanted to share that. So again, online course show with, uh, Jacques Hopkins, episode 1 94. If I was starting an online course business in 2023, what would I do? Awesome.
James Marland: I'll put that in the show notes. Uh, yeah, I listen to that show almost every week too. It's a, it's a really good, really good information.
Mm-hmm. Um, inspiring too. So, uh, my tip of the week is a little low tech, I guess, but I, I'm gonna suggest putting things in your calendar. Uh, but, uh, at the end of January, I was getting a little frustrated with like, all the things I wanted to do for the year and my goals. And so I just simply took out a piece of paper and wrote down, okay, what do I, what, what courses do I wanna launch in the month?
What are my projects for the month? What are my responsibilities? And, and put them in a calendar for the month. And, and I also have the list on the month. So when people ask me, you know, what, what do you wanna do for this month? Or what, what can we launch? Or What projects do you wanna work on? I can. Kind of feel out my schedule in a, in a big overview mm-hmm.
Uh, area. And I can say yes or no based on mm-hmm. Data rather than, oh, I think I can, I think I have time. Mm-hmm. So, yeah, my tip is a little low tech, but your calendar is very useful. And then, um, you can also add, add, like things like click up or, or, um, Trello for deadlines and stuff. So, uh, use your calendar, get it outta, get it outta your head and onto paper and you're gonna thank yourself later.
So yeah, that's, that's my tip.
David Hall: Yeah. I use Trello and, and here's something I would add to that cuz it's something that frustrates me and I have to tell myself, I use a calendar imperfectly and I think sometimes people will, if, if, You might be a naturally organized person. I'm not. And so what happens for me is I get, like I, I was a child in the eighties and nineties and one of the big things that was a big deal when you would start the school year back then was your trapper keeper.
Mm-hmm. And I would start the school year with a new trapper keeper and it would be organized and I would have these ambitions of how, like I'll put these papers here and use these tabs and all that. I was the sort where my trapper keeper, my school locker. Would just get piles and piles and it would just be, and, but what I would tell myself is, well, I can't be organized.
And to a certain extent that's kind of true, but the unhelpful cognitive distortion in that is, is the all or nothing way of thinking about things. And so where I present it to myself is, I can always be more organized and so I keep on coming back to my calendars even though I don't use them to their fullest extent or this is discipline.
It is still better than nothing and it still helps me, like I've got a whiteboard in my office that on the edge of it, which is right in front of my desk, I have my launch schedule for 2000. 23 for online courses. Now, it's already wrong at this point because I've already changed things and, but it's a, it's about 60% still correct.
And looking at it is still helpful because I'm like, okay, like this is, at least reminds me that, that like I'm working on some timeframe. And so, yeah, do not let the perfect be the enemy of the good. Or they improved. So I, I would concur about the calendar
James Marland: one. One of the quote, I think it was a military person, said, planning planning's, essential plans are useless.
Or something like that. Like you, the planning is essential, but when you, when, when it gets down to it, sometimes your own plans are useless.
David Hall: So sure. But it doesn't mean the planning's not that is correct.
James Marland: So the planning is very useful. All right. So great. Uh, those are the tips of the week. Um, if you found anything useful or if you have a tip of the week, just send me an email, [email protected].
Maybe we'll read some, uh, uh, listener, listener tips. I'd love to add some of that. Ann. Mm-hmm. All right. So, uh, David, we're talking about growing or scaling as a solo practice. Um, I think a lot of people start out solo, right? I mean, how many, how is it odd to start out in a group practice? Or is it normally solo?
David Hall: you mean. Like, it, it, it's the,
James Marland: I mean, statistically, statistically, I'm, I'm assuming there's more solo practitioners than people that join as a group, but, but maybe
David Hall: this's just, I don't know. It, it, I think Sure. Where you're like, I've, I've worked in a group, like if you mean like, Is it more common as an entrepreneur to start a solo practice than it's to start a group practice?
Yes, I'd say so. Yeah. But a lot of people end up working in group practices and mm-hmm. Um, I worked for eight years, well, 10 years in two different ones, uh, two years in, one and eight years in another, and somebody else's group practice. And so that was my practice journey where I was a, um, The first practice I was in 10 99 and then I was a w2.
But it was, it was in a lot of ways, like solo practice, except I was an employee. I was paid proportionally of the client, of my client fees, but I was still, my income was based on client fees. And so in that way it mirrored solo practice in certain respects, not in others, but you know, as far as, yeah.
What's your experience? Oddly enough, none. And that's the, that's the something we were joking about. Like I, we've talked a lot about the show because, you know, I, I have a fairly wide experience as therapist goes, and the different things I've done, I've, I've, in the settings I've worked, I've worked in, you know, residential treatment, I've worked in group practices, I've worked in psychiatry, I've done online courses, I've done seminars and, and I've just, That's just been part of my journey.
But one of the things I've never done is I've never been in solo practice. I went from working in a group practice to starting a psychiatry practice, which we talked about that in a previous episode. Mm-hmm. But that was a interesting journey and when I got out of that, out of being in a psychiatry practice, I immediately went into running a group practice.
I went from. To immediately into three people, myself and two other people. And so I was in a small group, but a group. And so I didn't have that solo practice phase, and that was on purpose. I, I never sought that for certain things, but, um, but it is certainly a lot of people's journey. And so what James and I wanted to talk about today was how to get the most out of it.
That if you wanna grow and scale, but your phase is solo practice, how to. Get the most out of solo practice and not just, cuz some people think the idea of, well, if I'm in solo practice, I wanna scale, I need to start a group. And that is one way to scale. But we're not gonna talk about today, that today we're gonna talk about how to get the most growth and, and scaling out of solo practice.
James Marland: So, Um, some people, you know, their, their per their dream job is the solo practice, right? They're like, they work for themselves, they see who they wanna see. Um, they're their, their own managers. But, um, besides some of those things, like why would, why would somebody want to be in a solo practice? Like you, you're thinking, oh, if I'm gonna grow, I gotta like, get higher employees and buy buildings and do all this stuff.
But why, why would somebody want to be a, a solo practitioner?
David Hall: Depending on what you're moving from, it could mean different things. So let's say you're employed or contracted under somebody else. Mm-hmm. Uh, in a group practice, or let's say you work in community mental health for, for that person, solo practice means, uh, A typically greater return of income for your therapy time if you're working.
You know, this was my journey in working for a group practice of I kept a portion of my client fees and the practice kept a portion of my client fees. Mm-hmm. And if I was in solo practice, I would in, in theory, keep a higher portion. Now here's why I say in theory, um, People can get pretty, uh, starry-eyed about when they look at their income numbers of what they think they can make in solo practice, uh,
James Marland: versus working in a agency
David Hall: place.
Yes. Yes. But it, it's, there are factors that I think sometimes are easy to diminish. Like what does running a practice cost? Yeah. Um, there's, there's, um, intake flow. That was a big thing that kept me in group practice. For a lot of years was, um, I worked for a pretty established group practice and there was a lot of intakes that came into that, and I could not have seen, I, if I was in solo practice, I could have kept more of my client fees, but that's only helpful if you have the clients.
Right. Uh, and but to the point of, of why you, you can keep, you know, depending on how you're managing your overhead, you can keep a, a higher proportion of. Client fees versus sharing it with some other entity. Uh, and if you have a good referral network, um, then, you know, that solves one problem, uh, of things.
But for a lot of people, it, it usually represents if they're going from, definitely from agency work, like if you're doing community, community mental health, but other things as well. It usually represents an income increase. That's one reason people would wanna do it. Um, there's oftentimes a greater sense of autonomy.
Mm-hmm. You know, I, of, of being able to make decisions as a, as a, you know, in that sense, a small business owner, um, you can make all different sorts of decisions on, I I think one of the big things for me when I left group practice was, uh, I, I worked for a, uh, a group practice owner. He was a psychologist and he didn't like it when I wore jeans to work.
And so I was encouraged to add, uh, he, he wanted us to. The men to wear slacks or mm-hmm. Or khakis. And I'm a pretty casual person. I, I struggle in my own group practice sometimes to, to, to set my, to keep my own standards. But yeah. Uh, I, I felt there was a generational gap too of what, you know, what casual slash.
You know, professional look like. And, and depending on where you are in the world, there are different standards. I think of someone I knew who was a solo practice person in Charleston, South Carolina, and he wore a suit every day. Mm-hmm. And that was just the culture that he was in of what was expected.
I'm, I'm, I can get away with a bit more. So anyway, just when I was my own boss, I get to decide, well, this is what I'm gonna wear. And I think of a friend of mine, she started her solo practice in recent years. Leaving group practice and, you know, she loved, um, just having decisions on the decor of her space that she had more freedom on.
Uh, she set up a home office where she set up, um, a suite attached to her house. And so she would talk about like, my commute got a lot better. Uh, uh, she got to, and so, you know, I think there's autonomy. I think there's income, increased potential, um, and. Some, some people just enjoy also the simplicity of, of kind of greater solitude in their work.
You know, I, I think of, yeah, the conversation I had with one person of that they were tired of company birthday parties, they were tired of, and I like that sort of thing, but I, I realize for certain people it's like, you know, I don't wanna do another event, another team building sort of thing. Mm-hmm. Just let me.
Leave me alone, let me do my work and mm-hmm. Um, so I, I think the autonomy, um, the simplicity and the income are, are typically the big things that drive people.
James Marland: Yeah. Uh, I, um, my, my experience is only working inside an agency and some of the things that people would, um, some of the, the therapists would.
Complain about is they didn't get to choose how many clients they saw. Mm-hmm. They sort, they sort of felt like on a treadmill that was one of the big reasons people would leave, is they had all this mandated paperwork and mandated like, how many clients they saw. And the bonus structure was a little weird.
And, and uh, it just felt, it just felt like, you know, you're doing all this work but not getting, All the reward. And of course, the agency provided the things that you were talking about, like clients mm-hmm. And a space, but mm-hmm. You know what, what, as you've said before, what pain are you going to pick?
You know? Mm-hmm. What, what is your pain point that you want to pick? And if, if you're comfortable with like that paycheck, then. You, you can stay with the agency, but if you are interested in doing something more or having more of those mm-hmm. Those freedoms and decisions mm-hmm. Then there, there isn't much you can do unless you decide to go solo.
David Hall: Mm-hmm. Mm-hmm. Yeah.
James Marland: So that, one of the, one of the questions though that was you, you, you brought up as one of the, the benefits, you know, you get paid more money, but one of the challenges was you got, you're responsible for all the. The cost, so. Mm-hmm. I, I was, I was trying to like, bite my tongue saying like, what are those challenges?
Because I know we have this, this, this set. The next section is what are the challenges of being, uh, a solo practitioner? And one of them was cost. So we can start there. Like, what, what costs more, you know? Oh, you just gotta, you just gotta wake up and see people, right. David?
David Hall: Right. Um, I mean, you can, there, there are issues with it.
I, I, um,
So I, I'll start off this idea. Cause you asked the question of costs, and that's a moving target. Depending on when someone is listening to this, it may have changed. Mm-hmm. I know in my arc, my career arc, it's been different. So my very first job out of grad school, I worked for an L P C in, uh, Atlanta, Georgia.
And I was, so, I worked in a group practice, but it was really low overhead, uh, support or really, there wasn't a lot of structure in the practice. It, it was, uh, there was no reception staff. Mm-hmm. Um, I, it was in a lot of ways it was light being in solo practice where I had, I had my office space and, but I was responsible for most things.
I ran my own schedule. I. Booked clients. I took phone calls, like there wasn't a central line, there was lots of stuff. So, um, and this was in 2006, so quite a bit of time ago for a lot of people, you know, getting close to 20 years, which is just nuts for me to think about. Uh, so I had, uh, you know what, running a practice in that, so, we'll, we'll treat that as I was a version of solo practice.
Mm-hmm. Um, I. My office phone was my cell phone. I know a lot of people do that now. Um, they're, they're more options now of not having to be out of your cell phone where they're, um, in my office we have desktop phones, but I also, all my staff have a, uh, A V O I P, which is, um mm-hmm. So it's an app based thing where it allows them to have.
To make office phone calls on their cell phone without it being their cell phone number. Because generally it's, it's a, you know, different practices run differently. I, I don't like, um, I, I, I think that's an important boundary of just, uh, yeah, I would agree with that. I, I know therapists that do it, that's just the nature of how they run their office or how things are, but I don't text with clients.
I don't, um, that's just a boundary I have, but I, I had less of an option then. Because they needed a way to get in touch with me. And so I ran things out of a cell phone. I did all my notes by hand. I had, uh, physical files where I would write out my psychotherapy notes. Uh, I had a, a calendar book, which is where I kept my appointments, and I, I set up codes so I, so, uh, I wasn't giving away client information.
I, I had like a legend. That I kept separately of clients and what their, uh, uh, code was initials were Yeah. Uh, to kind of put in and then write that in the calendar. And so that was, uh, that was how I did it Then, um, now, Most of us run out of electronic health record systems, and there, there are a lot of options to choose from, but that allows you to handle your billing.
And like that was the, you know, I had, I had, we, I, we had a credit card machine in my office. I didn't pay for that. That was my, my boss paid for that. But I literally had to take credit cards from clients and run credit cards. And I, I, I've not touched a credit card from a client in years. Uh, because it's all part of the E H R system now, all my client reminders and, um, and now telehealth is something that's, and so there's, I bring that up because there's a lot more that makes it simpler now, right?
But it also represents expenses. You know, I, my expense for my notes before was paper and, and folders. And now if you're in solo practice, you tip you, you. I would treat is you need to have a a, an ehr. So that's a monthly expense. You need to have malpractice insurance. In the group that I run, we offer a group malpractice insurance policy, but if you're in solo practice or you're a 10 99, you have to maintain your own.
Uh, malpractice insurance. There's, um, any advertising you do, like a lot of people will do an online profile on the different directories. Mm-hmm. Uh, sometimes multiple. So whatever you're doing for advertising, there's that, um, webpage. Yeah. Yeah. You have a website, like a lot of EHRs, you can, they'll have website builders, but you, you need to have a website.
Like I, when I started, uh, Almost 20 years ago, a lot of therapists didn't have websites, but you can get away with that lesson and less. Now, I, I'm very distrusting of a business that doesn't have a website right now. I'm, I'm often fearful I'm going to be murdered when I go to that place, uh, if, are they even real?
Yeah. Are they even real if all I see is the street view picture on Google Maps and there isn't any further information, I sometimes look at like, am I gonna go into that building? Will I come back out? So that may be a bit melodramatic, but, but there's co and, and this is the same thing if you're an independent contractor, but you have to pay self-employment tax.
That's the thing of, that I offer people that work for me in group practice is they're W two employees. And so I pay as their employer part of their employment and taxes. And that's, um, not an insignificant percentage. Uh, I think it's like 7.68%. I haven't looked in a little bit, but it it's that, that they, that you have to pay for yourself.
And so if you're self-employed, you've gotta be, ideally if you're self-employed, you wanna be doing quarterly. Um, estimated, uh, uh, tax payments. Otherwise, you know, you may end up with penalties if you just pay your tax bill once a year. And that means, and I, I know a lot of people that this throws them off because they've got, you know, they get their money in and they think, oh, you know, great.
And then they get a tax bill and they hadn't put enough aside for their taxes. Right. Or they underestimated what they have. And so you, you have to be a little bit of an accountant. You have to be an accountant and you have to be an office manager, and you have to be in, and I'm just describing what it is too for a cash practice.
Yeah. If you're doing insurance, that's its whole other thing too, where you have to, either you're doing your own insurance filing, which I know therapists will do in solo practice, or you have to pay somebody for that. Either pay them an hourly rate or a flat fee or a percentage of your, and so all that becomes expenses for you being in solo practice.
And that's an expense and complications, it also be kind of isolating and lonely. Yeah. Um, most, not all, but most things I hear about ethical violations or legal violations that therapists can get into. This isn't an absolute, but I, I, I'm odd like this, where I, I will read the disciplinary reports for my state licensure boards.
Uh, part of it I just like keeping up with. You know what's happening and you know, what's affecting my profession and things like that. And I've, I'll come across the stories of people that are censured or even have their licenses taken away because they cross boundaries or want, um, maintaining records or, and.
A lot of them, they're on their own. And I think there's something about when you're in isolation, there's the emotional toll of that, but it's also easy to let a lot of things slide. Yeah. That if you had the accountability of even suite mates, you uh, maybe not have quite in the same way.
James Marland: Yeah. Those are some significant challenges and, and I.
Um, unlike you or no, unlike your, your people who said they miss birthday parties and stuff, that's one of the, or they don't miss it. That, that's one of the things from working from home for the last four or five years now, is I do miss some of the birthday parties and also the accountability and like the, the sharpening of, you know, some meetings, not all meetings, but some meetings, you know, where you, you talk about things and plan for things.
I remember. They had group supervision in, in the agency and going to those and like hearing about other cases and learning things, even though it was, you know, somewhat mandatory for the, the license or whatever, the facility license or whatever they were doing. Mm-hmm. Um, it was, it was a, it was human contact and learning, you know, learning together.
And one, one of the challenges of being alone all the time is you gotta find another outlet for that.
David Hall: Mm-hmm. Mm-hmm.
James Marland: All right. Uh, any other challenges before we move to what are, what is the best way to get the most out of solo practice? Um,
David Hall: yeah, I, I it relates to theen, the sense of community. You know, we talked about community as accountability, but there's also the community as it relates to a sense of solidarity or support.
So, um, I, I think of what the experience was is to be in practice at the beginning of the Covid pandemic in 2020. Mm-hmm. There was a lot of hard shifts that people in mental health had to do, and it, it's weird to think about now, but a lot of us had very minimal, if any, experience at all with telehealth.
Right. And, and then I had done a very, Minimal amount of telehealth in 2020, before as 2020 was started. And the E H R I used, they actually had like a month before lockdowns had happened, or maybe two months, but it was fairly recently in that timeframe, they had just rolled out their, their, uh, integrated telehealth feature.
And that was a very fortunate thing to be able to have access to because, uh, people were a lot more EHRs now have it standard, but in spring 2020, there were a lot that didn't. And so people were trying to figure out like they were, you know, do, do Zoom and trying to figure out what was HIPAA compliant and Right.
You know, Teladoc and there were all these different things that people were trying to figure out. And a lot of people I knew in solo practice were calling me for my advice. I'm like, what do I do? Because there was all this, they were trying to figure out like, how do I maintain my, how do I maintain my livelihood?
How do I, and I bring this up cuz you're in solo practice, oftentimes you're trying to figure out these hard things on your own when you're faced with an ethical dilemma. Mm-hmm. When you're faced with a business, um, struggle, it's on you. You've gotta figure out, like, and, uh, you know, I'm, I have the benefit of, you know, I'm, I'm business partners with my wife, who's another therapist, and so she and I have the ability to lean on each other and even, you know, staff, we have the, you know, I, I, I wasn't making, I had to make decisions of how we were going to navigate things, but I wasn't making the decisions in a vacuum, right.
I had kind of a community around me where we were kind of in it together, and I think my anxiety would've been quite, uh, quite a bit more heightened. If I was on my own in that and, and you know, that's a pandemic. But there are other things too of just, you know, what happens when the unexpected happens cuz the unexpected will always happen in business.
Mm-hmm. And between, you know, a physical issue in your building to, you know, some law passes and you know, like a thing that happened in recent years was the no surprises act of how people Yeah. Now have to disclose and, you know, those are things you have to figure out on your own if you're on your own.
So I, I would add that as another challenge. Okay.
James Marland: So what are, what are some ways people can get the most out of their solo practice? Like it the, for the people who are like, I love to be a solo practitioner. This is, I'm not, I don't have dreams of like, hiring people or buying other buildings or doing other things, but they still wanna grow and scale and kinda like maximize their time and maximize their return on investment.
What are some ways a solo practitioner can grow and
David Hall: scale? There are two ways to categorize your time in solo practice. Mm-hmm. There's your therapy time, which is, you know, and, and that's the time you get paid for. It's the time you're doing therapy. Um, and I would add your documentation and notes in that as well.
I've, I've talked to therapists that sometimes they forget that their documentation is a part of the therapy work, and, you know, you can't treat that as, as extra, but there's the, there's the therapy part and then there's everything else. Yeah. And everything else is, is communicating with your landlord or if you have your own Mm.
Uh, Building, it's managing all the things that require, you know, making sure that there's enough toilet paper and that the bathrooms are in working order, and that the lobby, if you have a lobby isn't messy, or you take your pick on all that, you know, as the roof leaking is, you know, uh, You know, there's the physical space, there's, you know, if, if you have an insurance based practice, it's the billing.
Mm-hmm. It's dealing with that. It is client communication outside of the therapy time. Like how do you, how do you book people? How do people book? It's returning phone calls. It's returning in emails. It's uh, it's, it's everything else. And usually everything else is all the, yeah.
James Marland: Well, all the hats like, yeah.
You're like all the things that like, okay, I'm a therapist or I take off my therapist hat. I gotta like empty the trash can. I'm the janitor. Okay. I got to do the, the, the landlord stuff. Okay. I'm, I'm a, I'm a building renter, you know, you're like switching your hats.
David Hall: You're an accountant sometimes. You're kind of all these things and Yeah, generally efficiency in the scaling process is how do you streamline all the other stuff.
Because usually solo practitioners feel the best where they find that they're able to spend the minimal amount of time on the non therapy stuff. Yeah. And the maximum amount of time on that, that is both in the sense of reward because that's what they desire to do typically, and it's the most profitable use of your time because everything else is overhead time.
It's not any time that's generating income. So thinking about how to streamline the process of everything else, how do you keep
James Marland: the therapist ha on the longest Yeah. While streamlining the other systems and responsibilities that keep your business running. Mm-hmm. And full of clients.
David Hall: Yeah. So the things I recommend for that is, is, you know, if you're in solo practice, Uh, do kind of a self audit.
Look at where, where's my time allocated and the things that are non therapy related. How to, you know, brainstorm on what to do. And I'll give you an example of something I did in my group practice of one of the things that I found from hearing from clients and, and taking some questions would be, People trying to find a therapist with openings because I, I have a fairly large group practice and this has become more of an issue the larger the group has gotten.
So if you go to our website, they're over a dozen therapists with profiles to look through it. Well, people would look through therapist profiles and choosing a therapist and cuz we have an online booking system where people can request a therapy appointment online. But they would go through and they would pick out a therapist, oh, I really like this person.
And they go to book and then realize this person isn't taking new clients. And it wasn't until they went to book and then I have to go back. And so they would, they do that a few times and that became an issue the larger the practice gap cuz there were more therapists for them to go through. And just the fuller, more therapists became, so I became aware of this as a problem.
And it was both a problem where it was delaying clients from booking. Sometimes clients, because of the time it would take them, they wouldn't book in the end. Hmm. Because they would, you know, go through two profiles and realize that no one was, and they would be discouraged and or they would have to, they ran out time and all come back and looking again later.
And there was that. And I also realized that I needed a way to funnel clients to therapists that had the openings and because. There were, there would be therapists with openings, but it would take clients or potential clients a while to get there. And that was more of phone calls I had to handle, uh, as a practice administrator.
So I, I thought through this problem and I thought, well, what's a way for me to streamline this? And what I came up with is, I created a color coding system on our website that if you go on our website, our, my practice is Haven Counseling Center. You can find [email protected] and you go to the profile pages of the therapist at at least the time of this recording, everybody has, there's a legend at the top of the page saying that like, um, because every therapist profile has a colored ring around it.
Depending on the color of the ring, it says that indicates where they are and how many openings they have. And it says at the top, there's a legend that says if they're on green, they can usually get you in within a few weeks. If it's a yellow ring, uh, they can, uh, You know, they, they have more limited openings for maybe certain client groups that they're not taking anymore of certain things but are of other, and there's a intake form for that, or if they're red, they're not taking new clients.
Is this something
James Marland: you have to update manually?
David Hall: I do. Um, but I have a pretty, I use Wix as my website manager and that's pretty easy to update and, okay. Therapists just communicate that to me in the practice where they'll say, Hey, I, I'm need to go to red. And it usually, it's, it's not very time consuming. I can usually, you know, make the updates within a minute or two, but it streamlines the process of people booking cuz they can go through a, clients can look on the profile page, on the master profile pages and see like, okay, who's taking new clients or not.
And so that really, and I found that increased. Uh, booking flow, people could book more easily online, and it decreased my time as a practice manager having to answer potential client questions. So, People do this in different ways. They'll, they'll, you know, refine their FAQ on their website or they'll, they'll do updates on their website, copy, how they write about things of if you find that you get a lot of questions on, do you take my insurance?
You may need to highlight more. And where clients are finding you in information about your insurance policies or what you take or what you don't.
James Marland: That, that takes me back to what you were saying in, uh, in the, in the beginning about knowing where your time goes. Mm-hmm. Like take, uh, do a time audit and there, there are plenty of like, um, templates out there I think for, for time audits.
But one of the most useful things we did at the virtual assistant company was we did a time audit for where all our time was going and then we saw where the hotspots were and we could apply resources to it. So for the therapist to do the same thing. If you're spending, you know, five hours a week on uh, insurance, or five hours a week on scheduling or whatever it is, could you get a return on investment by hiring a virtual assistant and seeing three more
David Hall: clients?
You know. Well, and that, that becomes the Yeah. The other thing is decide where you need help because a lot of people are, are reticent to spend the money on a virtual assistant or an in-person, uh, admin person. But you've gotta look at, um, I, I don't mow my lawn. And there are two reasons for that. First is I don't like mowing the lawn.
I did it when I was in high school, and I never li some people, I, I, it's very therapeutic for them. I know a lot of people that they love coming home and having a physical activity that's different from therapy. Mm-hmm. And I enjoy that for other sorts of things. Like, you know, I'll do different yard work sorts of things.
I, I enjoy certain yard work. Mowings not one of them. So I don't mow for one. I don't like to do it. The second is, It is much more efficient for me to pay somebody to do it and you know, cause I look at like if I, the time it would take me to mow lawn if I did a therapy session, what's my return? Right? My return for is, is much better for me to just do a therapy session step because what I get paid for a therapy session is significantly higher than what I have to pay somebody to mow my lawn and that.
Becomes, you know, it, it's a logical exchange. And for you, if you enjoy certain admin things, then great. I don't want, no one wants to take your, you know, your joy in that. Yeah. But if, if this is stuff that. Is a barrier to you in, in your time and you doing what you really want to do, then think about like, what would a virtual assistant cost me to have them?
Mm-hmm. You know, how many, how many hours a week would I need somebody? And what would that cost and what does that equate to my, uh, income producing time? How many therapy sessions is that? And it's, it's not complicated math. And just decide like, is it worth it to me to do an extra therapy session a week and not have to return phone calls of having somebody that does intake coordinator work?
James Marland: talked about this before, um, but Julie Harris for her show, um, the Therapy, therapy of Money, I think she's from Green Oak Accounting, uh, one of her freebies is an ROI calculator, so you can just plug in your numbers and. See what's my break even and what's my, my return And, uh, uh, it's, it's, she does, so the math is done for you in a spreadsheet, but yeah, I'd, I'd for any of these extra, uh, uh, expenditures.
Mm-hmm. It go, it's good to kind of see is it worth it to do this type of things, cuz there, there might be some, Some expenditures that it's gonna take you like three years to make your money back, or there's other things that it's only a couple months. So what? And so then when you give that work away, not only.
Can you be more efficient? But then you don't have to do the things, you don't have to do the things you don't like, like you're not, we're not good at everything. We don't love everything about running a business. Mm-hmm. Uh, so find the one, the things you like and maximize that. And that's where you make a lot of your mm-hmm.
Your, that's where you get your joy first, but, but it's also where you make your most money.
David Hall: Mm-hmm. Absolutely.
James Marland: All right. Any, any other, uh, uh, you, you mentioned, um, I think it was in the pre-show about sharing expenses. I guess that's one more way of maximizing your
David Hall: Yeah. And that, that is a good, um, I love how you call the conversations we have offline, the pre-show. Because it, it assumes that people that like, cuz you say, like, when you say it like that, I know what you mean, but it sounds like a pre-conference.
It'd be like, oh, for those who are with us in the pre-show, which is just James. Yeah. Maybe someday. Yeah, maybe someday. I don't know if that would be worth recording, but, uh, but yeah, most likely not. Most likely not. Uh, so, um, yes. And, and so it does become very few things are an absolute. Either or in business and lots of other things in life.
And solo practice doesn't have to be completely by yourself. And because there are practices in town, uh, in my community and in a lot of communities that are true associate practices and what that will often mean, and I'll, I'll one that comes to mind that several of my friends work in. They have certain shared expenses, but they're, each individual businesses, like they all are incorporated individually.
They run their own EHRs, they have their own malpractice insurance. People pay rent, uh, to the same kind of master entity. However, um, there are things that they share in the way of expenses, like they have a single website. And people pay. You know, I, I think it's part of their associate agreement that they kind of share expenditure, but, um, there could be ways to have certain group practice fields where you can have a sense of community, you have a sense of comradery with other people, but still be running your own business and.
You know, if I was ever in a place, I, I could see myself one day not wanting to be the principal of a group practice. It, it is, I, I generally enjoy it, but I, part of it is I don't assume anything forever. I don't assume that my life will always look business wise or personal wise in, in the, you know, there, there's certain things in my life I'm very committed to.
Uh, but they're short. Like I'm, I'm very committed to my wife. I'm very committed to my family. But outside of certain relational commitments, things are flexible. I, I'd like to be a good and loyal friend. I want to be, I want to treat my employees, um, well. But that doesn't mean I see that they're always gonna work for me cuz they may choose not to work for me at some point.
Right. And I may choose that they as individuals aren't gonna work for me at some point, or the business structure, I may just choose, I don't want to do business in this way anymore. Or there might be changes in my circumstances or the circumstances in our industry that how I run a business won't be viable in the future and Right.
That may be hard in adjustment. But all I to say, I, I don't assume anything forever. I never imagined wanting to be like in an office by myself. Uh, but I could see being part of an associate group one day if, if in a different phase, uh, because I would want the community, I would want things, but I could see like, well, but, you know, keep my part of the business simplified.
And so that's, that's I think some way where people can, and you may be in a place where you have been truly solo, truly on your own, and you, you're over some of the downsides of that, but you're not ready to hire people or you don't wanna work for somebody else. You know, you can create an associate collaboration with other people and look at that.
Usually in that there's certain shared expenses and there are certain things that are still individual expenses, but it is a, a greater efficiency. Sometimes people in associates too, they'll, they'll pool resources to hire, um, an, an intake coordinator and mm, you know, a virtual assistant doesn't have to be just your virtual assistant.
It could be if you have an associate, uh, co-op. It could be part of the shared expenses, and so that makes it even more affordable. Great.
James Marland: Okay. So, uh, David, what's one thing you want people to remember from the episode or one, one thing that, uh,
David Hall: that is, this is my bias as a group practice person. I think, again, solo practice of it is, uh, de decide what headache you want to deal with, because I think some people, We'll go into solo practice thinking that it'll make their lives easier.
And it might or it might not. Um, I've just seen people that they don't, their overhead ends up being greater than what they think it's going to be. And, um, I, I was talking to a friend recently who had, he, he runs a small group practice and somebody recently left his employee to go on their own. And she's complaining about the former employee about the expense of rental spaces.
Because I think they had this idea of like, oh, I'll be able to make all this much more money. It's like, well, they're realizing that rent is gonna cost 'em far more than they anticipated, and is, I think it's now having some regrets on their decisions. So, uh, know your numbers. No. Like, is it really gonna be worth your time?
Um, know yourself and to know. And so I guess it's just, you know, The one thing take away is solo practice can be better. It's not always. Um, and that could be a self-serving bias as somebody who runs a group practice, but I, I wouldn't wanna be in it. Uh, and, but if you are and you know your numbers and it fits your personality, then um, uh, you know, that could be great.
James Marland: So yeah, I was, I was gonna have, my tip was gonna be something like that, because, From, from being on the other side of running a business and having all those extra expenses, it, it was, it was a struggle. It was more of a struggle than just like, oh, we're gonna deliver this service and. It's, you know, all this money's gonna come in.
But then, then there were taxes, and then there's mm-hmm. Um, insurance. I don't know all these expenses, uh, there, which left a smaller pot. So know your numbers. But that was not, um, my tip was gonna be, uh, know your time. Know your time. Because, uh, doing those time audits, they, they, they're, nobody likes to do them.
Okay, we'll get that outta the way. Nobody likes to write down exactly what they're doing, when they're doing and what, how long it took them. Um, but it is so eye-opening when you put all the data together and you're like, I spent 20% of my time doing this task that doesn't, you know, like email or something, like something that is not producing the bottom line.
It's not delivering on our promise. It's not helping our staff. It's, it's something that is just a needs to get done, but it's a time waster. Uh, it, it's eye-opening. And, uh, we were, we were doing, we were doing time audits, uh, quarterly, you know mm-hmm. In, in the company just to see where our time was going and how to be efficient.
And it opened our eyes to like, Hey, people get stuck on this process. So what if we, what if we did a training on that process or added some support and now all of a sudden the, the bump in the road goes away and they use their time more efficiently. Uh, and as a practi, you know, a solo practitioner, you know, a time audit is gonna help you figure out where it's going.
Do you like doing it? Is it a strength for you? If not, can you, can you delegate it or minimize it? I, I highly recommend doing a time audit. It, it's very eye-opening. So that's my, that's my tip of the week. Yeah. Or my one
David Hall: thing. Yeah. Uh, we'll, ju yeah. Who's gonna end?
James Marland: Go
David Hall: ahead. You end. We're this is this good conversation.
Happy for it. I hope this was helpful for whoever's listening to this. I have been Dr. David Hall, and this has been James Marlin with the Scaling Therapy Practice Podcast, and we'll see you all next time. See you.
We did this
James Marland: before. You did it. It was great. Uh, how do I stop this thing? Okay. Stop recording.
James Marland: Thank you for listening to the scaling therapy practice. I hope you enjoyed the show. I want to remind you that the content shared today is for general information and entertainment purposes only. Opinions given should not be considered as legal or tax advice. If you need a professional advice in those areas, please consult with a licensed attorney or accountant, but thank you so much for listening.
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