January 15, 2025 • 29 mins
Katie May shares her journey from solo practice to successfully managing a group practice while emphasizing the importance of strong systems, a supportive culture, and data-driven decisions. Her insights offer essential guidance for therapists looking to grow without sacrificing the quality of care or their well-being.
• Transitioning challenges from solo to group practice
• Importance of culture and support within teams
• Utilizing systems and processes for clarity
• The role of data in managing productivity and performance
• Salary vs. commission: Which model works best?
• Overcoming burnout and maintaining a healthy work-life balance
Work with Katie:
Consulting website: www.visionarytherapist.com
Stabilize & Scale: www.grouppracticescale.com
Austin Group Practice Owners Summit: https://stabilizeandscale.thrivecart.com/visionary-summit-austin/
Our Profit Coaching program is enrolling new practices now.
We specialize in helping therapy practices like yours achieve financial clarity, so you can focus on what you do best—helping your clients and managing your team- while we help handle all the businessy stuff they didn’t teach you in grad school.
To see if your practice might be a good fit, schedule a free consultation at therapybusinesspod.com.
Meet with one of our coaches
*Intro/outro song credit:
King Around Here by Alex Grohl
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:01):
My name is Craig and I'm the CEO of Desi Financial
Coaching.
Our goal is simple to help yourun a therapy practice that is
permanently profitable.
If you own a solo or grouppractice, we're here to help you
build a business that createsmore time, makes more money and
serves more people.
This is the Therapy BusinessPodcast.
Today we have Katie May, withVisionary Therapist, joining us
(00:27):
to talk about everythinginvolved with owning and growing
a group practice.
Katie has launched and grownher own therapy practice that
has multiple locations andaround 20 employees, and has
taken what she has learned andbeen consulting therapists like
you into how to grow yourbusiness, what systems and
processes do you need and howcan you successfully grow a
(00:48):
thriving group practice.
So, without further ado, let'sjump into the interview.
All right, Katie?
Thank you so much for joiningme today.
Speaker 2 (00:57):
Yeah, I'm psyched to be here.
Speaker 1 (00:59):
Yeah, so I'm such.
I know so well how growing agroup practice and how
challenging it can be and withour clients a lot of them either
they're new to the grouppractice thing or they're solo
and they're wanting to become apractice owner and have
therapists under them.
It's kind of choppy waters,like not really knowing what to
(01:19):
do and how to navigate that.
Has that been your experience?
Speaker 2 (01:23):
Yeah, I want to start off by saying I never thought
or knew that I wanted a grouppractice.
So that's kind of.
The starting point was that Iwas in solo practice and I just
had more referrals than I couldhandle.
I specialize in team dbt so Ithought I can't send them to the
generalist down the street.
All right, fine, likebegrudgingly, but also
excitingly I'm going to start agroup practice, and things
(01:45):
really exploded from there.
But to your point, my instinctin not wanting to start a group
practice was because I knew Icould count on myself.
I knew what my skills were, Iknew what I could do.
But having to manage otherpeople felt really challenging
to me and it was yeah, yeah.
Speaker 1 (02:01):
I went through the same, the same fears and hiring
a team at my business and one ofthe big pushbacks I hear a lot
and I felt too was it's it's mybrand, it's my name out there
and these, you know, trustingpeople to represent me was
terrifying you definitely needand it's vulnerable once you
(02:22):
start imparting that wisdom orcreating the systems, all of
those things is trusting thatother people are going to follow
through and actually uphold thequality that you yourself know
that you can uphold.
Absolutely 100%.
Well, tell us a little bit.
I know you have a coupledifferent businesses that you do
, but you have your therapypractice, but tell us about you
and your businesses.
Speaker 2 (02:42):
I own a group practice in the Philadelphia
area.
We have give or take on any dayabout 20 employees and two
locations.
Like I said, we specialize inteen DBT so we work with teens
and parents and I've reallycreated a solid brand around
these services.
I published a book for parentsof teens around this idea.
So really strong brand inhelping teens and parents in
(03:06):
high-risk behaviors and in thesuccess of growing my practice.
Because I started as solo, Iwent to a little small group
practice of four which thendoubled in size, then I bought a
building, then I bought anotherbuilding, so things just kind
of really grew every single yearfor me and because I was
sharing these successes, itnaturally led to me then
coaching and consulting withother practice owners to help
(03:29):
them develop the practices thatsupported their lives, that
supported their vision and alsowasn't so hard in the process
like learn from my mistakes andshorten the struggles so that
you can see more successes morequickly.
Speaker 1 (03:42):
Yeah, that's so fantastic and you've done
amazing things with your ownpractice and then to turn around
and almost pay it forward toother practices is huge.
So what's one of the commonstruggles?
When people come to you for thefirst time, what do you usually
see they're struggling with?
Speaker 2 (03:59):
People when they come to my program and I co-lead it
with another owner of thisbusiness, shailene Kite.
So when they come to my programand I co-lead it with another
owner of this business, ShaileneKite.
So when they come to our program, what I'm typically seeing is
that they've grown beyond thepoint that they can manage.
So maybe they started with thislittle scrappy and strong team.
That really was part of thatstartup vision with them, and
typically I and others that I'veseen are pretty transparent
(04:20):
about we're just starting thisthing, we're learning the ropes,
but the more you grow, the moreyou become a real deal business
and then the people that youhire into that business have
different expectations thanemployee one, two and three when
you are a scrappy startup.
So what I start to hear is thatemployees are quote unquote
entitled, that they want morefrom you, that the expectations
(04:42):
are different, that they'repushing back against the system
because now, all of a sudden,this power dynamic has been
created.
Because you're a boss, you havea real business, and so that
becomes the struggle point thatI see when people are coming
into the Stabilize and Scaleprogram because they're like,
wait a second, this is not howit was before.
I've seen this level of success, but the struggles that come
(05:04):
with that success look different.
Speaker 1 (05:07):
They really do and I've felt that, and even working
with my coaches right now, it'sbeen what was working for me
when I was a solo business owner.
Doesn't work when you'regrowing, you have a team of
people, and the number of leadscoming in the door when it was
just me, it felt like, wow, I'vegot more people than I can
handle, than all of a suddenit's like we need more leads
(05:27):
coming in the door so we can getmore clients.
So it is an interesting pivot.
Speaker 2 (05:33):
Well, and what I see is that it becomes transactional
.
The mirror is then turned backaround for you to look at
yourself, because what wasrequired from you as a solo
business owner or a smaller teambusiness owner now looks
different and it requires you tostep into different roles in
terms of holding a higheraccountability, in terms of
(05:54):
being more direct in sayingthings like I expect this from
you, versus like having twoemployees who are really jazzed
and want to do all those things.
Sometimes you have team memberswho don't want to do things and
you still need to uphold thatexpectation, and it becomes this
uncomfortable shift in how youshow up as a leader and really
manage your team and hold themaccountable.
(06:15):
And that's one of the biggestpieces that I see as struggle is
that shining the light ofaccountability and really
holding people accountable in away that's not overshooting it
and being aggressive, but alsonot sitting back in your chair
and letting things happenbecause it's uncomfortable to
address it.
Speaker 1 (06:31):
Yeah which I think is really common to see both sides
of that coin I feel like withtherapists and this has been my
experience with the clientswe've worked with I feel like
that side of they don't want tocome off too harsh or too strong
or overbearing or micromanaging.
That seems to be a huge trendthat I've noticed.
I notice it in myself too.
No one teaches therapists ingrad school how to become
(06:55):
business owners and all of asudden you find yourself in this
business owner and manager seatand having to balance making
people happy while also makingsure that things are getting
done and that it's to yourstandards.
Speaker 2 (07:08):
Absolutely, and I have the thought that if I find
myself having to micromanagesomeone, I've made a wrong hire
or I haven't properly orientedthem to my expectations and the
systems that they need to follow.
So I don't like to micromanage.
I have very clear expectationsand systems that we follow and
(07:29):
quality assurance that we havein place like checkpoints for
those systems.
But if I'm having to manage youto do your job well, you are
not in the right job right nowand you need to be somewhere
else.
Speaker 1 (07:39):
Yeah, fantastic.
So when it comes to teammembers too this is a question I
have, I think, a lot of timesthere's fear for practice owners
that their team is going tocome in, they'll grow a caseload
.
Then they'll turn around and go.
You know what?
I can go make more money on myown and they'll leave.
And so there's this fear of Iwant to entice them to stay.
But also, what's that balance?
(08:00):
Do I nurture them wanting tostart their own thing?
Do I try to hold them in?
What is your experience withthat?
Speaker 2 (08:06):
Yeah, well, it's true is that I mean, I am an
entrepreneur.
I once worked for somebody elseand had the thought I want to
do this on my own.
I want to be my own boss.
I'm otherwise unbossable, so itmakes sense anyway that I don't
work for somebody else.
But there, I think to someextent there is the reality.
What I teach is that we rent ouremployees.
We don't own them.
(08:27):
They're not ours to keep.
And so in my practice, we'rereally transparent about I want
you to have a career worthhaving.
I want you to be fulfilled andachieve your dreams, because
that's my value system andthat's what I want for myself,
and if I want it for me, I wantit for all of you.
And so what that looks like isbeing really transparent.
(08:47):
Some choice points I would say,like when pre-licensed
therapists achieve licensure.
When therapists have been withme, you know, between that three
to five year mark, we're havingthese conversations around like
is this still aligned with yourgoals?
What's the next step for you?
Is it here, becoming asupervisor?
Have you thought about being inyour own practice?
They're thinking about it,whether or not I say it, and I
(09:10):
think there's this fear of likeoh, I don't want to put the idea
in their head, but I see thatas the cost of doing business.
When therapists leave mypractice, they take their
clients with them, because wedon't own clients.
Clients are people withautonomy and so we just need to
plan for the onboarding andoffboarding process.
So you had mentioned leads,like knowing there's enough
(09:30):
leads coming in, that if someoneleaves with 20 clients and I
hire someone new, I know exactlyhow long it takes to fill that
new therapist.
So it's really just having yoursystems and your data that
support.
People will leave One day.
I might leave, so we need to beprepared for those changes.
I often look at owning abusiness like trying to balance
(09:52):
on top of a rolling beach ball,and I remember these really
distinct points in my careerwhere all I wanted was that
beach ball to stop rolling rightso that I could finally relax,
and then I had this realizationthat this beach ball is never
going to stop rolling.
So my job is really to justlearn how to balance on top of
the beach ball and find my zenwithin that, rather than trying
to stop it Like realityacceptance here.
Speaker 1 (10:14):
Yeah, I think that is really really great advice.
I think, as we are even justtalking about that, that fear or
the sit back and let thingshappen, and so that
confrontation I've seen thatthat can even derive from fear
of pushing people out and thatthey're like you know, and I
don't want to boss anymore, butjust nurturing that or leaning
into it and just saying, yeah,like you just said, we're
(10:34):
renting our team, which I thinkis a fantastic perspective,
because every practice ownerstarted working with somebody,
most likely, and we all had thatdream.
And then there's also peopleout there who have zero interest
in the business side ofmarketing and lead to all that.
They're like nope, I just wantto be a therapist, that's what I
want to do.
Speaker 2 (10:52):
Yes.
Speaker 1 (10:53):
So finding that balance.
Speaker 2 (10:54):
And I love those people.
You know those rock stars thatcan excel within our practice,
and I think it's also likeknowing the value that you bring
within your practice.
We have a really strong cultureat my practice.
We have consult teams.
They have learningopportunities.
You know great benefits thatyou can't always find when
you're in your own practice andso knowing the value of your
(11:16):
offer for me, it makes me feelcomfortable knowing people will
leave but we can attract newgreat therapists too.
Speaker 1 (11:24):
Yeah, I think that's awesome.
So you've been talking a littlebit about systems and processes
and the importance of that.
I'm the creative visionary typesystems and processes.
I importance of that I am.
I'm the creative, visionarytype systems and processes I.
I love them cause I need them,but I don't.
Naturally they don't comenatural and so luckily, I've
hired a team of people who arepatient with that and know for a
long time it was just what's inmy brain is is my process, and
(11:47):
so translating that intobusiness itself.
What have you seen in that?
Is that a common struggle withpeople?
I'm hoping I'm not alone inthat.
And then how do you help peopleovercome that, taking it from
their brain and turning it intosomething actionable that can be
repeatable across other people?
Speaker 2 (12:04):
You're definitely not alone in that, and one common
struggle that I've seen withmany business owners is when I
hire people in.
It's a lot of work to teach tothem.
But even if I hire people in sothat they can support me like
an admin or a virtual assistant,there's all this front loading
to teach them what's in yourbrain so that they can do it the
(12:25):
way that you want it done.
And so when I work with grouppractice owners, my rule is the
rule of twice.
So I'm telling them you're notgoing to sit down and write a
hundred page manual of everysingle system in your practice.
You're going to build uponwhat's already there and do it
on an as needed basis.
So if someone asks me aquestion more than once, that's
(12:46):
my rule of twice.
I'm either going to use Loom andrecord myself doing the process
.
I'm going to write it out, andthen I'm going going to use Loom
and record myself doing theprocess.
I'm going to write it out, andthen I'm going to add that to
our handbook.
And so we're building as we go.
We're really building the planeas we fly, which is something I
think that I do in every areaof my life.
But you need to be comfortablewith that.
You know, as a business owner,you need to be comfortable
letting things happen and thenattending to them.
(13:07):
I think in the beginningthere's a lot more fires to put
out, but then there's not, andso it's okay.
So that's my starting.
Point is like, breathe.
There's a lot of systems to getout there, but they don't all
have to be in a nice neatpackage all at once Because,
honestly, if they were, you'dhave to change one by the time
it's already printed right.
Speaker 1 (13:27):
Yes, so true, so true .
And I learned, you know, mywife works in a corporate job
and she's like you know, theirtrainings aren't any, it's not
any more cohesive than probablywhat you're doing.
I was like, okay, good, becausesometimes it feels super sloppy
and I'm just learning as I growand I've been doing this a
while and I've had a team for afew years, but it's still this
(13:47):
year.
We're still having to implementnew systems or create processes
that a team member will pointout, like what do we do in this
situation?
Like, yeah, I guess you don'tknow, do you?
Because I never told you ornever figured that out.
So I think that's huge andthat's been a revelation for me
is implementing processes andsystems, because that improves
client experience.
(14:08):
If everyone is on the same pageand knows what to do and when
and how to follow up and how toserve our clients, then
everybody wins and it's a lotbetter across the board.
Speaker 2 (14:21):
Exactly, and that goes back to what you were
saying about the vulnerabilityof having people that work for
you and represent your brand.
So the more specific you canget when you're writing out
those processes.
I have the process.
I have it in a visual form in avideo.
I have the process.
I have it in a visual form in avideo.
I have the written instructions.
Sometimes I have pictures, Ihave scripts or email templates.
So my goal with my brand isalways to be cohesive.
So I know the experience myclients are getting and I know
(14:42):
that sounds like a big,overwhelming burden to have all
those pieces but again, theydeveloped over time.
So if you write an email andit's a good template, save that
template, put it in your GoogleDoc.
So if you write an email andit's a good template, save that
template, put it in your GoogleDoc.
Like we're just continuing tobuild as we go.
Speaker 1 (14:55):
Yeah, that's great.
So I want to touch on somebodygoing from solo to group
practice.
I don't know how many clientsyou have who are in that
transition phase.
Speaker 2 (15:10):
Do you work with people who are solo now trying
to go group?
Typically, when I'm workingwith a practice, they have at
least one employee, so they'vealready kind of made that leap.
But the you know where they arein that process differs
depending on when they come intothe program.
Speaker 1 (15:19):
Okay, perfect.
Well, and even I guess ifthey're that small, they have
one person.
Sometimes that transition from.
I have a full caseload ofclients and I'm trying to free
up my time.
But if we have, let's just say,50 clients total and I hire
someone and they take 20, and Ilose 20, revenue stays the same,
but my expenses justskyrocketed, that is such a
(15:42):
delicate balance.
Have you seen that, and whatkind of approach or advice do
you have in that realm, ifanything?
Speaker 2 (15:48):
Yeah, I see that there's these tipping points of
when things happen.
So definitely when you're juststarting, yes, your expenses are
going to go out more, but Ithink that's a natural scaling
process, like when I went from12 to 18 and 18 to 22,.
Sometimes there's thisinequality in what's going out
(16:08):
versus what's coming in.
For example, the more employeesyou have, the more admin
support you need.
But there's this like weirdmiddle place where you don't
have enough revenue coming in tomake it make sense for two
admin but you need to admin todo the work if that makes sense.
So I think, the acceptance ofas you grow, there will be
(16:30):
periods when profit margin willbe lower and that makes sense.
But you need to know yournumbers enough to know if this
is where you want to be at thislevel and you need this kind of
support.
What revenue needs to come into support that.
There's a lot of just likelooking at the numbers to make
it make sense and sitting withthe fear of those like middle
places.
Speaker 1 (16:51):
Yeah, You're speaking my language and yeah, I think
with that profitability, youknow I'm reflecting on 2024.
This morning, with one of mycoaches and I was like, yeah,
revenue was up, we grew, butprofitability was down.
And you know it was adouble-edged sword for me, cause
I hate that, but cause we'reprofit coaches.
But it also came withintentionality, because we knew
(17:12):
this year was a year of growingthe team building infrastructure
so that we could, uh, take onmore people Cause we had, um, we
do personal finance coaching,our uh, we had, uh, the head of
that.
She was capped out and was twomonths out before she could see
clients, so we had to bringsomebody else in.
And so all that to say, I think, just knowing your numbers and
that kind of what you're talkingabout being proactive and
(17:33):
having a game plan and justwatching it and and being okay
with the fact that you're goingto have those tighter years and
then you're gonna have thoseyears where you're just wildly
profitable.
Speaker 2 (17:42):
Exactly, and for me a lot of it comes back to what
your vision is as well.
So I've talked a lot publiclyin the past two years about how
I actually downsized.
I was bigger, I had threebuildings, three locations, way
more employees and I wasprofitable, but I kind of hated
my life.
It was just more than I wanted,with also having other
(18:05):
businesses, having a family, allof these other things.
And so when I downsized I wasvery intentional about
maintaining my profits buthaving less work output going
out, if that makes sense.
And so I really do think aboutlike you can keep growing and
growing and growing, but inservice of what it needs to be,
in service of your life.
So knowing what those profitmargins look like at each level
(18:26):
is also helpful to be in serviceof your life.
Speaker 1 (18:28):
So knowing what those profit margins look like at
each level is also helpful.
Yeah, that's so great, that'sthat's.
I find it so important to lookat profit versus revenue.
And revenue is just how we'regeared, especially as
entrepreneurs and businessowners.
Like we're trying to grow, growand we're trying to hit that
next target, that next target.
But revenue is just one, onepiece of the puzzle, whereas
profitability I would ratherhave a $500,000 a year business
(18:50):
that is just incrediblyprofitable, versus a million
dollar a year business that'snot making me as much profit and
not putting as much in mypocket.
So, yes, I think we're speakingthe same language and you kind
of even touched on time withyour family and how it was
robbing that, and is thatsomething that you see with
people that they kind of quittheir nine to five and they
start this business and now theyare working more hours and not
(19:12):
taking care of themselvesfinancially and they're just
burnt out?
Speaker 2 (19:15):
All the time.
I mean, isn't there a sayingaround that, like you, quit
working 40 hours a week only towork 80, 100.
I don't know what the saying isbut the concept is there.
So, yes, all the time, and Ithink there's a part of that
that when you're working withinyour passion and what matters to
you, it doesn't always feellike work, but the flip side of
that that I hear from practiceowners regularly is like it's
(19:38):
hard to shut off your brain.
You're on the couch and you'reon your phone looking at Google
Sheets of how many clients wereconverted today and it's hard to
shut that off because it'salways on your mind.
You're always working on it.
So the balance is hard to comeby.
I think I've cracked the code,but it took a while and
intentionality to get there.
Speaker 1 (19:57):
Yeah, absolutely it's .
I feel like I'm always tryingto crack the code.
I've done really well withshrinking my availability and
when I can take calls.
But then I guess there's alwaysthose seasons of where maybe
it's on my mind all the time,I'm feeling a little bit more
anxious about it, and so I mightbe after the kids go into bed,
I might be sitting down to dosome writing or something.
(20:17):
But I do have to watch itbecause, you're right, it can,
it can creep in, especially inthis day and age where a lot of
us have our remote businesses.
Maybe they're doing virtualtherapy and my office is here
and my kitchen is there andthere's not a commute for me to
kind of decompress.
Speaker 2 (20:32):
Definitely.
Speaker 1 (20:34):
Okay, so for me, data is something I know is
important to business.
We have different dashboardsand things, but with therapists,
when you're working with them,what kind?
What do you recommend they'relooking to or paying attention
to?
As far as numbers go and data?
Speaker 2 (20:48):
Yeah, so there's different parts of this.
I would say we're looking atdifferent departments From the
intake department.
We're looking at how manyinquiries are coming in, how
many of them are being converted.
I'm also looking at a wholebunch of other information about
what marketing stream broughtthem in, what they're looking
for.
But the main numbers I wouldwant to know is how many leads
are coming in and whatpercentage are being converted.
(21:09):
And then if we're moving thatdown into our operations
department, where what I'mlooking for is are my therapists
meeting their numbers?
Each of them have anexpectation to see 20 client
hours a week and that matches toa revenue goal.
There's a reason for that.
So because I say 20 doesn'tmean that someone else should
have 20.
(21:29):
So again, it goes back to likeknowing your numbers and knowing
what you need to bring in.
But I like to pause there,because when you implement this,
if you are a group practiceowner who has never talked about
numbers before, and then youstart talking about numbers with
your therapist, you're going tohear things like you're too
corporate, all you care about ismoney.
Things feel different becauseall of a sudden, that
(21:53):
accountability has shown up fortherapists.
Fight or flight kicks in.
They're feeling like, oh my God, now there's this microscope on
me and everything that I'mdoing, and I like to remind
group practice owners thatpushback doesn't mean that
you're doing it wrong.
You get to a certain point inyour business where you can't
just wing it anymore and youneed to know that the people
that you're paying are doing thejob that you're paying them for
(22:13):
and meeting the expectation.
You know there came a time in mybusiness when I realized that a
therapist that I was employingfor four hours a week was not
making me money.
In fact, was sometimes losingme money to have, you know, on
the roster.
And so these are importantchoice points for practice
owners, and that's when I thinkthey need the most support is
(22:33):
when they're making thesechanges, they're putting
accountability in place, they'restarting to look at their data
and freaking out a lot of thetime because it's scary once you
start realizing, oh no, likethis isn't working or I'm paying
people too much, like all ofthese things that start to come
up.
So I think having support inthose moments is the most
(22:54):
critical to help you stick withit rather than fold.
And then what's the point ofbeing in business if you're
going to run it into the groundbecause you don't know your
numbers or you're not monitoringthem well?
Speaker 1 (23:05):
Yeah, absolutely.
I think that is so great.
It's this counterintuitivething to our nature which is
sometimes and we'll do this withour clients too it's like,
let's, we need to step back and,yes, you're, you're clinicians,
you're therapists.
They're people, they're humans,we care about them deeply.
But let's just look at thenumbers and how profitable are
(23:25):
they being?
And it can feel sometimes icky,I think the first time you do
it, because you're looking at,like, just them as a number on a
spreadsheet.
But truthfully, if you don't,then they're not being served
well, your team's not beingserved well.
You can't serve as many peopleif you're not as profitable as
you can possibly be.
Speaker 2 (23:44):
I mean, I really look at it as for the greater good,
like if we're going to a potluckand everyone's bringing a dish
but you didn't bring anythingand you're just eating everyone
else's dishes, you're notcontributing to the greater good
, you're just taking from it.
And so we want to be mindful ofhow everyone contributes, so
that everyone wins, rather thansomebody being a drain while
(24:05):
other people overcompensate forthat.
Speaker 1 (24:08):
Yeah, ma'am.
So you touched on thecompensation piece, or making
sure you know are we payingpeople too much, which?
we've run into that many timeswe have a whole episode on just
titled help, I'm overpaying myclinicians.
So, when it comes to payingclinicians, we know there's
multiple ways.
You know that we've seencommission flat rate, even just
(24:30):
hourly or salary.
Is there a recommendation thatyou have that you think is the
best way, or is it really justdependent on the practice owner?
Yeah, as far as payingclinicians go, how do you
approach that?
This is one of the biggestfears, I think, when people
start hiring clinicians.
Speaker 2 (24:45):
So I actually talk about this a lot.
I pay my team on salary and Ilove it, and I came to that
decision because we werepreviously commissioned.
But we do groups and we doindividual and I'm not good at
math, and so all of those thingscombined became a lot of
payroll errors and a really longpayroll process and I just
(25:08):
decided that I wanted tosimplify things and I moved us
to salary.
I think there's a lot of feararound that, with good reason.
For me it worked because I knowhow to market.
I consistently bring new clientsinto the practice, I know how
long it takes to fill atherapist all of these like data
points right.
So for me it works and it helpsme to control my costs.
(25:29):
So I know that this is how manyclient hours I require from
each of my therapists, this iswhat I'm paying them, this is
what my expenses are, and it'sstable, so they're getting a
stable paycheck.
But I also know my numbers in astable way, so that things
aren't fluctuating in terms ofwhat's going out.
I just know how much I need tobring in to make it work for me.
(25:49):
So I really love it and it'snot a magic fix.
I've worked with group practiceowners who think, like if I move
to salary, it will magicallyfix that people need to be more
motivated.
No, they're actually lessmotivated.
You need to find other ways toincentivize them.
So I wouldn't say it's foreveryone and I wouldn't say
there's one right way.
I just think that it's whatworks for me and it's simple.
(26:13):
I'm a fan of things that aresimple in administration.
Speaker 1 (26:16):
Yeah, and I think when, as we look at numbers,
salary is the greatest profitpotential, because I think when
you get into a commission-basedstructure, which is the typical
how people typically start, andit's easy because you're hiring
someone for the first time.
You don't have a lot of cashoverhead, so it's like hey.
I'm only paying you if you'reworking with people and if you
(26:39):
don't, then I'm not.
But salary gives you theopportunity because I think when
that person the clinician theyhire gets a caseload of people,
the profitability doesn't change.
They're still taking 60% ofeverything that's coming in,
where salary kind of gives thatoverhead some ability for the
profitability to grow, abilityfor you to ask your clinicians
(27:00):
and therapists to do otherthings outside of just clinical
hours, which I think is a hugefear.
Speaker 2 (27:06):
Yes, that was.
Another benefit is that Iwasn't having to think about an
admin rate for when I want themto come to a consult meeting or
what it looks like for them towrite notes.
Like everything is this packagedeal.
It just made things so mucheasier.
Speaker 1 (27:18):
Yeah, man, that's great.
So that's good to hear.
I don't run into a lot ofpractice owners who are doing
salary, which I am a huge fan of, and so, but also going back to
that point of knowing yourclinicians, profitability if
your salary, that is justincreasingly more important
because it's not this weightedpay structure.
I could pick your brain forhours, but we need to wrap it up
(27:41):
here.
But first I want to give anopportunity for listeners to get
in touch with you, because Ithink everything you're talking
about I know for a fact.
There's people out thereresonating who are saying I need
these systems, I need theseprocesses, I'm ready to scale
and grow.
So how can people get in touchwith you?
Speaker 2 (27:56):
Yeah, if people are interested in the program that I
run, it's atgrouppracticescalecom and so
they can check that out, or myconsulting website,
visionarytherapistcom.
Or my consulting websitevisionarytherapistcom Love it.
Speaker 1 (28:06):
We'll link those in the show notes for everyone.
Kate, thank you so much forjoining and just sharing your
wealth of knowledge on growinggroup practices.
Thanks for joining us on theTherapy Business Podcast.
Be sure to subscribe, leave areview and share it with a
practice owner that you may knowIf your practice needs help
getting organized with itsfinances or just growing your
(28:29):
practice, head totherapybusinesspodcom to learn
how we can help.
My name is Craig and I'm the CEO of Desi Financial
Coaching.
Our goal is simple to help yourun a therapy practice that is
permanently profitable.
If you own a solo or grouppractice, we're here to help you
build a business that createsmore time, makes more money and
serves more people.
This is the Therapy BusinessPodcast.
Today we have Katie May, withVisionary Therapist, joining us
(00:27):
to talk about everythinginvolved with owning and growing
a group practice.
Katie has launched and grownher own therapy practice that
has multiple locations andaround 20 employees, and has
taken what she has learned andbeen consulting therapists like
you into how to grow yourbusiness, what systems and
processes do you need and howcan you successfully grow a
(00:48):
thriving group practice.
So, without further ado, let'sjump into the interview.
All right, Katie?
Thank you so much for joiningme today.
Speaker 2 (00:57):
Yeah, I'm psyched to be here.
Speaker 1 (00:59):
Yeah, so I'm such.
I know so well how growing agroup practice and how
challenging it can be and withour clients a lot of them either
they're new to the grouppractice thing or they're solo
and they're wanting to become apractice owner and have
therapists under them.
It's kind of choppy waters,like not really knowing what to
(01:19):
do and how to navigate that.
Has that been your experience?
Speaker 2 (01:23):
Yeah, I want to start off by saying I never thought
or knew that I wanted a grouppractice.
So that's kind of.
The starting point was that Iwas in solo practice and I just
had more referrals than I couldhandle.
I specialize in team dbt so Ithought I can't send them to the
generalist down the street.
All right, fine, likebegrudgingly, but also
excitingly I'm going to start agroup practice, and things
(01:45):
really exploded from there.
But to your point, my instinctin not wanting to start a group
practice was because I knew Icould count on myself.
I knew what my skills were, Iknew what I could do.
But having to manage otherpeople felt really challenging
to me and it was yeah, yeah.
Speaker 1 (02:01):
I went through the same, the same fears and hiring
a team at my business and one ofthe big pushbacks I hear a lot
and I felt too was it's it's mybrand, it's my name out there
and these, you know, trustingpeople to represent me was
terrifying you definitely needand it's vulnerable once you
(02:22):
start imparting that wisdom orcreating the systems, all of
those things is trusting thatother people are going to follow
through and actually uphold thequality that you yourself know
that you can uphold.
Absolutely 100%.
Well, tell us a little bit.
I know you have a coupledifferent businesses that you do
, but you have your therapypractice, but tell us about you
and your businesses.
Speaker 2 (02:42):
I own a group practice in the Philadelphia
area.
We have give or take on any dayabout 20 employees and two
locations.
Like I said, we specialize inteen DBT so we work with teens
and parents and I've reallycreated a solid brand around
these services.
I published a book for parentsof teens around this idea.
So really strong brand inhelping teens and parents in
(03:06):
high-risk behaviors and in thesuccess of growing my practice.
Because I started as solo, Iwent to a little small group
practice of four which thendoubled in size, then I bought a
building, then I bought anotherbuilding, so things just kind
of really grew every single yearfor me and because I was
sharing these successes, itnaturally led to me then
coaching and consulting withother practice owners to help
(03:29):
them develop the practices thatsupported their lives, that
supported their vision and alsowasn't so hard in the process
like learn from my mistakes andshorten the struggles so that
you can see more successes morequickly.
Speaker 1 (03:42):
Yeah, that's so fantastic and you've done
amazing things with your ownpractice and then to turn around
and almost pay it forward toother practices is huge.
So what's one of the commonstruggles?
When people come to you for thefirst time, what do you usually
see they're struggling with?
Speaker 2 (03:59):
People when they come to my program and I co-lead it
with another owner of thisbusiness, shailene Kite.
So when they come to my programand I co-lead it with another
owner of this business, ShaileneKite.
So when they come to our program, what I'm typically seeing is
that they've grown beyond thepoint that they can manage.
So maybe they started with thislittle scrappy and strong team.
That really was part of thatstartup vision with them, and
typically I and others that I'veseen are pretty transparent
(04:20):
about we're just starting thisthing, we're learning the ropes,
but the more you grow, the moreyou become a real deal business
and then the people that youhire into that business have
different expectations thanemployee one, two and three when
you are a scrappy startup.
So what I start to hear is thatemployees are quote unquote
entitled, that they want morefrom you, that the expectations
(04:42):
are different, that they'repushing back against the system
because now, all of a sudden,this power dynamic has been
created.
Because you're a boss, you havea real business, and so that
becomes the struggle point thatI see when people are coming
into the Stabilize and Scaleprogram because they're like,
wait a second, this is not howit was before.
I've seen this level of success, but the struggles that come
(05:04):
with that success look different.
Speaker 1 (05:07):
They really do and I've felt that, and even working
with my coaches right now, it'sbeen what was working for me
when I was a solo business owner.
Doesn't work when you'regrowing, you have a team of
people, and the number of leadscoming in the door when it was
just me, it felt like, wow, I'vegot more people than I can
handle, than all of a suddenit's like we need more leads
(05:27):
coming in the door so we can getmore clients.
So it is an interesting pivot.
Speaker 2 (05:33):
Well, and what I see is that it becomes transactional
.
The mirror is then turned backaround for you to look at
yourself, because what wasrequired from you as a solo
business owner or a smaller teambusiness owner now looks
different and it requires you tostep into different roles in
terms of holding a higheraccountability, in terms of
(05:54):
being more direct in sayingthings like I expect this from
you, versus like having twoemployees who are really jazzed
and want to do all those things.
Sometimes you have team memberswho don't want to do things and
you still need to uphold thatexpectation, and it becomes this
uncomfortable shift in how youshow up as a leader and really
manage your team and hold themaccountable.
(06:15):
And that's one of the biggestpieces that I see as struggle is
that shining the light ofaccountability and really
holding people accountable in away that's not overshooting it
and being aggressive, but alsonot sitting back in your chair
and letting things happenbecause it's uncomfortable to
address it.
Speaker 1 (06:31):
Yeah which I think is really common to see both sides
of that coin I feel like withtherapists and this has been my
experience with the clientswe've worked with I feel like
that side of they don't want tocome off too harsh or too strong
or overbearing or micromanaging.
That seems to be a huge trendthat I've noticed.
I notice it in myself too.
No one teaches therapists ingrad school how to become
(06:55):
business owners and all of asudden you find yourself in this
business owner and manager seatand having to balance making
people happy while also makingsure that things are getting
done and that it's to yourstandards.
Speaker 2 (07:08):
Absolutely, and I have the thought that if I find
myself having to micromanagesomeone, I've made a wrong hire
or I haven't properly orientedthem to my expectations and the
systems that they need to follow.
So I don't like to micromanage.
I have very clear expectationsand systems that we follow and
(07:29):
quality assurance that we havein place like checkpoints for
those systems.
But if I'm having to manage youto do your job well, you are
not in the right job right nowand you need to be somewhere
else.
Speaker 1 (07:39):
Yeah, fantastic.
So when it comes to teammembers too this is a question I
have, I think, a lot of timesthere's fear for practice owners
that their team is going tocome in, they'll grow a caseload
.
Then they'll turn around and go.
You know what?
I can go make more money on myown and they'll leave.
And so there's this fear of Iwant to entice them to stay.
But also, what's that balance?
(08:00):
Do I nurture them wanting tostart their own thing?
Do I try to hold them in?
What is your experience withthat?
Speaker 2 (08:06):
Yeah, well, it's true is that I mean, I am an
entrepreneur.
I once worked for somebody elseand had the thought I want to
do this on my own.
I want to be my own boss.
I'm otherwise unbossable, so itmakes sense anyway that I don't
work for somebody else.
But there, I think to someextent there is the reality.
What I teach is that we rent ouremployees.
We don't own them.
(08:27):
They're not ours to keep.
And so in my practice, we'rereally transparent about I want
you to have a career worthhaving.
I want you to be fulfilled andachieve your dreams, because
that's my value system andthat's what I want for myself,
and if I want it for me, I wantit for all of you.
And so what that looks like isbeing really transparent.
(08:47):
Some choice points I would say,like when pre-licensed
therapists achieve licensure.
When therapists have been withme, you know, between that three
to five year mark, we're havingthese conversations around like
is this still aligned with yourgoals?
What's the next step for you?
Is it here, becoming asupervisor?
Have you thought about being inyour own practice?
They're thinking about it,whether or not I say it, and I
(09:10):
think there's this fear of likeoh, I don't want to put the idea
in their head, but I see thatas the cost of doing business.
When therapists leave mypractice, they take their
clients with them, because wedon't own clients.
Clients are people withautonomy and so we just need to
plan for the onboarding andoffboarding process.
So you had mentioned leads,like knowing there's enough
(09:30):
leads coming in, that if someoneleaves with 20 clients and I
hire someone new, I know exactlyhow long it takes to fill that
new therapist.
So it's really just having yoursystems and your data that
support.
People will leave One day.
I might leave, so we need to beprepared for those changes.
I often look at owning abusiness like trying to balance
(09:52):
on top of a rolling beach ball,and I remember these really
distinct points in my careerwhere all I wanted was that
beach ball to stop rolling rightso that I could finally relax,
and then I had this realizationthat this beach ball is never
going to stop rolling.
So my job is really to justlearn how to balance on top of
the beach ball and find my zenwithin that, rather than trying
to stop it Like realityacceptance here.
Speaker 1 (10:14):
Yeah, I think that is really really great advice.
I think, as we are even justtalking about that, that fear or
the sit back and let thingshappen, and so that
confrontation I've seen thatthat can even derive from fear
of pushing people out and thatthey're like you know, and I
don't want to boss anymore, butjust nurturing that or leaning
into it and just saying, yeah,like you just said, we're
(10:34):
renting our team, which I thinkis a fantastic perspective,
because every practice ownerstarted working with somebody,
most likely, and we all had thatdream.
And then there's also peopleout there who have zero interest
in the business side ofmarketing and lead to all that.
They're like nope, I just wantto be a therapist, that's what I
want to do.
Speaker 2 (10:52):
Yes.
Speaker 1 (10:53):
So finding that balance.
Speaker 2 (10:54):
And I love those people.
You know those rock stars thatcan excel within our practice,
and I think it's also likeknowing the value that you bring
within your practice.
We have a really strong cultureat my practice.
We have consult teams.
They have learningopportunities.
You know great benefits thatyou can't always find when
you're in your own practice andso knowing the value of your
(11:16):
offer for me, it makes me feelcomfortable knowing people will
leave but we can attract newgreat therapists too.
Speaker 1 (11:24):
Yeah, I think that's awesome.
So you've been talking a littlebit about systems and processes
and the importance of that.
I'm the creative visionary typesystems and processes.
I importance of that I am.
I'm the creative, visionarytype systems and processes I.
I love them cause I need them,but I don't.
Naturally they don't comenatural and so luckily, I've
hired a team of people who arepatient with that and know for a
long time it was just what's inmy brain is is my process, and
(11:47):
so translating that intobusiness itself.
What have you seen in that?
Is that a common struggle withpeople?
I'm hoping I'm not alone inthat.
And then how do you help peopleovercome that, taking it from
their brain and turning it intosomething actionable that can be
repeatable across other people?
Speaker 2 (12:04):
You're definitely not alone in that, and one common
struggle that I've seen withmany business owners is when I
hire people in.
It's a lot of work to teach tothem.
But even if I hire people in sothat they can support me like
an admin or a virtual assistant,there's all this front loading
to teach them what's in yourbrain so that they can do it the
(12:25):
way that you want it done.
And so when I work with grouppractice owners, my rule is the
rule of twice.
So I'm telling them you're notgoing to sit down and write a
hundred page manual of everysingle system in your practice.
You're going to build uponwhat's already there and do it
on an as needed basis.
So if someone asks me aquestion more than once, that's
(12:46):
my rule of twice.
I'm either going to use Loom andrecord myself doing the process
.
I'm going to write it out, andthen I'm going going to use Loom
and record myself doing theprocess.
I'm going to write it out, andthen I'm going to add that to
our handbook.
And so we're building as we go.
We're really building the planeas we fly, which is something I
think that I do in every areaof my life.
But you need to be comfortablewith that.
You know, as a business owner,you need to be comfortable
letting things happen and thenattending to them.
(13:07):
I think in the beginningthere's a lot more fires to put
out, but then there's not, andso it's okay.
So that's my starting.
Point is like, breathe.
There's a lot of systems to getout there, but they don't all
have to be in a nice neatpackage all at once Because,
honestly, if they were, you'dhave to change one by the time
it's already printed right.
Speaker 1 (13:27):
Yes, so true, so true .
And I learned, you know, mywife works in a corporate job
and she's like you know, theirtrainings aren't any, it's not
any more cohesive than probablywhat you're doing.
I was like, okay, good, becausesometimes it feels super sloppy
and I'm just learning as I growand I've been doing this a
while and I've had a team for afew years, but it's still this
(13:47):
year.
We're still having to implementnew systems or create processes
that a team member will pointout, like what do we do in this
situation?
Like, yeah, I guess you don'tknow, do you?
Because I never told you ornever figured that out.
So I think that's huge andthat's been a revelation for me
is implementing processes andsystems, because that improves
client experience.
(14:08):
If everyone is on the same pageand knows what to do and when
and how to follow up and how toserve our clients, then
everybody wins and it's a lotbetter across the board.
Speaker 2 (14:21):
Exactly, and that goes back to what you were
saying about the vulnerabilityof having people that work for
you and represent your brand.
So the more specific you canget when you're writing out
those processes.
I have the process.
I have it in a visual form in avideo.
I have the process.
I have it in a visual form in avideo.
I have the written instructions.
Sometimes I have pictures, Ihave scripts or email templates.
So my goal with my brand isalways to be cohesive.
So I know the experience myclients are getting and I know
(14:42):
that sounds like a big,overwhelming burden to have all
those pieces but again, theydeveloped over time.
So if you write an email andit's a good template, save that
template, put it in your GoogleDoc.
So if you write an email andit's a good template, save that
template, put it in your GoogleDoc.
Like we're just continuing tobuild as we go.
Speaker 1 (14:55):
Yeah, that's great.
So I want to touch on somebodygoing from solo to group
practice.
I don't know how many clientsyou have who are in that
transition phase.
Speaker 2 (15:10):
Do you work with people who are solo now trying
to go group?
Typically, when I'm workingwith a practice, they have at
least one employee, so they'vealready kind of made that leap.
But the you know where they arein that process differs
depending on when they come intothe program.
Speaker 1 (15:19):
Okay, perfect.
Well, and even I guess ifthey're that small, they have
one person.
Sometimes that transition from.
I have a full caseload ofclients and I'm trying to free
up my time.
But if we have, let's just say,50 clients total and I hire
someone and they take 20, and Ilose 20, revenue stays the same,
but my expenses justskyrocketed, that is such a
(15:42):
delicate balance.
Have you seen that, and whatkind of approach or advice do
you have in that realm, ifanything?
Speaker 2 (15:48):
Yeah, I see that there's these tipping points of
when things happen.
So definitely when you're juststarting, yes, your expenses are
going to go out more, but Ithink that's a natural scaling
process, like when I went from12 to 18 and 18 to 22,.
Sometimes there's thisinequality in what's going out
(16:08):
versus what's coming in.
For example, the more employeesyou have, the more admin
support you need.
But there's this like weirdmiddle place where you don't
have enough revenue coming in tomake it make sense for two
admin but you need to admin todo the work if that makes sense.
So I think, the acceptance ofas you grow, there will be
(16:30):
periods when profit margin willbe lower and that makes sense.
But you need to know yournumbers enough to know if this
is where you want to be at thislevel and you need this kind of
support.
What revenue needs to come into support that.
There's a lot of just likelooking at the numbers to make
it make sense and sitting withthe fear of those like middle
places.
Speaker 1 (16:51):
Yeah, You're speaking my language and yeah, I think
with that profitability, youknow I'm reflecting on 2024.
This morning, with one of mycoaches and I was like, yeah,
revenue was up, we grew, butprofitability was down.
And you know it was adouble-edged sword for me, cause
I hate that, but cause we'reprofit coaches.
But it also came withintentionality, because we knew
(17:12):
this year was a year of growingthe team building infrastructure
so that we could, uh, take onmore people Cause we had, um, we
do personal finance coaching,our uh, we had, uh, the head of
that.
She was capped out and was twomonths out before she could see
clients, so we had to bringsomebody else in.
And so all that to say, I think, just knowing your numbers and
that kind of what you're talkingabout being proactive and
(17:33):
having a game plan and justwatching it and and being okay
with the fact that you're goingto have those tighter years and
then you're gonna have thoseyears where you're just wildly
profitable.
Speaker 2 (17:42):
Exactly, and for me a lot of it comes back to what
your vision is as well.
So I've talked a lot publiclyin the past two years about how
I actually downsized.
I was bigger, I had threebuildings, three locations, way
more employees and I wasprofitable, but I kind of hated
my life.
It was just more than I wanted,with also having other
(18:05):
businesses, having a family, allof these other things.
And so when I downsized I wasvery intentional about
maintaining my profits buthaving less work output going
out, if that makes sense.
And so I really do think aboutlike you can keep growing and
growing and growing, but inservice of what it needs to be,
in service of your life.
So knowing what those profitmargins look like at each level
(18:26):
is also helpful to be in serviceof your life.
Speaker 1 (18:28):
So knowing what those profit margins look like at
each level is also helpful.
Yeah, that's so great, that'sthat's.
I find it so important to lookat profit versus revenue.
And revenue is just how we'regeared, especially as
entrepreneurs and businessowners.
Like we're trying to grow, growand we're trying to hit that
next target, that next target.
But revenue is just one, onepiece of the puzzle, whereas
profitability I would ratherhave a $500,000 a year business
(18:50):
that is just incrediblyprofitable, versus a million
dollar a year business that'snot making me as much profit and
not putting as much in mypocket.
So, yes, I think we're speakingthe same language and you kind
of even touched on time withyour family and how it was
robbing that, and is thatsomething that you see with
people that they kind of quittheir nine to five and they
start this business and now theyare working more hours and not
(19:12):
taking care of themselvesfinancially and they're just
burnt out?
Speaker 2 (19:15):
All the time.
I mean, isn't there a sayingaround that, like you, quit
working 40 hours a week only towork 80, 100.
I don't know what the saying isbut the concept is there.
So, yes, all the time, and Ithink there's a part of that
that when you're working withinyour passion and what matters to
you, it doesn't always feellike work, but the flip side of
that that I hear from practiceowners regularly is like it's
(19:38):
hard to shut off your brain.
You're on the couch and you'reon your phone looking at Google
Sheets of how many clients wereconverted today and it's hard to
shut that off because it'salways on your mind.
You're always working on it.
So the balance is hard to comeby.
I think I've cracked the code,but it took a while and
intentionality to get there.
Speaker 1 (19:57):
Yeah, absolutely it's .
I feel like I'm always tryingto crack the code.
I've done really well withshrinking my availability and
when I can take calls.
But then I guess there's alwaysthose seasons of where maybe
it's on my mind all the time,I'm feeling a little bit more
anxious about it, and so I mightbe after the kids go into bed,
I might be sitting down to dosome writing or something.
(20:17):
But I do have to watch itbecause, you're right, it can,
it can creep in, especially inthis day and age where a lot of
us have our remote businesses.
Maybe they're doing virtualtherapy and my office is here
and my kitchen is there andthere's not a commute for me to
kind of decompress.
Speaker 2 (20:32):
Definitely.
Speaker 1 (20:34):
Okay, so for me, data is something I know is
important to business.
We have different dashboardsand things, but with therapists,
when you're working with them,what kind?
What do you recommend they'relooking to or paying attention
to?
As far as numbers go and data?
Speaker 2 (20:48):
Yeah, so there's different parts of this.
I would say we're looking atdifferent departments From the
intake department.
We're looking at how manyinquiries are coming in, how
many of them are being converted.
I'm also looking at a wholebunch of other information about
what marketing stream broughtthem in, what they're looking
for.
But the main numbers I wouldwant to know is how many leads
are coming in and whatpercentage are being converted.
(21:09):
And then if we're moving thatdown into our operations
department, where what I'mlooking for is are my therapists
meeting their numbers?
Each of them have anexpectation to see 20 client
hours a week and that matches toa revenue goal.
There's a reason for that.
So because I say 20 doesn'tmean that someone else should
have 20.
(21:29):
So again, it goes back to likeknowing your numbers and knowing
what you need to bring in.
But I like to pause there,because when you implement this,
if you are a group practiceowner who has never talked about
numbers before, and then youstart talking about numbers with
your therapist, you're going tohear things like you're too
corporate, all you care about ismoney.
Things feel different becauseall of a sudden, that
(21:53):
accountability has shown up fortherapists.
Fight or flight kicks in.
They're feeling like, oh my God, now there's this microscope on
me and everything that I'mdoing, and I like to remind
group practice owners thatpushback doesn't mean that
you're doing it wrong.
You get to a certain point inyour business where you can't
just wing it anymore and youneed to know that the people
that you're paying are doing thejob that you're paying them for
(22:13):
and meeting the expectation.
You know there came a time in mybusiness when I realized that a
therapist that I was employingfor four hours a week was not
making me money.
In fact, was sometimes losingme money to have, you know, on
the roster.
And so these are importantchoice points for practice
owners, and that's when I thinkthey need the most support is
(22:33):
when they're making thesechanges, they're putting
accountability in place, they'restarting to look at their data
and freaking out a lot of thetime because it's scary once you
start realizing, oh no, likethis isn't working or I'm paying
people too much, like all ofthese things that start to come
up.
So I think having support inthose moments is the most
(22:54):
critical to help you stick withit rather than fold.
And then what's the point ofbeing in business if you're
going to run it into the groundbecause you don't know your
numbers or you're not monitoringthem well?
Speaker 1 (23:05):
Yeah, absolutely.
I think that is so great.
It's this counterintuitivething to our nature which is
sometimes and we'll do this withour clients too it's like,
let's, we need to step back and,yes, you're, you're clinicians,
you're therapists.
They're people, they're humans,we care about them deeply.
But let's just look at thenumbers and how profitable are
(23:25):
they being?
And it can feel sometimes icky,I think the first time you do
it, because you're looking at,like, just them as a number on a
spreadsheet.
But truthfully, if you don't,then they're not being served
well, your team's not beingserved well.
You can't serve as many peopleif you're not as profitable as
you can possibly be.
Speaker 2 (23:44):
I mean, I really look at it as for the greater good,
like if we're going to a potluckand everyone's bringing a dish
but you didn't bring anythingand you're just eating everyone
else's dishes, you're notcontributing to the greater good
, you're just taking from it.
And so we want to be mindful ofhow everyone contributes, so
that everyone wins, rather thansomebody being a drain while
(24:05):
other people overcompensate forthat.
Speaker 1 (24:08):
Yeah, ma'am.
So you touched on thecompensation piece, or making
sure you know are we payingpeople too much, which?
we've run into that many timeswe have a whole episode on just
titled help, I'm overpaying myclinicians.
So, when it comes to payingclinicians, we know there's
multiple ways.
You know that we've seencommission flat rate, even just
(24:30):
hourly or salary.
Is there a recommendation thatyou have that you think is the
best way, or is it really justdependent on the practice owner?
Yeah, as far as payingclinicians go, how do you
approach that?
This is one of the biggestfears, I think, when people
start hiring clinicians.
Speaker 2 (24:45):
So I actually talk about this a lot.
I pay my team on salary and Ilove it, and I came to that
decision because we werepreviously commissioned.
But we do groups and we doindividual and I'm not good at
math, and so all of those thingscombined became a lot of
payroll errors and a really longpayroll process and I just
(25:08):
decided that I wanted tosimplify things and I moved us
to salary.
I think there's a lot of feararound that, with good reason.
For me it worked because I knowhow to market.
I consistently bring new clientsinto the practice, I know how
long it takes to fill atherapist all of these like data
points right.
So for me it works and it helpsme to control my costs.
(25:29):
So I know that this is how manyclient hours I require from
each of my therapists, this iswhat I'm paying them, this is
what my expenses are, and it'sstable, so they're getting a
stable paycheck.
But I also know my numbers in astable way, so that things
aren't fluctuating in terms ofwhat's going out.
I just know how much I need tobring in to make it work for me.
(25:49):
So I really love it and it'snot a magic fix.
I've worked with group practiceowners who think, like if I move
to salary, it will magicallyfix that people need to be more
motivated.
No, they're actually lessmotivated.
You need to find other ways toincentivize them.
So I wouldn't say it's foreveryone and I wouldn't say
there's one right way.
I just think that it's whatworks for me and it's simple.
(26:13):
I'm a fan of things that aresimple in administration.
Speaker 1 (26:16):
Yeah, and I think when, as we look at numbers,
salary is the greatest profitpotential, because I think when
you get into a commission-basedstructure, which is the typical
how people typically start, andit's easy because you're hiring
someone for the first time.
You don't have a lot of cashoverhead, so it's like hey.
I'm only paying you if you'reworking with people and if you
(26:39):
don't, then I'm not.
But salary gives you theopportunity because I think when
that person the clinician theyhire gets a caseload of people,
the profitability doesn't change.
They're still taking 60% ofeverything that's coming in,
where salary kind of gives thatoverhead some ability for the
profitability to grow, abilityfor you to ask your clinicians
(27:00):
and therapists to do otherthings outside of just clinical
hours, which I think is a hugefear.
Speaker 2 (27:06):
Yes, that was.
Another benefit is that Iwasn't having to think about an
admin rate for when I want themto come to a consult meeting or
what it looks like for them towrite notes.
Like everything is this packagedeal.
It just made things so mucheasier.
Speaker 1 (27:18):
Yeah, man, that's great.
So that's good to hear.
I don't run into a lot ofpractice owners who are doing
salary, which I am a huge fan of, and so, but also going back to
that point of knowing yourclinicians, profitability if
your salary, that is justincreasingly more important
because it's not this weightedpay structure.
I could pick your brain forhours, but we need to wrap it up
(27:41):
here.
But first I want to give anopportunity for listeners to get
in touch with you, because Ithink everything you're talking
about I know for a fact.
There's people out thereresonating who are saying I need
these systems, I need theseprocesses, I'm ready to scale
and grow.
So how can people get in touchwith you?
Speaker 2 (27:56):
Yeah, if people are interested in the program that I
run, it's atgrouppracticescalecom and so
they can check that out, or myconsulting website,
visionarytherapistcom.
Or my consulting websitevisionarytherapistcom Love it.
Speaker 1 (28:06):
We'll link those in the show notes for everyone.
Kate, thank you so much forjoining and just sharing your
wealth of knowledge on growinggroup practices.
Thanks for joining us on theTherapy Business Podcast.
Be sure to subscribe, leave areview and share it with a
practice owner that you may knowIf your practice needs help
getting organized with itsfinances or just growing your
(28:29):
practice, head totherapybusinesspodcom to learn
how we can help.
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