TTE 38: Forming a Group Practice is Easier Than You Think
Alison didn’t plan on building a group practice. In fact, she found it daunting to even think about a group practice.
But one day she decided to hire a play therapist to help meet the needs of incoming inquiries.
Then she hired more therapists that worked in the same niche she did.
And eventually, a group practice was formed. And guess what? It was easier than you think.
Best Marketing Move for Her Practice
- Cracking the nut of getting referred to by Doctor’s
How exactly did Alison crack this nut?
She has a BRILLIANT strategy.
First — She’ll go in, drop her paperwork off, and get the name of the office manager who makes referrals and writes that person’s name down.
Next — Well, you’ll have to listen to find out 🙂
Links & Resources Mentioned in This Episode
Thanks to Alison for joining me this week. Until next time!
TranscriptClick here to read the Transcript
Alison: I’m ready, I’m excited.
Perry: Alright. So glad to have you here Alison. Let me tell our audience a little bit about you first. Alison Pidgeon is a licensed professional counselor in the state of Pennsylvania and lives in Lancaster County. She has been working in a mental health field for the past 13 years and has been in private practice for one and a half years. She runs a woman center group private practice where she employs three clinicians and a virtual assistant. Her specialties include working with women with perinatal mood disorders, millennials, and she often uses cognitive behavioral therapy as a treatment modality. Alison has two young children and when she has free time she likes to go on dates with her husband, go wine tasting and go to the beach with her family. Alison, I gave a little overview of you there but why don’t you take a minute, fill in the gaps from that introduction, and tell us a little bit more about you personally and about your practice?
Alison: Yeah. Thank you so much Perry. I think one really important thing that I didn’t sort of include in my biography is that I came to private practice sort of, I don’t know if by accident is the right word, but essentially I was working in community mental health and I got super burned out and I didn’t know what else to do. So somebody suggested that I go into private practice so I did. And I just love being an entrepreneur and I love the business side as much as I love the counseling side. So it was just such a great decision for me.
Perry: So when you were getting burned out working in community mental health, what was your transition like going into private practice? Did you just jump both feet into water or did you sort of dip your toes in?
Alison: No, I jumped in with both feet. So basically Thanksgiving of 2014 I was really like at the end of my rope just not knowing what to do and started thinking about what would be next. And then Christmas I gave my six-week notice because I was a director. So I gave them lots of notice that I was leaving and then the end of January, the beginning of February of 2015 I had totally quit my job and I was in private practice.
Alison: It was very fast.
Perry: That’s amazing.
Alison: I don’t recommend it. Haha.
Perry: And then even more amazing is you’ve grown to have three clinicians working with you and a virtual assistant, in just a year and a half.
Perry: How did that happen?
Alison: So about six months in I figured out that it just made a lot of sens for me with my background being a director and having that experience, being a boss and managing folks, and seeing how much you could leverage the business as far as like helping more people, bringing in more income by having another clinician. So after six months I thought, well, let’s try it and just see how it goes. And it worked out pretty well and I then was excited and wanted to expand more. So I just happened to find some really good people to hire and that’s how we got to where we are today.
Perry: And you found really good people to hire. What kinds of people did you look for? Did you look for people who complimented your skill set? Did you look for people who added to your skill set? Tell us about who you looked to hire and what that process looked like for you?
Alison: Yeah. So in the beginning I hired somebody who actually did very different work than I did. She was a play therapist and I wasn’t really working at all with kids. So she was definitely like pulling a different population into the practice. But actually since then I hired other folks who are somewhat similar to me and I think either way works. Sort of like filling that base of other populations that you may not work with but also bringing on other people who are working with similar populations. I don’t know, it just seems to have worked out.
Perry: Did you find that you were getting– Let’s chat more about your business pals as well then. You own the business and then they work underneath you essentially, correct? Is that accurate or how is your business structured, I guess?
Alison: Yeah. I have an LLC and they are 1099 contractors. So we do a fee split. And also my virtual assistant’s also a contractor, so she just gets paid for the amount of time that she works.
Perry: And so then you’re in charge of all the marketing? You’re in charge of getting all those clients in to get them work essentially, correct?
Alison: Yes. I am in charge of paying the rent. I provide some of the structure to the business as far as like an electronic health record. I do the marketing, yep, all of that.
Perry: And how many clients– Do you still see a full caseload of clients or have you dialed that back?
Alison: I have dialed it back only because when new people come into the practice now I’m trying to give those folks to my contractors. So I mean, certainly my caseload could be full but I’d rather have the contractors be full before I get full.
Perry: Absolutely, that makes perfect sense. And from a business perspective I think hiring that play therapist first was really smart, especially because the kind of market you’re going after, you’re working with women and I would imagine typically it’s some mom bringing their child to a play therapy session. And if it’s not the mom certainly has some interaction with it. So you are building that rapport up with those clients and then you’re able to offer them additional services. Or if you’re doing, I believe you said you did perinatal mood disorders, that’s how you bring somebody in. And if they ever need a play therapist then you’re able to pass them off to your play therapist. So you’re building that brand up and building that brand loyalty, which is really great to see. So when you set out in private practice did you intend to build a group practice from the start?
Alison: I did not. I was like so kind of stressed out from quitting my old job and starting the practice that I was just like sort of focused on, I just need to get this stuff setup so then I can see clients. That was my only sort of priority at that point.
Perry: So what made you want to hire a therapist to work for you and start building this into a group practice?
Alison: I started to sort of see like even from the financial end, if I wanted to go on a vacation, oh, I’m not going to have income that week. It just seemed like there was much less of a cushion if it was just me in solo private practice, whereas if I have contractors even if I’m on vacation there’s still money coming in. So it’s not like all of a sudden I have to pay myself less because I wanted to take one week of vacation. So that just sort of like– That financial security just made me feel better about being self-employed. And I also like having other people in the office to work with and see, and I really like being the boss. I know a lot of people probably are turned off by that but I really do like managing people and being in charge, and having it be my own thing.
Perry: And coming from being a director at a community mental health clinic you have that experience of managing, of hiring, of firing, of not necessarily building a business but building a community and building these systems and processes and maintaining the engine of the mental health center. That certainly has lent itself to allow you to see such immense success in just year and a half. I mean, going from leaving your job to having, I believe, four full-time therapists working plus a virtual assistant. That’s phenomenal.
Alison: Thank you.
Perry: What would you say to our audience listening now that, let’s say I’m a therapist, I’ve been in private practice for two or three years and I hear what you said. And I’m like, yeah, I want to be able to take more vacations and not have to feel like I’m going to struggle financially if I take a week vacation here and there. What kind of advice would you give to them to help guide them in taking the first steps to build more of a group oriented practice?
Alison: Yeah, I think the whole process of thinking about that seems really daunting. And I remember feeling really overwhelmed by like, wait, how do I even do that? But I think if you start sort of pulling apart the pieces it’s actually not that hard. And I think one of the most important things is that you hire the right person. That was my utmost number one priority because I think from my experience in community mental health I had employees who were great therapists but they were terrible with paperwork, and I was always on top of them. Like, you didn’t do this, you didn’t do that. And I realized that I need to look for that therapist who was really a great clinician but also could manage their schedule, could do the paperwork without me being on top of them and hounding them about it. So I really made sure that I hired that type of therapist and at one point I had to wait. It took me like, six months to find the right person but it was totally worth waiting to find the right person. Because now it’s like, she does an awesome job, I may answer a few questions for her here and there during the week but really she’s very independent and she’s bringing income and it’s awesome.
Perry: And that’s the play therapist, correct?
Alison: No. This is actually Melissa who I hired in March, and she came from an agency. She’s just like one of those rock star therapists who’s good at the administrative end and also a really good clinician.
Perry: Which hire was this then? The one that you said was really crucial and integral in helping you expand?
Alison: So the first person that I hired?
Alison: Okay. Her name is Laury and she has actually– Go ahead?
Perry: I’m sorry. The person that took you six months to hire the right person?
Perry: Melissa, yeah. Which hire was that, which number?
Alison: Number two.
Perry: So number two took you six months to hire the right person with that and you want a clinician who’s not only a great clinician but also one that’s good with paperwork, didn’t need to be managed, one that could manage her own schedule. And that allows you to take a step back and focus on other things in their private practice. If that’s an integral part of growing a group private practice, how would the therapist who’s listening to this right now recognize in a candidate that they’re looking to hire, that they would be not only a great clinician but good with paperwork and able to manage their own schedule and their own paperwork. What kind of traits would they look for? What kind of experience would they look for?
Alison: Yeah, I think that’s where in the interview being really sort of forthright about that kind of thing is important. Obviously, someone could make it sound better than it really is but that’s where calling the references and talking to the references is really important. To say like, hey, do you know if Melissa had any issues with getting her paperwork in on time? Your coworkers know that about their coworkers. So people were pretty honest about that with me which I really appreciated.
Perry: Thank you so much. That’s such a great response there. Even just calling references. I’ve read statistics that– I don’t know the exact numbers but such few businesses actually called the references of people they’re going to hire. And then, knowing what to ask I think is very, very challenging. That’s something that I personally struggled with knowing what to ask references. Personally, what I look for is just having a conversation with the person and trying to determine if they have leadership qualities. If somebody demonstrates leadership qualities in previous jobs generally they’re going to be a good fit here. And I think they would be a good fit with you too because they’re going to take on their own paperwork. You’re going to make sure that they take care of all those important details that allow you then to focus on other things in your business.
Alison: Right. And I was very straightforward too in the interview about, this is sort of like the drawbacks of this kind of physician, and I sort of put that out there right from the beginning to sort of weed out the people who it wasn’t a good fit for. So one of those things was like, you know, I’m not going to be in the office all the time. If you need to run something by somebody on a regular basis, this was not how it works here. You have to be independent enough and experience enough as a clinician to sort of be able to handle lots of different situations. So I interviewed somebody who was like, that’s not a good fit for me, and I just appreciated the fact that they would be honest with me about that. So I just feel like I don’t beat around the bush, I just sort of say, if this is how it’s going to be, this might be a drawback but I just want you to be aware upfront so that you know if it’s a good fit for you or not.
Perry: Absolutely. When you’re hiring somebody you want them to be happy, just like you want to be happy with who you hire you want the person who’s joining your team to be happy with the position. And sometimes if you’re hiring your first person you don’t really know what it’s going to look like. I remember when Andrew joined us here and he was our first full-time developer, we didn’t really know what the position was going to look like. We had maybe two dozen, three dozen clients at the time, and what the position looked like when Andrew joined is so different than what the position looks like now when our most recent developer Zach joined the team. So it’s a moving target but if you hire people who are adaptable and eager to learn and take on responsibilities themselves, they should be able to ideally roll the punches with you.
Alison: Right, right.
Perry: So one thing, Alison, that we found therapists really struggle with is marketing their business. And you’ve grown such a thriving group private practice where you’ve got other clinicians working for you and you’re building a great business here all in one and a half years, which is remarkable. You do not hear about this very often. So you must have figured out some really great marketing strategies for you to get here. Would you mind sharing with our audience what you feel is the best marketing move that you’ve made for your private practice and why do you feel like it’s worked so well for you?
Alison: Yeah, and I think we can probably do a whole podcast on this topic.
Alison: I think one of the toughest sort of nuts to crack for me was like how to get into those family doctors and those pediatrician’s offices to talk to them, because I hear from so many other clinicians, they try to go in and talk to the person at the front desk and they get blown off, which was my experience. I go with my little brochures and I’m all excited, and they’re just like rolling their eyes, oh, there’s another person bothering me.
Perry: Yeah, they’re the gatekeepers. They’re like, okay, we’ll take it. And then it just ends up in the trash.
Alison: Probably, probably. So I have a friend who worked for many years in pharmaceutical rep industry and she sort of laid out this sort of plan of attack to get in to talk to these doctors.
Perry: Ooh, let’s hear it?
Alison: Yeah. So this is what she told me. She said, go into the office, don’t call ahead, show up with some brochures or literature, whatever you have about the practice. So I did that and I got the eye roll and I got blown off by the secretary. And I asked, who is the name of the office manager or the person that makes referrals? Got that person’s name. And I said, oh, is so and so here today? Of course, they weren’t there today. They’re off on Tuesdays. You know, this whole line I’m sure they’re very good at giving. So I wrote that person’s name down. So then in two weeks I follow up and I call and I say, hi, can I talk to Deb or whatever the person’s name is. So I get a hold of Deb and I say, hey Deb, I was in here a couple weeks ago, dropped off some brochures about my mental health practice, did they happen to cross your desk? And so probably about 50% of the time they said, well no, they didn’t cross my desk. So then I can kind of lead into a conversation about kind of gauging that interest level and, do you need places to send people for therapy or is that something you’re kind of set with? Sort of gauge how likely they were to sort of let me get my foot in the door. So then that conversation then led to, do you think the providers would want to get to know me as the therapist so they feel comfortable potentially referring patients to me? And a lot of them said yes. So then I sort of whipped the pharmaceutical reps to– I bought them lunch. I sort of found out like, what do you guys don’t like that you get all the time? And then I wouldn’t get that same. So I’d bring lunch and I would kind of just do the whole sort of chitchat, sort of marketing talk with the doctors. And they were thrilled to meet me and so excited there was another resource to refer to. So it’s sort of like, once you figure out how to get in the door the doctors are happy to talk to you. It’s just sort of like figuring out how to navigate that process.
Alison: So that was what I did this summer and now those referrals are starting to roll in. We see people who are being referred from those practices which is really exciting.
Perry: That’s tremendous. Wow, I mean it’s such great advice. Hahaha.
Perry: Every week at the podcast in the show notes we say what the marketing tip is, and I think I’m just going to take the entire transcript that you just said there and put that in. Because that is just a step by step process that’s repeatable and clearly defined on how you get into doctor’s offices. Because yeah, just going and dropping your paperwork off, no one’s going to do that. I’m sorry, everyone’s going to do that. But they always say, the fortune is in the followup. But just following up blindly is not going to do it. You got the name of the office manager and you went in there. You knew your paperwork is just going to be thrown out most likely. And that’s fine, you got the name of the office manager so you can call them later and begin that conversation. And then those questions you asked, do you need places to send people for therapy or are you all set with that? If they’re all set with that they’re going to say, yeah, we’re all set with that. So you’re like, okay great, no harm no foul. But if they’re interested they’re going to say, yeah, we need some places. Then you get your foot in the door. And that’s just so great. Just what a gem. Because we hear all the time from people on this podcast that, you know, yeah, networking with doctors and pediatrician’s offices, but we never hear how you get in the door. And getting in the door is much more– If you get in the door just one good office, it’s much better than networking with a dozen different people and not getting in your foot in the door with any of them.
Perry: So Alison, you went to school to become a therapist, not to get your MBA but between being a director of a community mental health center and now owning this thriving group private practice and having a clear process and strategy for getting into doors of doctor’s offices, you know business. But what’s the one thing you wish you would have learned in school about starting your own business that they never taught you?
Alison: Oh, I really wish I would have learned accounting.
Perry: Gosh, it’s so important. Right?
Alison: And that probably sounds really boring but, oh, my accounting in the beginning was like a mess and then it just took a lot of help from other people and reading books. And now I feel like I finally have like a good handle on it.
Perry: Do you do the accounting yourself right now or do you have a bookkeeper that’s working for you?
Alison: So my bookkeeper is my dad. Hahaha.
Perry: The best kind of bookkeeper there is, right? They’re not going to let you make mistakes.
Alison: That’s right. Well, he actually was the director of a budget for a local hospital for 30 years. So he knows exactly how everything works with insurance and numbers and yeah, he’s a good resource.
Perry: What’s some great advice that you’ve gotten from him that gives you a competitive advantage?
Alison: He actually did something really cool where he was able to sort of like break down the money that’s coming in, and the expenses. And he was able to say like how much money I’m making for a patient.
Perry: Oh, that’s great.
Alison: Yeah. And it’s cool because he is now looking at– He’s helping me do my data entry for explanation of benefit forms from insurance companies. So he’s seeing how much they’re reimbursing and he looked at this one and he’s like, no, you got to get off this insurance panel. He’s like, they’re not paying you enough.
Perry: So when you know how much money you’re making for a patient, are you looking at gross or you’re looking at net profit, or both?
Perry: Okay. Have you used that information to help you determine different marketing strategies yet?
Alison: I mean, I think that it helps me to see, like he said, there’s just certain insurance companies that’s probably not even worth being paneled with because they pay so little. But also then I’ve been on the push to try to get more self-paid clients as well. Because obviously that just raises the average of what we’re getting paid.
Perry: Right. And are you looking on a per session basis, how much you make per a patient then?
Perry: Okay. So what you can then do as well, once you have more data, which I’m sure your father will work with you on, is figuring out what your lifetime value is for a patient. Which is one of the most important business metrics that’s out there when you’re dealing with customers. What’s a lifetime value of a patient, what’s it worth to your business? If you’re seeing a net profit of let’s say 70 dollars per patient and they typically see you for 10 sessions, well then your lifetime value of a patient is 700 dollars in that profit. So then you can figure out how much you’re going to spend to acquire them and start doing some paid acquisition and paid marketing as opposed to network marketing, which is paid marketing as well in a different sense.
Perry: Fantastic, such great advice here Alison. Now what we’re going to do is move into the final part of our interview. The part we like to refer to as Brighter Insights. And I hope whoever’s listening to this episode has a pen and paper and was writing all this down because there is just a gold mine of information in the last 25 minutes. If you have not been doing that, don’t worry, you can always go and re-listen to it at any time and find all the great resources mentioned by Alison at this week’s show notes which will be over at Brightervision.com/session38. But what we get to do now is really distill down your experience and advice into little sound bites and quick answers that our audience can use to inspire, motivate, and excite them in growing their private practice. Are you ready?
Alison: I’m ready.
Perry: What or whom inspired you to become a mental health professional?
Alison: I had a mentor in college who was actually a PHD candidate at the time, who really encouraged me to go do graduate school. I never imagined going to get my master’s degree before. So I would say she was really the inspiration for me going to become a clinician.
Perry: What is it that you do to clear your head and get a fresh start in your day?
Alison: I like to get to the office a few minutes early so I can just sit and have a couple of minutes to take a deep breath and finish drinking my coffee and it sort of like helps me get set for the day.
Perry: What are some tools that you’ve used to leverage the power of technology in your private practice so that technology is no longer a hurdle but instead an asset for you?
Alison: I would say the electronic health record that we have is like the backbone of our whole business. It does so much of what we need to do and it’s so efficient.
Perry: And what is that that you use?
Alison: We use TheraNest.
Perry: TheraNest, great. And we’ve heard such great things about TheraNest, great guys over there that run TheraNest. And we’ll have links to that in this week’s show notes at Brightervision.com/session38. Alison, what’s a quote that you hold near and dear, something that has helped formulate your perspective on life or has inspired, motivated, or provided guidance for you?
Alison: Yeah, I think about the quote and I’m paraphrasing, “Being kind for everyone you meet is fighting a hard battle you know nothing about.”
Perry: I like that a lot. If you could recommend one book to our audience, what would that book be?
Alison: Along with my accounting comment before I just read a book called Profit first that is all about accounting for a business and it really helped me to get a handle on the finances. I actually figured out that I was underpaying myself from that book.
Perry: How did that allow you to figure that out?
Alison: So they sort of assigned percentages to how much your expenses should be, what you should be paying yourself, et cetera, et cetera. And you know, there was sort of like a formula for that. And I was actually, that’s how I figured out based on the income I’m bringing in I’m underpaying myself.
Perry: And so you adjusted what you were paying yourself and is your business still profitable then I would imagine?
Perry: Alright Alison, last question. If you moved to a new city tomorrow, you didn’t know anybody there and all that you had with you was your computer and 100 dollars to start a new private practice, what is it that you would do on your very first day?
Alison: I would probably just try to reach out to other therapists and network with them just to sort of get the lay of the land of what the mental health community was like in that area.
Perry: Fantastic. And probably then start calling some doctor’s offices and getting the names of the office managers, right?
Alison: That’s right.
Perry: Well, Alison. I know that you’re doing something really exciting with Joe Sanok coming up here from The Practice of The Practice. Would you mind sharing that with our audience?
Alison: Yeah. So Joe and I are in kind of the beginning stages of talking about consulting together. So I’m going to be kind of helping folks who run a more insurance based practice with doing some consulting for them.
Perry: Great. And do you guys have anywhere our audience can go to find out more about that?
Alison: Yeah. So for right now because we haven’t made like the formal announcement or launched it formally, they can just email me at my practice address which is email@example.com.
Perry: Great. And we’ll have the links to that in this week’s show notes of course, over at Brightervision.com/session38. Alison, any parting advice for our listeners?
Alison: I think that one thing that I would really encourage other therapists to look at is if you’ve ever thought about forming a group practice I think it’s probably easier than you think it is and it’s a great way to leverage your business and increase your ability to help people in your community.
Perry: Fantastic. And Alison, thank you so much for being on this show today. I think this is just jam packed with so many great information that our audience is going to be able to use to inspire and motivate them to really building a fantastic group practice. I know that I speak for our entire audience here that we appreciate the great advice that you provided and the therapist experience that you have shared. Thanks again.
Alison: Thank you Perry, yeah. Thanks.
Perry: And thank you so much for tuning in today. If you have a question for us email it to us at firstname.lastname@example.org and if you’re interested in launching a website, please don’t hesitate to reach out to us. Brighter Vision is the worldwide leader in custom therapist website design. For just 59 dollars a month we’ll build you a website that’s as unique as your practice, provide you with unlimited tech support, and complimentary SEO so people can find you online. Head on over to Brightervision.com to learn more and drop us a line through one of our contact forms. That does it for today, thanks again for listening and we’ll see you next week.