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Episode 105 | What I Wish I Knew When I started My Group Practice



  • Episode 105 | What I Wish I Knew When I started My Group Practice 00:00


Hi Group Practice Listeners! In this episode, I’m talking all about what I wish I knew before I started a group practice.

In this episode I discuss:

  • Slowing down to make better choices for your practice
  • Learning to balance self care
  • Knowing when to stop at the end of the day
  • Resisting the survival trap
  • Resisting the comparison trap
  • Learning there is no “perfect time”
  • Creating a network of business owners
  • Focusing on your own leadership skills
  • Automating, Delegating, and Elimate
  • Knowing what you know + what you don’t

This episode is sponsored by TherapyNotes. TherapyNotes is an EHR software that helps behavioral health professionals manage their practice with confidence and efficiency. I use TherapyNotes in my own group practice and love its amazing support team, billing features, and scheduling capabilities. It serves us well as a large group practice owner.

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Maureen Werrbach

Today I want to talk about a question that I see being asked often of established group practice owners which is: what I wish I knew before I started a group practice.

People ask us often and want to know those questions and things that established group practice owners wish they knew when they first started their practice. So I assembled questions and thoughts and things I wish I knew when I started my group practice. As well as ones that I’ve seen, posted by established practice owners in my facebook group. So these aren’t all my own things that I wish I knew, but many of them are.  I thought it would be a fun idea to put together a list of some of the things that will establish your practice owners wished they knew when they first started.

So let’s start. The first is to slow down.

Don’t try and do all the things all at once. I know this is a huge one. Because when you first start off, you tend to be eager and excited and ready to kind of grill yourself as much as possible to get as much done in a short period of time. The excitement makes you want to move forward really quickly. To just be at that next place at that next level with that first therapist and that second therapist. And so my biggest piece of advice that I wish I would have taken back in the day when I first started was to just slow down.

You’ll get there when you get there. It’s not necessarily better to get there quicker. And if you slow down You end up making better decisions for yourself and for your group practice.

And you also set the tone for your productivity and how you want to work when you fly through things and don’t slow down and don’t give yourself time to think. You’re just opening yourself up to errors and misjudgments and needing to rectify or switch courses. Because you made a decision that was maybe not well thought out.

Along with those lines is knowing your mission, vision values and, and your business plan. Because when you aren’t slowing down, and when you aren’t taking your time and knowing that you’ll get there when you get there. And that there’s no right pace to get there. You end up making better decisions that are in alignment with what your mission, vision and values are. So that’s my first one.

Second is: it will take a lot of your time.

And I know this is something that we all all sort of know in the back of our minds. But we don’t know how much time it’ll take until we actually start. Until we hire our first few people and put our policies and procedures in place. It takes a lot of your time. A lot more than whatever it is that you’re thinking. Whatever amount of time you think it’s going to take you, I would multiply that by 10. Because it does take a lot of your time.

But you need to make sure that you’re self caring, and that you don’t burn out. Whatever self care looks like for you. You need to know that your to do list is not going to go down. So don’t fall for the trap of trying to get it done and trying to catch up. Because you’ll end up spending all your days and all your nights, checking off your checklist. And feeling like it’s a never ending list that never ends, you know. So it’s going to take a lot of your time. And it’ll take a lot of your time for a long time. But there is a light at the end of the tunnel.

One being that as you start to delegate and hand things off to other people, you can allow it to take less of your time.

But that’s also part of like this habit thing is that when you put yourself in a position where you’re kind of grinding all day getting worked on and you know, for the sake of growth when Mike Michalowicz talks a lot about. A lot of the work that we do actually doesn’t promote growth and is just time wasters. But you put yourself in a position of getting into the habit of working a lot, and so even when you’re delegating things, what you’re going to do is just getting continue this position of finding things to do. So although it will take a lot of your time.

Another piece of feedback is that I wish I knew and that a lot of practice owners wished they knew back in the day is to really pace yourself and to know when to stop at the end of the day.

Just let it go and start back up the next day, the to do list will always be there, there’s no need to grind yourself to the till the end of the night. Watch out for the survival trap. This is a term that Mike Michalowicz uses in one of his books, which is the survival trap of needing to always put out these small fires. And instead of focusing on the one big thing that you should be focusing on, there’s going to be emails that come in every day of things that people need you to fix. There’s going to be billing issues and people taking off and people leaving and people you need to hire and clients who are unhappy and people who are calling and you don’t have a front desk person.

There’s always going to be what feels like a fire that you need to put out. But don’t fall into the survival trap of needing to continuously put out these small fires. It is okay to let the small fires continue if you’re focusing on a big thing, the thing that is actually really important to your business.

I know that small fires feel important to your business in terms of growth and not having it, you know, go in a negative direction. But typically underneath all the small fires is one bigger thing,whether it’s a policy or a procedure, that ends up rectifying a handful of small fires. So instead of putting out these fires, let’s go deeper and focus on the bigger things whether that’s a sales issue or a profit issue, because oftentimes, that ends up clearing out a lot of the small fires.

Next, don’t compare yourself to where other people’s journeys are with where your journey is right now.

And in this digital and social media age, it’s really easy to see all the successes of all the other group practice owners and you know, people with hundred people, group practices, people with 20 locations, people who are 777 figures, it don’t compare yourself to that. It’s great to have goals and ambitions is great to be excited for other people’s group practices in their own successes. But don’t start comparing yourself to where they’re at. What ends up happening is you feel less than you’ll feel like you’re not moving fast enough or doing good enough.

Or you’ll have the shiny object syndrome, where you start to implement all the things that these other group practice owners are doing, which don’t fall in line with your mission, vision and values and end up wasting your time, sucking away your energy and your own happiness.

Focus on your journey, congratulate the other group practice owners on their amazing journeys, but we’re all on an awesome journey. We all have a different pace. We all have different goals, where you’re at is where you should be at right now. If there’s somewhere else you want to be, take the steps that you need to take to get there but don’t look at other people’s journeys and think, what am I doing wrong? I should be there. It’s a great recipe for disaster and something I wish I would have paid more attention to.

Instead of looking at other people’s journeys and thinking, Oh my gosh, we started at the same time, how do they have seven people and I only have two, I must be moving really slow. Take your time and move at your own pace.

Don’t wait for the perfect time.

So it’s kind of I say, sometimes contradictory things. And this is one of those where it’s, I’ll say, Take your time. Don’t rush into things. But I will also say, don’t wait for the perfect time. It’s kind of like pregnancy. I don’t know if any of you who have had kids had this time where you thought like, I have to wait for the right time. There’s the right time, when’s the right time. And then you realize, at some point, that there’s probably never the greatest time.

There’s always going to be things that feel like might be an obstacle. And this is same for owning a group practice or a business of any kind is there isn’t going to be a perfect time. There’s always life that gets in the way. There’s always struggles in your personal things happening at home things you need to take care of vacations. You know, fake trying to figure out the perfect group practice structure, there’s always things that can get in the way of feeling like it’s the right time.

And so I also want to give permission to those of you that are waiting for the perfect time that it’s okay to not feel like it’s perfect. If you feel prepared enough. And it’s something that’s a part of your business plan and your goal to do, then take that first step in and start it.

Seek help is another big one.

Whether it’s through business coaches, or partnerships, or friends who own businesses, even if it’s group practice owners, or even if it’s other types of business owners, whether it’s accountability groups or masterminds or other people in your community or Chamber of Commerce, people having help, and not just from family members and friends, but like people who own businesses, people who know what it feels like to Manage and balance home life and childcare and hobbies and business and growth and all that stuff. Find people that you can talk to about what it feels like to own a business, whether that’s someone that’s a practice owner, or not.

This one is probably my biggest one personally, that I wish I would have paid attention to is to focus on your own leadership skills.

I don’t care if you are the CEO of a company before which 99% of us weren’t. Or if you supervise a couple of clinicians before, when you own a business, it is an interestingly different experience to how you lead. It will test you in terms of feeling good enough as a leader in terms of feeling like the people that work with you value your input as a leader, it will take strength, it’ll take a lot of work. And so and you’ll need to embrace your imposter syndrome that is related to being a person who’s leading A group of other clinicians and administrative staff. I urge you to focus on how you’re going to actually grow those leadership skills that feels like something that you can just tack on. And you know, you’ll kind of figure it out as you learn.

A lot of times, again, this is part of that survival trap thing is, you want to focus on the things that will actually grow the business. So, versus focusing on the important things. And really, leadership is so important 99% of people who leave a business employees who leave a business leave because of bad leadership. So it’s just as vital as sales and profits and structuring your organization is your own leadership skills and making sure that you’re dedicating time every week to growing your leadership skills, whether that’s through reading books, listening to podcasts, having a leadership coach, whatever, just make sure that you’re focusing on that.

Know your non negotiables this is another good one.

Whether that’s in the staff that you’re having Whether that’s in rates that you want to set for your business and for your team, it’s really important to know what your non negotiables are, because it’s really easy to fall into this trap of settling, because you’re eager to grow, or because you’re afraid that nothing better is going to come along. So know your non negotiables before you start seeking those people or those processes to put in place, nothing is worse than not having those non negotiables.

And knowing let’s say, you know, in terms of hiring, I do not want provisionally licensed people because I don’t have the time to supervise them or I don’t part of my business mission and vision is to have a group of well established clinicians and provisionally licensed therapists don’t align with that. Okay.

So then when interviews come or interviewers come in, you know, to check about what their licensure is before interviewing them because I’ve done this before, and many other practice owners have done it. They’ve hired people who didn’t have every quality that you were looking for, whether it’s about the culture, whether it’s about the licensure, whether it’s about specialty type, and then leader, they’re kicking themselves in the butt because they said, Oh, but this person was really nice in the interview, they seemed like a great person. I can see them being good on the team, but then they let go of some non negotiables there. So know your non negotiables.

Next, automate, delegate and eliminate.

I love this trio, as was something that someone posted in my facebook group and I love it. I’m all about delegation, I’d love to delegate things. It feels really good to be able to hire people and employ them and pay them a good wage. So delegating for me is not only fun, because I get to let go of some things myself, which was hard to do as someone who likes to control a lot of things, but it felt double as good knowing that I was able to bring one more person on who I knew was going to be paid really well and help them you know, have a job that they love.

And that to me is even more awesome than the act of delegating. But automate, delegate, eliminate, automate processes in your practice, make sure there’s no redundancies, streamline things so that they don’t take a million years to get done, and that it doesn’t take 15 people to do that thing.

So that’s automate delegate obviously means let go give these jobs these tasks to other people whose strength those tasks are, and eliminate the things that are either redundant or not helping you grow or not helping things be streamlined or not helping the culture of your practice, automate, delegate eliminate.

Another thing that I wish I would have known is that you’re not gonna be able to wear your clinician hat as much as you think you will.

I don’t care if you’re a group practice. owner who still sees 10 clients, or your group practice owner who sees none 100% of group practice owners think and maybe not for more than a day or so but 100% of us did not anticipate that we would need to reduce our client caseload. Some of us might have been thinking, I’m excited that I can reduce my caseload a little bit and diversify some of the stuff that I’m doing.

But none of us realized the imperative of reducing our clinician patient caseload in lieu of adding a lot more hours to the business hat we were. And so this is something I wish I would have sort of been more aware of getting into it, because those of you that really want to be clinician first and foremost, that’s something to really think about because it is impossible to own a good practice and have your main hat be clinician.

It can be one of the hats, but it’s gonna be a smaller hat. It can’t be that the biggest first and foremost that you were.

And then lastly is have a good employment attorney, malpractice attorney and accountant.

These people will save you in many ways. An accountant will help make sure that you’re doing profit first that your business is profitable. I’m gonna be talking about this in an upcoming podcast episode is why you were making less now than you were when you were a solo practitioner. An accountant is a really helpful person in terms of figuring out how to make a profit first so that you’re not losing money by being a group practice owner.

And an employment attorney and malpractice attorney are going to help make sure that you are employing people in an ethical and legal way and that they’re able to be supported in terms of their clinical work by a malpractice attorney because you don’t know all the answers and now it’s not just you kind of winging what you think is legal and ethical when it comes to dealing with your clients, you have clinicians now who also have clients.

Having a good malpractice attorney is going to be just key to ensuring that everyone’s doing things legally and ethically. So those are the main tips that I feel like I could go through a whole lot more.

But these are the main things that I wish I knew that some group practice owners who are well established have also said they wish that they knew when they were starting.

Hopefully you have a great day. Those of you that are just starting off in your group, practiceownership journey, take these pieces of information, move them over. And those of you that are established, if there’s some other things that you wish you would have known, shoot it up and let me know what that is because I’d love to put that out there.


Thanks For Listening

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Here are the resources and guides we recommend based on this episode

therapy notes

*Need a good EHR for your group practice? TherapyNotes is it. I’ve been using it for years in my own group practice, and it does really well when it comes to having the features group practice owners need. Try it out for FREE for 2 months by clicking here.

* I am an affiliate for some of the businesses I recommend. These are companies that I use in my own group practice, and make recommendations based off of my experience with them. When you use some of these companies through my links, I receive compensation, which helps me continue to offer great free information on my podcast, blog, Facebook group, and website.

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Meet your host


Maureen Werrbach is a psychotherapist, group practice owner and group practice coach. Learn more about her coaching services here:


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The podcast is structured so that you get practice building tips in small doses, where an episode can be listened to (and a group practice building lesson can be learned) in a single car ride.

Episodes are structured into categories: coaching sessions where I coach a group practice owner on a specific topic, tips of the day by yours truly, real talk where you get to be a fly on the wall while an established group practice owner and I talk about the highs and lows of ownership, and trainings done by experts in the field.

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