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Episode 113 | Delegating with Christine Barker



  • Episode 113 | Delegating with Christine Barker 00:00


Hi Group Practice Listeners! In this coaching episode, I’m talking with Christina Barker all about delegating.

In this episode we cover:

  • Identifying problems to delegate
  • Seeing the bigger picture when delegating
  • Thinking through delegating to in-house vs virtual assistants
  • Benefits of delegating to an admin team

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

Hey everyone, welcome to another episode of the group practice exchange podcast. Today’s episode is a coaching episode and I’ve got Christine Barker on with me. Hey, Christine. Hi. We were talking before recording and I realized she lives in a suburb not too far away from me. So I always love when I get to talk to someone who’s from my state. I’m so used to talking with people that are just in California and Texas in New York. It’s always really nice when I have someone that’s in my neighborhood. Yeah, we’re neighbors. And you’re in the neighborhood that I like, love. Her practice, Inner Courage Counseling.

Christine Barker 

Yeah. Inner Courage Counseling.

Maureen Werrbach 

In Naperville. Naperville is one of my favorite neighborhoods.. So today we’re gonna be talking about delegating. And it’s something that you had filled out in the coaching application, which was pre COVID, though barely pre COVID. But it’s still something that you’re wanting to talk about. I’m sure the questions around delegating may have changed now that we’re, you know, in this teletherapy world. So let’s just hop in and ask any questions you have around delegating, and we’ll see how I can help

Christine Barker 

Yeah, so pre COVID. We were getting were coming up on our year anniversary. So we have five clinicians Total, including myself and the other co owner. And we’re all kind of getting really full. So we hired a new clinician, which was our first one. But a lot of the responsibilities like the billing referrals, phone calls, emails, shopping needs, cleaning, you know, marketing, all of the things. We were splitting up between me and Brittany Roback, who’s my co owner. And that was getting really overwhelming with, you know, seeing 30 clients a week and running a business and doing all of those things. So we decided we wanted to, you know, kind of make a move somewhere, and that’s where I reached out to you and said, you know, what, if I could talk to you about that, that would be great.

And then COVID hit, so that was a big shift.

So we all went to telehealth, and we decided to hold off on hiring anybody or making any of those decisions because we took a little bit of a hit on referrals. So we didn’t know you know, affordability wise, you know what this was going to do. Especially with insurance companies like you know, that question mark of payments and things like that I was too nervous to, you know, hire someone or make a decision about that.

But now that we’ve kind of been in this world for a little bit, you know, things are picking back up. We’re getting, you know, referrals, people coming back, that left and new ones coming in. I think people are getting more comfortable with it. So now I’m kind of back on “okay, this is getting really busy again, I need some help.”

Maureen Werrbach 

You know, it’s interesting, one of the things I learned looking back on my own journey of delegating things is realizing that I was always delegating in response to something and I found that just specific to me, and maybe you can relate. But when I delegated in response to being really busy in a particular area, we’re actually I was like, I want someone to take this. What I ended up doing was not doing very good at ensuring that what I was handing enough things off. So I felt like what I what I was doing initially was I didn’t want to answer phones anymore.

Phones was­–I’ve talked about this before–was something that was a weird feeling for me. Because you know, you would initially when when you first start your group practice, you get excited every time the phone rings, because it’s like, “yes, I might be able to refer someone to my new therapist!” And so there’s like this positive feeling every time the phone rings, but I would have the mix of like, feeling excited, and also dreading it because usually the phone calls would happen when I was driving in my car on the way to target or whatever. You know, not in the office or not in front of the computer where I’d be like no, like, why are you calling now I don’t want you to call right now because now you’re gonna go to voicemail and I have to either pull over, whatever!

So the phones was the first thing that started delegating.

Give it away. And I remember, you know, every step of the way, for a really long time, I would find a problem, something that I did not want to do, right. And then I would find a person to delegate it to. So what I see what I see happening, my my thing was is I delegated a task at a time. And then very quickly, another task would just take over. Then I would be like, I need to delegate that thing now, too.

I noticed for me, that it took a lot of years for me to realize that I needed not to look at individual tasks to delegate, but to actually look at my bigger picture of the work that I do. And kind of organize the different things that I do into like categories, so that I could hire one or two part time or full time, people that could do a variety of tasks. Even if some of those other tasks aren’t yet issues for me.

Because like I said, I found that I would want to give things away as they became problems and sometimes the different tasks or not, under like, one person couldn’t do them either because it wasn’t a strength of theirs to do, you know, phones and calling clients to get new credit cards, right. And so what I found was I was having to either hire different people. Because I would be like, okay, now I need to get rid of this second thing. And then, you know, the initial person I hired, that wasn’t a strength of theirs. And obviously, as we know, we don’t want to hand off tasks that don’t match the strength of the person.

So what I found was for me, and I think this is a good suggestion for anyone who’s thinking about hiring someone to delegate things to, is to not look at just what’s right in front of your nose as what you want to delegate. But to really write down what are all the hats you wear.

What are all the from big tasks to small tasks, what are the things that you’re doing and start today. Lump them into similar categories.

So you know, you might find that under Administrative, you have a whole lot of tasks that you can actually hand off, even though some of them were things that weren’t feeling like issues to write. Because as we know, the more our group practices grow, the more we want to delegate.

And like I said, in the beginning is I tended to be this person that was, like, I found people in response to a problem that I would have of wanting to delegate. And I think being proactive in this area. People don’t talk about productivity when it comes to delegating. I think most people look at it as okay, you’re having a problem and you need to delegate. Now it’s time to delegate it. But I would suggest, you know, I know you’re thinking about delegating. So there’s clearly an area at least one area that you are thinking about handing off. My first suggestion would be to think about what are some of the other tasks that you’re doing.

Because every person–and if you go into my facebook group, you’ll see this all the time. There’s not one person that is answered differently to this. But every person said, once I hired my admin or my VA or in house out of house doesn’t even matter. I very quickly had a positive return on investment. Like really quickly, you know, because people get nervous about spending in this area, rightfully so because they feel like well, I’m doing it so costs no money.

Which is a-whole-nother episode to talk about. Costing money, it’s just, you’re not viewing yourself as someone that should be being paid for the thing. But so a lot of people get nervous about it. But literally every person that has ever brought on someone that they that they feel is a good fit first, has said that it’s a good return on investment and that it actually helped boost profits or sales.

Christine Barker 

Because I’m looking at the hours that I’m spending doing a lot of these things, and how draining it is to do these things. And then like looking at, you know, it takes so much to do all this stuff so much in it and thinking and then, you know, you’re organizing and doing all these things that it’s taking away from other things that I think could make a big difference just in our practice. And yeah, we’re kind of leaning towards like a person, an admin assistant person in-person. Yeah. But we were kind of, you know, flirting with the idea of a virtual assistant at one time. I just didn’t know how that worked and how other people’s experiences with that were.

Maureen Werrbach 

I have a VA for the group practice exchange, and she does some ads and stuff for my group practice as well. Uriah is a good person to ask as well, Uriah Guilford, he has The Productive Therapist business. And he’s a group practice owner. He’s also in our membership sites, you can always talk to him in there too. But he’s like the VA guru.

One of the things that I have always said was, with regards to in-house or having a virtual assistant. If you end up having–for me, I found because VA is cost more than having someone in house you can have someone in house and potentially pay, you know, $15 or $20 an hour to have someone in house. But Vas will sometimes cost upwards of 45 to $65 for an hour. And there’s a whole slew of reasons I can send you. Uriah wrote a really good article about why they cost more and it makes a lot of sense. So I don’t want to go into too much detail about it, but it’s just one it’s a separate business to, you know, in house people you have to pay for all the time that they’re working and sitting in the office even when the phone is not ringing.

Whereas with a virtual assistant, they’re really tracking their own hours. So, and they’re typically working with a lot of different businesses. They’ll be sitting and working for all a bunch of different businesses and if your phone is not ringing, even though they’re there and available to pick up your phone, if it does ring, you’re not necessarily being charged for any of that time while you’re while the phone’s not ringing. So it’s kind of it’s a really positive for having a VA.

But I found that I realized it was time to have an in house person when I had about 20 hours of work per week that I wanted to be delegating.

For me that felt like that, where the scale sort of tipped and it became financially better for me to have someone in person because you know, essentially you could have a full time in house person at the same cost typically as a part time, VA because they typically cost you know, two to three times as much as as a in house person.

And so once I got to, you know, having around 20 hours worth of work for them to do, it typically was the time for me where I would realize it’s time for me to have someone in house doing this. And I could pay the same amount and they’d be working full time, you know, if 20 or $25 an hour. Then obviously, you have the ability to hand off even more tasks. So that was that’s kind of my scale of how I see when it’s time to move to move over to in person or in house.

But I’ll post, I’ll send it I’ll send this to you, but also post it in the show notes here. Uriah’s blog article that he wrote, because it’s a really good, a really good one with regards to just the cost differences between a VA and in house. Because I think that’s a good consideration to have when thinking about it. Not just kind of the hours that you need them to work but also factoring in pay. But that’s kind of that’s how I start things. With regards to thinking about having in house.

Christine Barker 

Yeah, that’s really good.

Maureen Werrbach 

Yeah, because there’s definitely a lot of benefit to having a VA. You don’t have to do any training typically VAs know how to do what they’re doing. In house people, if you, you know, a lot of people hire an in house person who maybe has a minimal amount of experience in mental health, private practice, etc. But if you find a VA, especially, there’s a ton that are businesses, VA businesses out there that are specific to group mental health group practices, you have to do no training.

So you’re saving all of that time, your time, your money, and can essentially hand things off pretty much seamlessly and right away. So another pro to a VA is that but again, I get to a point, you know, around that 20 hour mark where I think I’d rather spend time training that person because at the end of the day, the cost is more and it works better for me to have them In house at that point.

Christine Barker 

Yeah, that was another question that I was that I had too. You know, kind of an experienced person versus someone that doesn’t have a lot of experience. And, you know, being able to sort of mold them and teach them the way that you want them to do things. Is that a benefit? You know, I’m sure that’s you know, different per person, but that because that would take a lot of time to train.

Maureen Werrbach 

Yeah. I am okay with administratively hiring people who don’t have experience. Because I think one, I like to give opportunities to people who want to shift industries. But two, I do like the idea of really training someone around the processes that I have. When I look for people, I won’t necessarily bring up someone who is just new to the administrative world altogether. I like people who have had past experience, I find that they bring in a flavor that we don’t have and they bring in ideas and thoughts and you know, I just, they bring in ideas that I might not necessarily be thinking about. Because they have worked in maybe a different industry.

Like I had someone who I love and she never worked in mental health, but she worked in administratively in like an in the automotive, trucking sort of industry. And I find that she sees the world in such a different way because I’m so immersed in the mental health world even with when it comes to administrative stuff that she so often comes up with an idea that I am not thinking about. And she will be like, well when I worked, you know at full block, you know the way that the truck company owners were doing this, you know, somehow benefited x. You know, and, I think this is really a personality thing and time factor when it comes to hiring someone. Whether you should hire someone that’s new to admin or new to mental health admin or not.

If you don’t have the time, you should hire a VA and bring a VA on who knows how to work with a Mental Health Group Practice community.

Because one of the biggest, like, struggles that I see and I feel bad for the practice owner, but I also feel bad for the admin is when the group practice owner doesn’t have the appropriate amount of time. Which for me, when when we bring on a new admin, I clear my calendar of Group Practice Exchange, of all my Urban Wellness work, of my conference work for one full week. A full 40 hours I’m sitting with them, literally, and working with them and training them. And then the second week I’m there, halftime. So for two weeks, I’m pretty much out for the count, one full week on any other work. The second week, I’m coming back in, you know, part time being able to get back into the Group Practice Exchange and other things while sitting next to them for at least 20 hours.

If you feel like you can’t invest that amount of time, at least that amount of time, then a VA might be the best bet for delegating until you have that time because they obviously don’t need as much hand holding.

But like I said, people who feel like, you know, I see so many that say they have the time and then get frustrated or resentful because the person isn’t doing what they want. And they say they spent a good amount of time with that person. But when I dig a little deeper, it’s really that they were kind of in the office, they don’t want to be where they’re sitting with them. And that they train them for a couple of hours initially, or sat with them for one or two hours each day. And then kind of you know, let them have the reins for the last six hours a day.

Or they thought because they explained it once that it was going to sear into their brains and never be forgotten. And, yeah, I feel like I said, it’s really going to be dependent on the time investment that you can make. For me, I’m willing to make a time investment to have someone who’s just a part of the family. And who’s invested in my business.

Christine Barker 

Oh, I love that. That’s a good perspective. Thank you.

Maureen Werrbach 

Yeah. So what are you looking for? For delegating?

Christine Barker 

Oh, I have the list.

Maureen Werrbach 

Let’s go through the list

Christine Barker 

Well, phone definitely. Phone, email responses. Referrals that we need. You know that I spent a lot of time doing that myself kind of like you were saying. Like someone calls, you gotta a pull over you gotta stop what you’re doing, you know. And those phone calls can take 20-30 minutes. Billing, I do billing myself. I know. It’s like the number one thing I want to get off my plate. I’m like, oh, I need to stop doing this. But like you said, it was like, oh, well, I could do it for free. So why would I pay somebody? But it’s getting to be where it’s like taking up so much time right now. And so I didn’t know if that was like, do you have somebody that does just billing? Is that like a separate category?

Maureen Werrbach 

Yeah, I find that billing needs to be its own category. There are some VA companies that kind of blend those because they are mental health, administrative companies that work specifically with group practices. So there, if you’re looking for outsourcing, you know, there’s definitely a couple of businesses out there that are specifically to group practice owners and they have just enough staff on their team that can do phones and billing. So you potentially could, you know, hire one company, all of that.

But I find that those are two very different beasts and they take two very different skill types. And it’s typically pretty hard to find someone that can do both things.

The other thing I’ll say is, and I get that I’m a large practice. So I have a lot of people, I have one that answers the phones. One that does billing, one that does benefit checks. And these are all full time people. One that does oversight–just overseeing those two people the billing and the benefit checks person. And she also does payroll, and then one administrative assistant who’s our person that’s sort of shifting into client care. Where she sends out the surveys she makes sure that the client files are, you know that the telehealth forms are filled out in there and you know, cuz clinicians don’t always make sure to have things signed the way they’re supposed to. So she checks on that kind of stuff. So I have a lot of people.

I did that because what I found was, once I delegated it felt really good. But then anytime that person was sick, anytime we had to let that person go or anytime that person left and found another job, that task fell back on me or my clinical director. And so I decided to have a team in place. And so I’m saying this knowing that I’m a larger practice, and it is easier to do this.

But each person knows how to do a couple other roles aside from their main role.

So if someone’s on vacation, my admin assistant knows how to do phones, if my phone person leaves, my admin assistant can pick up the slack and do the phone so it does not have to fall back on me. My benefits person and my billing person both know how to do each other’s job. My billing person will check benefits, my benefits person knows how to submit claims if my billing person is gone. So we’ve we’ve made sure that there’s–it’s in Michalowicz’s book Mike Michalowicz’s book Clockwork. Oh my gosh, what’s he call it like a linchpin it’s where there’s like a bottleneck in your process where things can slow down if there’s not a if a key person is gone. And so I worked you know, last year, really hard putting something together.

So knowing that I know my practice is larger, so I can have more of that. But that’s something to think about too.

You know, with a VA, if one VA is on vacation, typically a VA company has a different person that comes in and does that work for them. So definitely is another benefit to having a VA is if the one that works with you is on vacation or sick or gone. The company likely has backup people so that it doesn’t have to fall back on you. If you decide to have in person I would look at maybe potentially, initially at least having a couple of part time people versus let’s say one full time person so that both people can learn the jobs together and know how to in each person can have a different role but they learn each other’s roles so that if one is gone, sick and vacation, leaves, the other person can pick up that slack.

So that was a thing that I you know, recognized and felt pretty strongly after hiring and just have one person went off, finish grad school, she was a VA and did grad school. And then once she was done with grad school, like got a job in her field, and the phones came back to me this was that, like, we’re at where I was pretty large. I think I had 15 or 20 people. And I was like, well, I can’t believe I answered.

And it was really the place where I realized, you know, having a VA or an in house person is nice. But there’s really more to think about. You know, what happens when that person’s gone or leaves. And we see a lot of that in the Facebook group where people are like, oh, my gosh, I’m like, so busy, and my phone person just just gave her notice. And they freak out, you know, and it’s because you have another person in place, and they don’t have the time because they’re doing you know, still seeing a lot of clients or doing a lot of business stuff.

So it’s something else to think about when structuring the administrative position.

Thinking about is there a way for you to potentially have a backup. Whether it’s having two part time people initially, so you’re not putting too much emphasis on one person so that one person leaves it kind of shatters your administrative process.

Christine Barker 

That’s a great idea. Yes, that’s a great idea. I’m just taking notes. This is so good. Yeah, that’s a really good thing to think about. I like that too. Like, and being able to train them at the same time. So they you know, they’re both getting the same information. Yep. No, that’s really smart.

Maureen Werrbach 

I think it’s made a huge difference for us. And for, you know, with the process we have now. We probably have 40 hours a week worth of administrative support that we’re paying for that we don’t actually need. Because of the benefit of ensuring that there’s always support when someone’s on vacation or gone or leaving.

That doesn’t mean that there’s 40 hours of work not being done.

It means that we’re kind of like, really on top of things. So, more so than, you know, most people probably because we have we have the extra time administratively that we can say, hey, this week, do you mind going through all the client files, and just making sure that the credit card forms, that there aren’t any ones expiring? You know, the things that kind of get put on the wayside? So I feel good about that. Because I know that we have little odds and ends that typically are not viewed as super important. So they get put on the wayside, that we can always be on top of, and with the larger benefit of I know that I’m fully covered administratively if anything is to happen to you know, any one of them. We’re still going to be good.

Christine Barker 

Yeah, that’s such a good idea.

Maureen Werrbach 

Any last questions before we before we close out?

Christine Barker 

No, I don’t think so.

Maureen Werrbach 

Well, you’ll have to let me know what you do! VA or in house, if you do a full time or a couple part time people. Like I said in the beginning, I would start with really writing down all of the administrative tasks that you do, not just the ones that you want to get rid of. But just all of them and start to lump them into categories, because you might find that you’re looking for a certain kind of person or a person with a certain set of skills, more so than, you know, another set of skills.

So I found that that helped me out a lot, especially in the beginning when I was trying to look for someone and I had only a certain amount of money and I needed to make sure that I hired the route like the perfect person is yes, is really having that whole list of tasks that needs to be done.

It just makes it easier than when you put the job ad out there that and you do the interviews that you know what skills they need to have beyond maybe that main one which might be billing, right?

So maybe billing is your first one that you’re going to give away. But maybe within billing or in connection with billing, it’s, you want this person to be able to not only communicate with insurance companies and rectify claims that are being paid out, but you also want to find someone who maybe actually calls clients and charges credit cards. So you know, having a billing person who just is doing billing and kind of is it back end administrative where they’re not client facing they’re kind of inputting data they’re calling insurance companies, they don’t need to have some of the in person skill or in person sales. They don’t need to have some of the person to person communication skills that receptionist needs to have, right? The receptionist then has the ability to be engaging to clients and make clients feel comfortable and welcome.

But if you’re maybe having this feeling person call clients, too get updated credit card forms, you maybe want someone who has a little bit of that front desk personality to, you know, so that the client feels comfortable and doesn’t feel like the person’s abrasive or whatnot. So that’s why I really like writing down all of the tasks that kind of fit into a category, because you might find that your ad will change a little bit, too.

Christine Barker 

Yes, definitely. All of that. Mm hmm. And especially now because we’re not, you know, not knowing when we’re going to be going back into the office. Like, I would say, now, for us at least it would be good to get more of the back end person. Yeah, going. While you know, because of the situation because the phones are a little bit slower right now.

Maureen Werrbach 

So maybe there’s less of a need for that immediately. Yes, exactly. I was just thinking as you’re talking there’s we should have a-whole-nother podcast on how do you train someone virtually. Right.

Christine Barker 

Oh,that was running through my mind this whole time. I’m going How am I going to do that?

Maureen Werrbach 

You know what? Maybe we can have a part two on this. I’ll send you an email since you’re kind of going through this. There’s no point in finding someone else to talk to this about. But a really good topic is just how do you train someone when it’s all virtual?

Christine Barker 

Yeah, that’s a fun. Okay. Oh, yeah, that’s a good one. To train me on how to train them.

Maureen Werrbach 

That’s right. Well, it was really nice talking to you and yeah, you know getting to meet you virtually! Maybe one day when we’re allowed to in person we can get some coffee.

Christine Barker 

Yes, absolutely. Thank you for having me. Yeah, no problem. Thank you for your help. Have a good one. You too.

Thanks For Listening

Thanks for listening to the group practice exchange podcast. Like what you heard? Give us five stars on whatever platform you’re listening from. Need extra suppor? Join The Exchange, a membership community just for group practice owners with monthly office hours, live webinars, and a library of trainings ready for you to dive into visit www dot members dot the group practice exchange dot com forward slash exchange. See you next week.


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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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