Episode 124 | Decisions Around Structuring & Onboarding Admin with Heather Frank

Maureen Werrbach 

Hey everyone, welcome to another episode of the Group Practice Exchange Podcast. Today is a coaching episode and I have Heather Frank on with me today. Hi, Heather. How are you?

Heather Frank 

I’m good. How are you doing?

Maureen Werrbach 

Not too bad. I just realized you’re in Chicago too.

Heather Frank 

Yeah, that’s exciting, not far from each other.

Maureen Werrbach 

No, that’s awesome. I didn’t actually realize that before before school, literally just as I’m talking to you know, I see the show notes that you have Chicago Counseling Collective. I love that name.

Heather Frank 

Yeah. Thanks!

Maureen Werrbach 

So we’re gonna be talking today about developing and training an admin team. So why don’t you start with just introducing yourself and your practice and the size and all that fun stuff. And then we can just hop right into questions you have around the topic.

Heather Frank 

Sure, yeah. very appreciative of all you have created and put together for us, therapists, business owners. So thank you, and thank you for the opportunity to be on the podcast.

So I just a little bit about Chicago Counseling Collective I probably went into private practice about four or five years ago and was just a solo practitioner for a while. I came from a University Counseling Center background, so I really missed training and certainly working with a team and collaboration so I decided last year, probably July 2019, was it to create a S-corp and then brought on two postdoctoral fellows into the practice. And that was kind of the big year to see how that went in. I really enjoyed it. I thought it went really well certainly there was a lot to change and things to work out along the way.

But I decided to continue expanding and have recently have two new postdocs coming on for the fall year because they’re kind of on a yearly cycle for their training.

And then also recently hired a hybrid clinicians, physician, office manager. She very talented woman also has a marketing background so she might also do some social media work for us. So I’m kind of at this, I guess, area of growth where I feel like I need to delegate better. I need to help bring on maybe even more admin staff to do the things that I’m finding I don’t have the time to do with still like managing a pretty heavy clinical load.

So, yeah, that’s kind of really my struggle right now. And I will certainly be self reflective and admit it’s very hard to let go of control to trust other people. So I’m trying to figure out kind of the best ways to kind of start letting somebody into that process and how best to train and kind of create an admin team?

Maureen Werrbach 

So you have one person right now, admin wise?

Heather Frank 

Yeah, she was hired more specifically for that role. And then the postdoctoral fellows do have admin, they can’t have administrative components to their positions. I’ve just kind of waxed and waned what tp give them.

Maureen Werrbach 

Yeah, you have three clinical people than right, the two postdocs and the one.

Heather Frank 

Yes, they don’t. It’s three right now. And that’s starting September 1, there will be two more, so it will be five.

Maureen Werrbach 

Okay. Perfect. So one of the things that I like to think about with decisions around administrative teams is looking at the next year or so and seeing, you know, what is it? What’s your plan in terms of growth on the clinical side?

I see that smaller teams obviously don’t need as much administrative support. So they may not need full teams, administrative teams. And it kind of changes how you look at who you’re looking for. If you’re gonna stay smaller for the next couple of years, or the next year or two, you can really get away with having a couple of full time or handful of part time people who can cover more than one base. But as you get larger, it tends to be smarter to delegate positions administratively to individual people, and then have them cross train so that they know each other’s roles.

One of the things that I learned in sort of growing was I started with one person who did sort of everything.

And then that grew out where we hired a couple more people. And what issue we always had and something that I see often happening is that whenever someone is on vacation, and an administrative person is on vacation, or leaves, you almost have to start all over again with either you, you know, picking up while that person is on vacation or gone, or if that person is leaving, kind of reinventing the wheel. Again, with the whole new person.

And so I like starting with: what is your goal for the next year in terms of size? Because that will sort of guide the decision around who to look for now, and how much how much of a role to give them or how much of administrative you know, different components to give them right now.

Heather Frank 

Yeah. So how much am I thinking of growing?

Maureen Werrbach 

Yeah, I bet right now plus you. So that’s six, right. You’re going to be at in the next you know, couple weeks?

Heather Frank 

Yes. Yeah. And it’s, it’s always unclear with, you know, postdoctoral fellows, they may, after they complete their fellowship, they get licensed and they may or may not stay in the practice. So it’s kind of like unclear I guess, yeah, where things might go from now to six months from now. I’m sorry if it’s a little loud out here.

Maureen Werrbach 

So, is your part of your business plan to have posts fellow doctorates in your practice?

Heather Frank 

Yeah, and I was also thinking I would like to go, this probably answers your question better. Maybe in the next year hire on a light, a few more license, okay, either clinicians or psychologists so that there can be more support also for supervision of the postdocs, but maybe also hiring staff who are planning to stay, or you know, at least have the career plan to stay in a group practice for at least a few years so that there isn’t so much with postdocs and trainees it can be hard because then there is turnover. Yeah, sometimes year to year. So my hope would be maybe a few more clinicians. I mean, the question is always to office space, but we’re in this odd time where, you know, for staying remote, I have a lot more options, right? To hire on staff. If I have to put someone in an office that would be yeah, an unknown, then.

Maureen Werrbach 

Okay, so with your one admin right now there, what are they doing answering phones? Doing billing?

Heather Frank 

Yeah, they’re kind of a hybrid. So they’re also clinician, so they’re seeing some clients. And then they are handling intake calls, responding to new client inquiries, teaching them how to send like the welcome email and the portal links for therapy notes. So some of the front facing admin tasks. I’ve currently been doing all the billing,

Maureen Werrbach 

Is that something you’re thinking of delegating? I know you mentioned letting more things go.

Heather Frank 

Yes, that’s probably one of the harder things to like go. But yes, I mean, that’s probably the thing that consumes most of my time right now.

Maureen Werrbach 

How much time is the clinician slash admin spending, doing administrative work on a weekly basis?

Heather Frank 

Probably five to 10 hours of the admin and then she’s working on social media posts and boosting our social media accounts. So that would probably be another 10 hours. So I say she’s, she’s working up to the 20 hours a week of the the admin time, but I don’t think she’s quite there yet. This has been a slow warm up, but there’s quite a lot she could do in terms of social media marketing.

Maureen Werrbach 

Yeah. And you said, is that like a specialty area for her?

Heather Frank 

Yeah, she comes from a marketing background. So definitely something she’s very skilled at.

Maureen Werrbach 

With adding sort of administrative duties, you’re thinking billing, is there anything else that you’re wanting to delegate? Or is billing really kind of the crux of it right now?

Heather Frank 

Um, yeah, billing and then something I noticed she’s kind of taking out which I appreciate is like helping, like with social socializing our kind of office culture so that would be something nice to have someone helping out with and thinking of ideas, just like corral everyone together sending emails to all the staff. Just kind of like a point person in a way.

Maureen Werrbach 

I’m hearing a few different things. I’m hearing with office culture. You know, that can be something administrative or clinical. So in some practices, a clinical director or a site supervisor might be someone that you know, part of their work would be an engaging, healthy workplace positive office culture. But also, from an administrative standpoint, some practices who may not have a clinical director or supervisor or something similar in a leadership position will have an administrative person who’s in a leadership position. Someone like a practice manager or an office manager? What are your thoughts on that?

Heather Frank 

Yeah. And that works, because that’s kind of the hybrid title. She has office manager and staff position. So I think that would fall nicely under her job description.

Maureen Werrbach 

So my I guess my question to you would be at this point, the person that you have is a clinician, what is their future looking like in terms of their role in the administrative piece? Is that something that they’re wanting to have a blend of? Is that something you’re wanting them to have a blend of? Or is this like a stepping stone between needing an actual, you know, full time administrative person on staff that you were using addition?

Heather Frank 

Yeah, that’s a great question. I think and I would have to check in with her certainly on this too. But I think from our discussions that understanding would be this would be a good fit for a while, as she said, her caseload and works toward independent licensure. And then I think the hope would be, we’d assess what parts of it she wants to hold on to in her role down the road. And then she would maybe train or onboard a future, whether it would be part time or full time, maybe admin staff who would be solely in that position. So maybe it would be a non clinician that would be brought on that she would, it would be nice because she will have been doing this position for long enough. I think that we could fine tune it and work together that she could actually train someone. Yeah, to do the things that she’s doing that she can hold on. My thought is maybe to the social media or the pieces she really likes.

Maureen Werrbach 

And that’s what I was that’s what I was kind of moving towards. A lot of practices, group practices, will use a clinician for the administrative piece because it’s a great stepping stone in it’s usually a great way to do it financially. You’re not wanting to use or outsource to a VA company or you don’t need someone full time in house yet. But from what I’m hearing from you, it makes the most sense to look at her position as one that is more short term where, in the long term, her role is more clinical, and maybe that social media piece, especially if that’s her specialty area, it’s really important to have someone dedicated to social media, who knows what they’re doing. So if you have that, that’s actually a really positive thing to have so early on with that, because I know part of your questions initially or around the training piece.

One of the things that I would start having this person do now, even if you’re not looking at hiring another administrative person at this moment, is to start having them record what the steps are of what they do.

So that a person that you do bring out in the future will have some sort of kind of training manual in the way and people do it differently. So we have a website we use. With Google G we have an intra-office site. And one of those is a is a training page. And we have it for clinicians. And we have one for admin. And it literally is videos walking through every step of everything we do. I mean, even from scanning a document into our scanner, we have a video showing how to do that. I mean, just everything. And it’s something it’s a living document or a living page, where we add to it whenever we think of another step or thing that we do. But it’s a great adjunct to in person supporting.

One of the things that all leadership books talk a lot about when it comes to bringing on new team members is that most businesses under train, because one, the person who is doing the training is likely been doing that work for a while that a lot of the beginning steps feel second nature and are automatically skipped as a thing that needs to be trained one. And two, because they’re typically having a full time job and doing doing their work. The amount of time that they spend on training is much less than what a person needs to feel fulfilled to feel like they’re doing quality work, and for the person who’s in charge of them are leading to feel like that person is learning at the pace that they should.

I forget, it’s been years, but I can’t think of the name of the book. But they had said for every five minutes of work, you want to train them for 20 minutes.

And so if you take that over the course of like a full 40 hour workweek, which obviously, in those 40 hours, you’re not doing you know different things every single hour of the day, some of that’s gonna be replicated. But you’ll realize that the amount of time that a person needs to spend training, a new hire is actually way more than we think. And so having some type of video manual can be a great supplement for times when your clinician slash admin may not have the time to sit with that person the whole time, they’ll be able to have that as an adjunct. And I always find that it’s really smart to as they’re actually doing the work right now, just to hit record, or just to, you know, make a document that kind of outlines what they’re doing whatever kind of works for that person.

Heather Frank 

Okay, yeah, that’s helpful. I think we we started having her do that with therapynotes, so I’ll try and extend that out too.

Maureen Werrbach 

Yeah, I would just say literally everything you do. I’m forgetting who had mentioned this, some years ago, but they they had said, you know, a way to really remember because I think the biggest problem people have with training is that they are forgetting those basic things the first level, like first step stuff, because it’s so second nature and basic to them, that they forgotten that it’s something that actually needs to be trained. And so thinking in terms of if I left, having your admin person thinks like, to themselves, if I left tomorrow, what things would the next person need to know? What can I put together so that if there’s literally no people available to teach this person, there’s this document or this series of videos that will 100% get them to be working exactly how I am now? And that typically will help people kind of think of some of those basic initial steps.

Heather Frank 

Okay, and when when you go to hire–so I’m just thinking down the road since I’ve really only hired people with clinical or mental health backgrounds. Where would you think of to hire someone who would be in like a purely admin role? Being that also maybe someone that has a skill set that they could, it could offer in terms of maybe bringing ideas around organization and I streamlining tasks.

Maureen Werrbach 

You’re Chicago, so, similar to me, and so anyone who’s listening, this could vary, you know, based off of the your location here. We’ve had really good success with Indeed handling the problems Indeed, I will tell you it for administrative, it’s a little different for clinical, if you’re looking for clinical but for administrative, you’ll get like 500 applications. And 490 of them are not going to be what you’re looking for. So my suggestion would be if you do use that to be as clear as you can, and then you’ll see that they have this questionnaire that you can put up so that it filters people out. Like they have to meet certain criteria.

So you can say they have to answer yes to this question or they have to answer no to this question to actually be able to submit an application. I recommend using that and being as you know, clear on that as possible, it’s for administrative, I wouldn’t know. I would add as many questions as I can to it that they would have to meet criteria for because there’s just so many people searching for administrative positions. And the algorithm is going to show your ad to everyone that mentions anything administrative at all, even if it doesn’t fit what you’re what you’re what you’re actually looking for.

So that’s a nice way to kind of weed out some people.

But we’ve we’ve had really good luck with it here in Chicago.

And then what’s nice is once we started having a really solid administrative team, we prefer to bring people in internally. So the, you know, clinicians and administrative staff that we have now, whenever we’re looking for another position, whether it’s clinical or administrative, we send an internal email out and say, hey, we’re looking for someone because we, you know, really like our team so much that if we can have more people like the people we have, you know, that’d be great. So I would start with with things like an engine are going to be really good for the Chicago Chicagoland area, just a heads up that you’ll be deleting a lot of the applications.

Heather Frank 

I did use indeed for the postdoc, so I’m familiar. It did work well. And I guess with weeding out did you find like is there I guess, experiences or a background that you have found, like fits very well for a mental for an admin person for mental health practice?

Maureen Werrbach 

So I’ve done this a few different times and my current administrator team is my hopefully forever team. I really love all of them and they do solid work. And interestingly enough, all but one, no all but two, did not have mental health or medical background. They all had leadership and administrative background. So they kind of led an administrative team one did at a lighting company, right. But she’s now moving up to be our Director of client services. She’s been with us a little over a year now and is great. We have two that were in the like medical field but not mental health, one who did work around ESL and the other who did work around occupational therapy. So sort of, not too far off from our field.

Yeah, actually I realized I’m more open on the administrative side, too.

Seeing what’s out there beyond someone who’s has specific Mental Health Training, because if they have administrative training and they know how to lead their position, I’m looking for someone who can work independently who’s autonomous, but also a team player who doesn’t need a lot of hand holding. And I’m more willing to train on, like the mental health piece of things than I am on training someone right off the get go on mental health and our practice and just how to lead their position.

Heather Frank 

Mm hmm. I see.

Maureen Werrbach 

So I’m more open to to, you know, finding someone outside of the mental health field as long as they have solid administrative background.

Heather Frank 

Okay. Yeah.

Maureen Werrbach 

The practices going to be different, you know, someone who has mental health background, more than maybe administrative leadership background.

Heather Frank 

Mm hmm. And in most of these positions, would you say they started out part time and you increased? their hours as the need for more admin as you grew as a practice?

Maureen Werrbach 

Yes. So all I mean, my one went straight full time, my person who does the phones, I hired as a full time person. But that was because the part time person that we had was leaving for grad school. And so we knew that we just needed more than what she was doing at that time. So full time. But all the other positions that we have five admin positions, were all part time initially. And I think that’s a great way to build a team, but be able to afford it without going you know, all in right from the beginning to a full time position. And then think about when making a decision to kind of separate that one clinician slash admin that you do have and bringing someone else on is what’s important for you, as the business owner, but also for your business beyond you know, just having someone do the billing or having someone do the phones.

For me, it was really important that it wasn’t all falling on one person.

And so for me, I prefer to have two part-time people than one full time person administratively in the beginning, because it allowed for them to each have their own roles. But once they learned their roles, they started to learn each other’s roles so that they could support each other for when one was sick or on vacation, or if one was leaving, the other one could, you know, sort of pick up and be able to support the other position. And that, for me, was kind of the most important thing. And so that’s something to think about is as you’re thinking of your administrative structure, what things are most important to you in terms of your time. And, you as a business owner, but also what your administrative and clinical team needs. Because that might guide what type of person or what roles that person is going to have.

Like I said, for me, I really preferred having starting off to people part time that got to know each other’s positions, but really had dedicated separate roles.

So that on a normal day to day basis, they each did their own thing and covered more administrative tasks across the board between the two of them. But if anything happened, you know, none of the administrative work would fall back on me or my clinical director, which was one of the things we were seeing a lot of and was totally draining, you know, many years into having a group practice having to answer the phones again, if our admin was gone for more than a day, you know. And so that was something that was important to us, which is why we had we started with hiring two part-time people versus just filling one full time position.

Heather Frank 

Okay, and it sounds like you found people that that arrangement works, that part time arrangement. That’s great.

Maureen Werrbach 

Yeah. Yeah. Do you have any other last questions?

Heather Frank 

Um, I think this is really helpful something for me to chew more on. And, you know, to play around with, I think. Is the suggestion about having this new, punishing the hybrid position, take note and really be being diligent about her kind of recording everything she’s doing right now.

Maureen Werrbach 

I think it’s definitely  gonna help things out in the long run. Because when you’re hiring, I find that when the only support that person has during their onboarding process is the person training them. It puts a lot of time commitment on that person and doesn’t leave them with enough time to actually get their own work done that they normally have to do or that you end up having to step in and add extra work to your load. So while things are still kind of in the calm and your person is still going to do the work anyways hitting the record button on their screen while they’re doing something in therapy notes or, you know, recording something that they’re doing anyways, isn’t going to cause more work for them. And we’ll make make it easier for that next hire to be able to have during some of that alone time, time to kind of watch those recordings.

Heather Frank 

And this is just a little technology question, but how do you work? How are people recording themselves when they’re in? Yeah, is that like a Mac thing?

Maureen Werrbach 

Um, well, I when I was doing it, I was using a QuickTime Player which is a Mac thing. But loom.com is free. And it’s a you can record your screen. You can record your voice. It’s a really simple program that anyone can use. Yeah loom dot com. Obviously zoom, you can use zoom that’s the same thing but loom is nice, it’s free and it’s I like that it has on the left hand corner you can have it so that you’re the person who’s doing the recording their face shows in like a nice little circle on the bottom corner where then the screen is showing up in the back in in all of the background it just has a nice look to it. So yeah, that I would recommend it’s free otherwise zoom is fine or QuickTime Player if they have a MacBook is fine.

And there’s a lot of recordings we did or onboarding coordinator did that were recorded on the phone you know like when she was doing recordings on how to send a scan or an opening procedures I mean she walked through at each location she went and walkthrough and showed where we turn it could we use like clamps not the overhead lights we turn on we fill the candy bowls I mean not now obviously but um you know. Just kind of walked through that process so that, you know, if they happen to be the first person in, you know, when we train people, they might not be the first person walking into an office for like four months, right? Because they might initially be coming in in the middle day or when someone else is there.

And so it’s nice, you know, you train, if you train someone, initially, a lot of that material that they’re learning isn’t going to absorb until they actually have to use that information.

And if it takes a handful of months, they’re likely going to forget. And that’s where these recordings are helpful, because they can just pop back into it and say, okay, now I’m actually opening. Let me make sure I didn’t forget something. And they don’t have to, you know, either worry about trying to get ahold of the onboarding person or whoever was training them. They’re not there.

Heather Frank 

Yeah, that’s great. I’ll definitely look into loom. Yeah. Great idea. Yeah. It was nice meeting you. Yes. Nice meeting you virtually as well.

Maureen Werrbach 

Yeah. Well, you have a good Monday and I’ll talk to you soon.

Heather Frank 

Yeah, thanks for all your help morning. No problem.

Maureen Werrbach 

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