Episode 136 | What Established Group Practice Owners Wish They Let Go of Sooner

Maureen Werrbach 

Hey, everyone, I hope you’re having a great day. Today I wanted to talk about a topic that was brought up in our Facebook group, the group practice exchange Facebook group on things that you wished you stopped doing sooner in your group practice. Or any policies or procedures or things that you were doing that really were just a waste of time. And so I’m going to talk a little bit about mine, but also I’m going to go through some of the responses in that Facebook group. Because if you’re anything like me, hearing other people with similar experiences, even when they’re negative, or even when they’re stressful can be stress relief. And it can feel like, you know, you’re not going at it alone.

So obviously things that we look back on as established group practice owners can be really helpful for new group practice owners trying to not reinvent the wheel or do things that will end up being a dud.

And so it’s nice to hear from established practice owners and things that they wish they let go of sooner or stop doing sooner. It also is gives a sense of connection among established group practice owners on those days way back when when we were doing all of the things. And so I thought this would be an interesting episode to talk about some of those things and see where where you fit in with that. I’d be really happy to hear if there’s other things that you wish that you would have let go of sooner as an established practice owner now looking back. Feel free to email me and let me know about that.

But one of the biggest things to let go of that comes to mind for me, and I’ve talked about this a lot is letting go with the phones.

I feel like the answering the phones, I was on two ends of the spectrum at the same time, I would simultaneously be excited because bringing phone is obviously something we all want. That means that people know that we exist, it means that there’s a potential for a new client to be scheduled. And so that’s a positive and exciting thing. And I’d feel that while at the same time, often feeling dread. Because the phone would ring when I wasn’t in the office that would ring when I was in the car or at Target or with my kids or while eating dinner. So often it felt like it was coming at the wrong time.

And so I remember daily, these things happening where I’d pull over while I was driving. I had two phones, one for my work, work cell phone and my own one. And I’d pull up my EHR and my one phone be on the other phone with with a potential client and be scheduling appointments off the side of the road.

But it was really stressful!

And I would hope that the phone wouldn’t ring which is literally going in the opposite direction of what we as business owners are hoping for, which is that the phone does ring so that we can fill our clinicians schedules up.

I remember that being the time when I really realized that I needed more support on the phone side and that you know, it was such a crappy thing to feel when it meant that my business was successful in some ways, right? And so that was the thing I wish I would have let go of sooner because I truly felt like I was saving money by me just answering the phones.

When in reality I was sacrificing my sanity. I was feeling more stressed out because the phones were ringing. And I just had a negative air around me when I wasn’t at work because I was tense and waiting for the phone to ring. It was such a weird negative feeling. And so, for me, I felt so good, like a weight lifted off my shoulders when I was able to truly let go and have someone else fully taking care of the phones. I wish I would have let go of that sooner.

The second thing I wish I had let go of sooner is a client caseload.

And I had a really hard time with reducing it, I don’t see clients anymore. Because my business has grown to a size where it’s just really hard to do it well, to own a business and see clients when you grow to a large size. Also, it depends on how you want to show up, you know where your strengths are. For me, I found that my strengths and what fills my cup up was when I was able to really do the visionary work on growing and expanding the business. And I hung on to seeing clients for more years than I needed to out of sheer feeling like I was selling out on, you know what I went to college for.

So it took a lot of time, a lot of reflection, a lot of talking to other group practice owners who had reduced their caseload or let go of seeing clients altogether, to really get to a place where it felt okay for me to reduce my caseload so that I can focus my efforts on expanding the business. Or just working on the visionary piece of my business, or also just having some extra free time. Because why own a business if we’re going to spend a million hours working more hours working than we would if we were employed by someone else?

And so that’s the other thing that really; it felt good when I got to a place where I was allowing myself to let go of this expectation that I had to be therapist first, business owner second, and really embraced the hat of business owner first, so that I can employ people who can help more people in the community.

Some of the other things that I’m seeing in the responses are echoing what I’ve mentioned is seeing too many clients myself while trying to grow, the group practice was hellacious. That response. Another good one was taking meetings, living without an executive assistant, a lot of larger practice owners get to a space where they really just need someone who can support them as an executive assistant.

And that’s beyond just a receptionist, but someone who can tackle some of the day to day of meetings with vendors, answering some of your emails, being able to schedule appointments for you beyond client appointments, but appointments with other staff members or leadership team members, people in the community with other businesses that you might have, because many practice owners eventually start a second business of some sort. Because we tend to be the creative types that just can’t sit still. And so having an executive assistant is something that has been echoed several times in this post.

Billing. Another huge one it was that was actually the first thing that I let go of and gave out to someone else was billing, and it was a lifesaver.

Claims were being paid on a much faster rate than when I was doing it. And this was obviously many, many years ago, before EHR has had a really robust system. So it might be a little bit easier now. But bringing on someone to do billing and not just the basic sending of claims, but talking with clients about payments, talking with insurance and companies, insurance companies about things that weren’t being paid out in a timely way or get paid out in the wrong way. As we all know, insurance doesn’t tend to do things right. And so having someone who can also see things ahead before they go bad, before something goes wrong is is really truly helpful. Admin assistant is another one for admin assistant or executive assistant.

Over pleasing staff. So that’s a good one. Someone mentioned when they were able to let go of over pleasing their staff.

Four years later, I know my value, I know what I offer. And if it doesn’t work, then you’re not a good fit. Because when you bend they want more and more. And this is really a kind of a leadership skill that takes a while to feel comfortable in setting into and something that I myself have struggled with and sometimes still do struggle with. as being therapists. We are highly attuned to the needs of other people and want the best for other people and want the best environment for our teams. And sometimes that can come at a fault, where we’re overstretching ourselves in time, we’re overstretching ourselves in finances, we’re bending in ways that our bodies can’t bend all to please the people around us.

So there’s a point where in leadership, whether any style of leadership that you kind of follow, where you have to look at the business and whether bending in the ways that we bend, as leaders, and as an organization, is in the best interest of the organization.

Because at the end of the day, you can focus individually on every person that works in your business, and try to bend in all the ways that you can to make it the best environment for each individual person based off of their individual needs, and pay them all what they need to be paid or want to be paid. But at the end of the day, if that doesn’t work with your business model, and if your business is going to crumble because you’ve overextended yourself financially and in time and in service, then you really not build a business that’s in the best interest of all the people in it, right?

And so that shift from looking at each individual person and saying how, you know, can I make sure that every person is having things exactly how they want it? and shifting to, how can the business be sustainable, while also supporting my team in the best way possible? is such a great shift.

And so I love this over pleasing my staff is a really good one and one that got almost 100 likes so clearly, is something that a lot of group practice owners struggle with.

Other ones to let go of were free and personal consultations with prospective clients, or with other colleagues.

This is a common one that I get with other colleagues wanting to get free consultation with me on how to start a practice. But it looks like it was mentioned in terms of that, but also with prospective clients. And it can definitely be a time sunk stuck in it depends on how you how you model it.

A lot of private pay group practice owners do do this because it is a way to increase buy in from potential clients. But it can also come at a negative if you don’t have boundaries that the practice doesn’t have policies around how much time is spent how they’re collecting information and data beforehand, so that they’re not doing in person cancels or right now, video consults for people that actually aren’t interested in ongoing therapy, but rather want to use that one session to try to get some, you know, get some therapy out of them.

Bookkeeping, billing, managing referral calls, those are things that are coming up a ton of times over and over, using an old, archaic or inefficient EHR.

This is something that’s really becoming more and more vital these days. But now that we’re virtual, we’re seeing all the ways that our businesses were not prepared for telehealth or prepared for a virtual world. And one of those ways is having an EHR that is old and archaic and not ready for the times. Or not having an EHR at all, and being a paper practice. So we’re seeing a lot of shifts right now, and a lot of change happening within organizations to move to EHR that work better for the type of world that we have right now. But we’re also seeing EHR making major shifts to accommodate that.

We also have some more for coaching people who aren’t coachable. And I think this, you know, this is an interesting one, because you’ll see people falling under two different camps, when it comes to coaching staff members, is one of the things I like to look at is the Ideal Team Player. It’s a book, you should really read it if you haven’t. But the end result is you want to make sure that you’re bringing up people who are hungry, humble and smart, and not brain smarts, but people smarts that that they can read a room.

They know how to engage in a relationship in the workplace, among peers and among leadership, and are able to be humble, and that they’re hungry for that they’re doing their work and able to go a little bit above and beyond.

People who are constantly just below what they’re supposed to be doing or purely meeting the needs, aren’t hungry, aren’t going to help the business move forward and aren’t going to be a good team player. Right? Team players are all about everyone being able to help each other out and that when one needs more support, other people are there to jump in and take on an extra load to help them. And so using that hungry, humble smart idea can be a great way to see whether someone is or isn’t coachable because at the end of the day. Least coachable people tend to be the ones that are lacking in in those arenas.

What else is on here: paying too much for staff leaving, too little profits so that they couldn’t hire an office manager help.

It looks like I’m looking through all these, a lot of the negatives are things that they wish they would have learned is how to pay their staff, how much they’re paying them, and how fast they’re paying them. It is part of the people pleasing aspect of many business owners, especially in our industry is really coming up with a compensation model that feels like it aligns with your business’s vision, and also aligns with all the state and local and federal laws that are out there. But also that aligns with you as a person as a business owner, and what you feel is fair.

At the end of the day, one of the things that I really learned about compensation, because there’s always going to be people that need more, because they live a certain lifestyle that requires them to make more money, that does not mean that you’re not paying well, it just means that they require a pay that is more than what you can afford, and they need to find a job to that allows that or that can pay for that. It doesn’t mean that you’re not paying enough. And that’s something that took a while for me as a group practice owner to learn and really be able to let go of that if someone needed more it was because I wasn’t paying enough.

When I really sat down and looked at what my offerings were, what I was able to pay out what that was in comparison to other practices in Illinois, I was able to see that I truly was paying very fairly and above average.

And that helped remind me and I use that as a reminder, whenever someone wants to make more money, or, you know, feels like they could be paid more is that I have paid as fairly as I possibly can. Anything above and beyond that just isn’t going to work. But I feel good with the compensation.

When you truly feel good about how you’re compensating, you’re able to let go of kind of back to our theme of this topic of what you’re letting go of is you’re able then to let go of this negative feeling that you’re not doing enough or that you’re paying poorly, which can can happen when someone is asking for more and you just can’t do it. So I really liked that as a thing to let go of and it looks like it’s something that’s probably the most common thing that was brought up in this thread. I hope those make sense for you if there’s anything that you would wish you were able to let go of now looking back as an established group practice owner, I’d love to hear it. Share that with us.