Episode 162 | 5 Things to Think About When You Want to Create a MultiDisciplinary Wellness Center with Kendall Hagensen
WITH KENDALL HAGENSEN
- Episode 162 | 5 Things to Think About When You Want to Create a MultiDisciplinary Wellness Center with Kendall Hagensen 00:00
Hey Group Practice listeners! In this episode, I’m talking with Kendall Hagensen all about what you should think about if you want to create a multidisciplinary wellness practice.
Considerations we cover:
- Getting clear on your “why”
- The structure of how your wellness center will work
- How are you going to build your team?
- What outside support will you need?
- What kind of leader do you want to be?
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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Hey, everyone, welcome to another episode of The Group Practice exchange podcast. Today I have a guest expert on her name is Kendall Hagensen. And she’s gonna be talking about five things to think about when you are wanting to create a multi disciplinary Wellness Center. Hi, Kendall, how are you?
Hi, I’m doing great. Thanks so much for having me.
I know we asked you to come on because you had been chatting in the Facebook group about it, it seems like you you know a thing or two about having a multi disciplinary practice. So just to get us started. And for the audience that may or may not know you tell us a little bit about why this topic is in your wheelhouse.
Yeah, definitely. I’m so passionate about this. And I really appreciate you having me. So yes, I own a multidisciplinary Wellness Center in Vancouver, Washington in the US. And we opened in 2016. I had been planning and sort of envisioning the Wellness Center and doing the initial business planning stages for probably 10 years before we opened. And on our team currently we have we have mental health, we have nutrition, massage therapy, Chinese medicine, and acupuncture and naturopathic medicine, fitness training, I think that’s everybody. And before COVID, we also had like a yoga and movement studio here. So before COVID, we had a lot of classes, yoga, dance, meditation, sound healing, all the things. And we’re kind of shifting, easing back into that a bit and getting those–shifting how we’re doing them, but bringing that back in. So that’s what we do on a day to day basis here. And the foundation of how we work is collaborative healthcare. So we’re trying to give patients that different experience of getting that sort of wraparound care when they come in.
Was this something that you had anticipated from the beginning wanting to do or didn’t kind of evolve to that?
Yeah, so my story and I’ll, you know, I’ll give kind of the short version. But I think like many of us who end up in helping professions, right? We identify as wounded healers at some point and we have life situations that impact what we choose to do. And so I grew up with my mom having MS and when I was in college, I was diagnosed as well with multiple sclerosis or MS. And it really informed–I got sort of a crash course in western medicine and how disjointed it is. And I’m so grateful to Western medicine for emergency care. And we are we are great at that. Right? We are great at emergency care and but preventative care and collaborative care and for chronic illnesses is it’s really difficult, very disjointed and no one talks to each other and the experience for patients is very exhausting.
So, you know, I was a freshman in college when that all started happening. And so I I kind of struggled through that and I started bringing in alternative providers for my own care. They weren’t really at the same place, though, and they still didn’t really talk to each other. So I started envisioning a place where, you know, the place that I needed. And I think, you know, the reason for opening, it started very selfishly, and I always, I always think of that as a positive thing, you know? I think a lot of us in this profession can identify with that, and I built what I needed, and it has grown to this, you know, expanded reason why we keep doing what we do is for the patient experience.
That, you know, they have chronic illness, they have been told over and over again, you know, nothing’s wrong, nothing’s wrong, but they know within their own body, like something is not right. And they come here, and we help them get to the root of what’s going on. And we help them get better, quickly and feel better long term. And it’s those patients who come to us and say, you know, they start with a mental health counselor, and then they start seeing a few of our other providers. And when they first came in they, you know, they were an elite athlete previously, but now they have this new diagnosis, this new medical diagnosis, right? So they come in, they have a chronic illness now, then now they can’t, they can’t run anymore, right? They’re super depressed, they’re having trouble functioning in their life. And they’ve kind of given up hope. And in six months, right, with the team of support, they’re coming to us saying, right now they, as a patient can speak fluently about Mind Body connection, and they’re at home meditating every day, and they’re, now they’ve signed up for a 5k run, and they’re moving their body and they’re eating well, and they’re feeling better. And they come to us and say, like, what would I’ve done without you guys, right? And it’s, it’s that that keeps us going now. And that’s our why and, and our team, we absolutely love what we do.
For sure. Such an amazing, like, I feel like having a why that connects with you, personally, is what really makes a business thrive and continue and have a legacy. And so thanks for sharing the story behind all of that. And I think, yeah, gonna be such a big reason why your practice stays successful. Because there it isn’t just about money, it isn’t just about owning a business. But kind of like what you mentioned, bringing your own needs into it, and then expanding that out to, you know, obviously, the ton of people in the world who have need the same types of multidisciplinary care, all within one house. That being said, I know a lot of practice owners think about this, either, intentionally, as you’ve seen in our Facebook groups. They’re either like, looking to bring a dietitian on or an alternate type of provider on or it happens kind of haphazardly, where someone replies, they’re like, I wasn’t even thinking about this. And then they go down this rabbit hole of trying to see like, what don’t they know that they don’t know? And yeah, what should they now know, before making this decision? So you have a few things, a few considerations and things to think about for the audience. And let’s jump into it. What’s your–what’s one thing? The five things for everyone listening, but what’s just one–
So the first thing I always tell coaching clients is like, we have to get so clear on the why. We have to get clear on your why and your vision. And I think this is true for all types of businesses, right?
We can’t just randomly hire people.
I mean, you can, and people do it, right. And I’ve certainly been in situations where it feels like feels rushed, or we feel like we need to do something to keep the business going. And, it’s so important to come back to the vision and the why, and make sure it’s in line. And when we’re, you know, I think most people listening to this podcast are group mental health practice owners, right? And so if you’re thinking about expanding to a multidisciplinary practice, it really there are a lot of things that are the same, but there are a lot of things that are different. It’s a very different business. And the different modalities have you know, they all have very different needs and mental health counselors and so we we really know mental health, right? We know everything about that we know how to hire and do all those things, right? So it’s very important to get clear on why you want to add wellness services. And what this really means for you and what the thing? What is the thing that is going to keep you going when it gets really hard, right?
That’s actually a good thing to add to that question, because all of us get to that place where we’re like, oh, why? Why did I do this? And knowing that beforehand can be really helpful to bringing that up in a time where we’re burnt out, or just in this like state of despair, because X happened, or Y happened.
So for example, a global pandemic, you know, it’s a mental health, you know, it’s pretty easy transition to put online, right? And mental health, the mental health side of our business grew and grew and grew and grew during COVID, right? But we’re over here with in person services, massage therapy, acupuncture, right? So then all of a sudden, we’re in the same boat as other businesses that have to close down those services. So, you know, and that’s a very extreme example, but there are lots of moments in the journey of business ownership, where it gets really hard. And so we have to have that. Some, whatever that fire is within you, right, that’s gonna say, we’re gonna get through it, we’re gonna keep going. I’m in it for the long game. And this is why, right?
I love that. And not enough people focus on the why, you know? They just want to either not work for someone else and have their own business, or they just want to go from being a solo practice owner to hiring someone, because they have extra office space. Or they want more passive income, and I’m air quoting it because people think it’s passive when they say–
–it’s not passive, guys, let’s get clear on it. Nothing is passive. No, nothing’s passive, you know?
So I like that you mentioned that because I feel like, the why piece can feel almost like similar to business plans. It can feel like, either boring, or like, why do I like–why is the Why is so important that I actually have to think about it? Like, why can’t I just say, I want to do it, and that’d be enough. And it’s one of those things I think a lot of people just gloss over. And so I’m glad that there’s, you know, authors now coming out with Find Your Why and all that stuff that are helping business owners realize, it might actually be important to think about this. So good. That’s a good first one for everyone.
That’s the first one. The second one is to really think about how it will work. Right? So if you have a mental health group practice, what is actually going to be your structure if you’re expanding into a wellness center. And it’s important to think about that before taking action. Because the structure of a mental health group practice, is it foundationally, it could be the same right? You could have all W2 employees, right? If you’re expanding to a wellness center, however, you just want to get very clear on how is that actually going to work to bring those other modalities in? And are they going to be integrated with what we’ve already built as a mental health group practice? Are they going to be separate from that? Are they going to take insurance? Are we you know, are they, are we all private pay? Are we what are we doing here? Right. And it goes much more smoothly. If everyone knows what to expect, and knows what they’re signing on for. So when you, if you have a group mental practicing, or all mental health providers, and then you go to hire a massage therapist, massage therapist is going to want to know what their places in your group. Right and–
–it’s actually really interesting to think about. If you’re starting as a multidisciplinary practice, or if you’re transitioning from having a practice with therapists, you know, adding another modality or a specialty, you have to it’s not just about the fact of adding that in, but like what does, how is that person going to feel and see that practice as if that support isn’t in there isn’t available to them in the same way that it is for the mental health side of it.
Exactly. And if your goal is to have a collaborative practice that like, where the providers are really working together to benefit the clients, then you have to really start transitioning to like everything with your marketing. And being clear with your mental health group like this is the direction we’re going. And we’re becoming a wellness center rather than a counseling center, or whatever you’ve been marketing as so far, and and really making an effort to have the new providers feel included in what you’re doing. And that’s why some structures, right, there’s lots of wellness centers, you can do like a collaborative, you can simply rent space. And as long as it’s clear to say, okay, we’re a counseling group, we’re renting space to some other providers. We’re not providing marketing, right, they’re doing their own thing. That’s something different right? And it can be done. But it needs to be so clear because, you know, providers will join on. And they might think it’s one thing, and they’ll be excited and say, oh, we’re going to join this Wellness Center. And then they get really disappointed if it’s not what they thought it was gonna be. And I mean, that’s for any business, but yeah, just just being so clear. And the key here is to put as much structure in place beforehand, right, as much as possible. And if you already have your group practice, you know about structure, you’ve created it for your group practice, right? But again, it’s coming back to, how is it going to work? How are we going to work together, and preparing your current group for that transition. And having–
There’s a lot of, you know, a lot of structure needs to shift. I mean, just in a simple sense, billing isn’t exactly different. And if you have a administrative team that is used to doing having something set up, where they go through the EHR, and auto submit claims, and all that kind of stuff, calling insurance companies, they’re one gonna have to, you know, first learn if there’s a shift in how they do billing for others. Like, we have nurse practitioners, there’s not much of a shift, other than, and we have psych testing, there’s not much of a shift, other than knowing that there’s a few different types of codes outside, right, fit like literal therapy codes. But if you’re adding other types of providers that either might not be billing insurance at all, that means you’re gonna have to shift your whole billing process so that they have your admin team has a structure for, you know, all the other types that you have.
Exactly, yeah. So it is a learning curve. And it takes training. And, you know, a lot of people that I work with, are mental health counselors, and they get stuck on, okay, how, if I’ve never had an acupuncturist, on my team, right, where do I even begin to hire that person? How to hire that person? And like, how much do I pay them? And how do we do the billing and like, all those questions, because it’s really, it’s out of our domain. And so unless you’ve gone to see those types of providers, and you’re really more familiar. It starts one by one of, okay, if you hire that first person, and it’s really communicating with them, like, what do you need, right? How does billing work for you? How, like, let’s go through all the codes, right? It’s more similar than we think.
But we have to in the beginning, we have to start gathering gathering those specifics from the other providers, right? Because we don’t know. Yeah. And, yeah, so just coming back to like, taking the time to imagine, you know, you have your why. So you’ve got that over here. And then it’s thinking, okay, if I envision it, like if I could have it any way that I imagined in my wildest dreams, right, what would that be and why? And what can I do now, to put the structure in place so that it can become that vision? Right?
I think sometimes we get stuck on okay, well, that seems too big. So we’re going to start small, which there are definitely pros to starting small and having things grow organically, which we did here. But we still started with a multidisciplinary team, because that was the long term vision of foundationally. We wanted to work collaboratively on behalf of patients. So we’re whatever we can do, we’re going to start that way. Like that’s the most important thing, right?
That makes sense. And I feel like, you know, people have this false sense of, if I start slow and small, I don’t need to have like all the structures or manuals in place for just the first person I’m bringing on. And it’s like, well, you actually do because that would be very helpful to me, you know, I started 10 years ago, I didn’t have a manual to start with, with my first person. But I always say, you know, that’s the learning curve of prior to Facebook groups and all the support that you could get now and learning from people’s mistakes wasn’t available 10 years ago. I, you know, a lot of business owners were making, taking much longer steps to get to where they needed to then. Business owners, I think these days who have more at their fingertips support wise. But I think so many people have this false sense of, if I’m just bringing on my first one or two people, I don’t need to have all this structure in place because it’s just one or two people. But it also plays into the culture, you know, those one or two people then are going to also one, not get the kind of support that they could get if there were has a system in place for them. And two, when you do decide to put those systems in place at higher number four, and five or whatever, like those people now have to navigate through changes that they might not have agreed to when they first started.
Yeah, it is way harder to shift a foundational structure later on after the fact, it’s much more difficult to get people on board with that. And, for example, with us, we have–we meet every week, we meet once a week as a full team, hour and a half. And we have a structure throughout the month of what we do in those meetings. A lot of it is supporting patients, but also supporting each other as a group. But the day we opened in 2016, with the original team, I said, we are going to do weekly meetings like this as part of our structure and foundation. And most providers, even if they’re holistic providers, they’re not necessarily used to working in that way of saying, like, sure, let me take an hour and a half out of my client week to do this meeting every week, right? And in the beginning, we had a collective of providers where they were their own businesses, and now it’s much more employees. Yeah, but in the beginning, they were taking their own time to do these meetings. And it took a lot of convincing of like, why is this valuable? And, you know, we were brand new at the time trying to build case loads and didn’t have a ton of shared patients. But now, it’s like, we could not function without that meeting. And everyone on our team now values it immensely. And we look forward to the time and it benefits everyone. So if you have something in mind that you know, like, okay, I really want it, I want the workflow to be this way, right? Even if it’s just you and one other person, like, go for it.
Yeah, this is going to be much easier. I can’t imagine if I tried to require weekly meetings at this point, it would be impossible. Change is hard to make. Once you’re really established, or you have, like people who have been used to having things a certain way, it’s always harder to change it. Alright, what’s point number three?
Number three? Yeah, so thinking about how you’re going to actually build your team, how to find these holistic health providers outside of your own modality. And we talked about this a little bit before. But we can get stuck in that of like, okay, I don’t really know much about this other modality. So what do I even, where do I begin, right? So my recommendation here is, when you’re hiring anyone on your team, no matter the modality, make sure you know, the top three values that anyone on your team has to have, right? And this can be for any type of business, but really getting so clear on those values and weaving that into your job postings, weave it in into your interview process. And making sure that anyone you hire is a fit for your group. Right? That’s step one, of hiring because it doesn’t matter their modality, right? At the end of the day, what I’ve learned over the years is, you know, sometimes we’re a little heavier on one modality sometimes we’re having on another we try to stay balanced. The end of the day, it’s all about people, this type of business is about people and relationships. And, the team is flowing better when the people on the team are the right fit.
And then always having a practical portion to your interview process. So especially with alternative health modalities, if you’re hiring a massage therapist and interviewing them, they should definitely be giving you a massage. You should, because I think when as mental health providers, we can’t, you know, have someone do therapy with us in the interview process, and we know Okay, they’re licensed, they had this experience, we’re pretty confident they can do their job.
You can do like in the vignette and get a sense of it. But yeah, like how could you do with a massage? Other than ask for one?
Yeah, so those those types of modalities, it’s really important to you have them give you a full session so that you can confirm like, this is how they’re gonna work with with patients. And then as far as finding people to interview for these modalities, of course, posting on all the sites that you already post on for mental health. Facebook is definitely your friend. I mean, there’s just it continues to be a huge opportunity on Facebook. There’s a group for everything. There’s a local group for massage therapists, there’s a local group for acupuncturists. Ask if you can join that group and post your job there or ask them to post it for you. Right? And they will, they will. So my biggest recommendation here is to ask your current team members if you have a current mental health practice, ask them who they know, have them talk to their massage service, you know their naturopathic doctor And tell anyone and everyone that you’re looking because you just never know.
Yeah, I’d much rather hire people that my existing staff connect with. Because the assumption is you’re going to get more of what you already have. And if you love what you have, having more of that’s going to be good. Point, what are we on?
We’re on number four, or number four? Um, so thinking about what outside support you need, actually, to make this happen. Right. So do not reinvent the wheel. Yeah, don’t do. Right. And if, if you already have a good mental health practice, right, you have some systems in place, you have any you have support, you have an external support systems in place. But the key is to learn how to ask for help from the right people. And I think, as business owners, you know, we can we feel sometimes, like, oh, man are we just wasting all this money or putting it on marketing? And we hired this website person, and it’s way more than I thought it was gonna be. And, you know, do I really need an attorney to create my form? Do I really, you know, all those.
So my recommendation here is to you don’t have to be an expert in every part of the business, right? We are, we are healthcare providers, right. And we might be the business owner. And we love that role. But we also don’t have to be a social media expert, and a webmaster and all those things. Like, they take a lot of skill and a lot of training. And we might not want to be experts in all those things. So I think in the beginning, I was a little hesitant to, like, work with a property broker or hire the attorney or you know, trying to find those ways to like, just not spend too much money, which is important, we want to be careful about that. But I would recommend as you know, if you’re gonna buy a space, if you’re gonna rent a space, work with a broker, they can help you, you know, get the best terms in your lease and all those things. Work with business coaches, work with consultants work with accountants and attorneys, right? They can help you make sure those systems are in place, and it makes it easier for you.
So asking for help from the right people has been integral to our success. And I’ve always said, like, people will say like, Oh, my gosh, you know, how are you doing all those things? And I say, I’m not. I’m not doing all those things. The smartest thing, smartest decisions I’ve ever made, are hiring the right people to help me and to learn from and hiring people who know more than I do
It’s like, my goal in life is to hire people who are better than me at the job. Absolutely. Put the ego aside. You don’t need to be–just because you’re the business owner doesn’t mean you need to know all the things about all the positions and all the roles. You just need to know what’s needed. And to find people who can really like kick ass in those roles. Exactly. Yeah.
And it can be hard to know who who those people are who the right people are to hire and help. And this can change over time as your needs change. Right. But just like anything, and like you’re saying, right, warm referrals are the best. So if you have someone on your team, or you have a colleague, who has this had this great experience with a webmaster, has this great experience with a consultant, take that recommendation, right, instead of just, you know, kind of randomly choosing. Those referrals usually work out better if someone’s had a personal experience.
100% agree. I don’t think I have in the past five years, maybe hired a person that wasn’t recommended to me by someone else. I’m not hold googling, and putting my trust in into Google to give me the right people.
Exactly, exactly. Yeah, it’s super important. You know, as business owners, we wear so many hats. And at some point, the pile of hats, the stack of hats is too tall, they’re all gonna fall. And we really need that support. So and then the last tip is really thinking about what kind of leader you want to be in this new business. Because if you’re expanding to a wellness center, it really is a new business. Even if you have the established group practice already. And no matter what structure you choose, even if you’re renting space to these other providers, and they’re not necessarily integrated to what you’re doing, you will always be seen as the person in charge and the person who is supposed to have the answers to everything.
So really thinking through like, how do you want to lead? What kind of boss do you want to be? How do you want to guide your team and coach them and how do you want to, how do you want to show up for that group of people that you’re leading? And, and really thinking like before you jump into it, like thinking about if you want to be that person, right, right. Does that does that fulfill your own personal goals and vision to be in that role? And, you know, I think a lot of times when people are looking at opening a wellness center, they do go first to this idea of, okay, well, I’m going to rent the spaces out, and have it be a collective, and it can work. But at the same time, it’s like that puts you in the role of being a landlord. Yeah. Right. And so do you want, is that the role you want? Or would you prefer to have it be more integrated, and that you’re actually leading these people and that you’re, you’re building a community.
And you also have more control. When you do it in a landlord sort of way, you don’t get to have some of that control of like, how the work is being done, how clients can connect, like providers with each other. You just get more of that, when you’re, you know, when you have employees or when you have, even with contractors, you have a better ability to do it than if you’re just renting it out. So I think along the lines with the idea of like, how you want to lead is also making sure that you’re talking to new hires about that too, because you might be set on how you’re going to lead. But let’s say you have contractors, I’m just gonna make it up. But like, they might have contracted other practices where it really feels more like an employee relationship, or they may have contracted at places that didn’t care if they actually were set up as a business like they should be. And, and so like how even if you’re competent, and how you want to lead and show up for your people, if you’re not transparent about it in the interview process, you can also end up having people who expected more of you or expected you to be out of it a little bit more than you are. And so I think that goes a line along the same lines is what you were saying is, once you know it, make sure you’re actually talking about it in the interview process. So people can confidently want that position, knowing that the version of you that they’re going to get that’s what it’s gonna look like.
Exactly. It’s so important, because I think sometimes we can we know that about ourselves. And we in our mind, we think, okay, yes, this is how I’m leading, right? But if you have a new hire, and they’re not necessarily experiencing that right away, then they are going to start to make assumptions about what they’ve just signed on to. And it can create tension very quickly. Yeah. Yeah. And unnecessarily, right.
Good five points. I know you do some coaching, so if people are interested in getting support around a multi disciplinary Wellness Center, how can they find you?
Yeah, definitely. So I do coaching specifically for providers who are wanting to open Wellness Centers do multidisciplinary practices or in the, you know, moving more towards the wellness space. So we have a Facebook group called Wellness Center Creators, so you can definitely join us there and start chatting with like minded people. The next thing that I have coming up is at the end of July, and it’s a business planning webinar. It’s an intensive, it’s three hours, and it’s specifically for business planning for wellness centers. So if you’re at the very beginning of your process, or have the group practice and you’re wanting to expand, this is a good way to really dedicate that time and work through your business plan. And it’s experiential type workshop and you get to meet other people who are on the same journey. So we have a good time. And you can always reach out through email we do i do coaching groups and individual coaching as well. So kind of Vancouver wellness studio calm and happy to chat. Perfect.
Well thank you for coming on and giving us your wealth of knowledge on wellness centers. Thank you so much. So nice to chat with you today. Yeah, have a good one with you.
Resources from Kendall:
- Join the Wellness Center Creators community on FB!
- Want to go deeper into business planning with Kendall? Sign up for the Wellness Center Creators Business Planning Workshop Intensive!
- Can’t make the live workshop? Grab the Wellness Center Creator Business Planning Webinar.
- Email Kendall anytime with questions or to learn more about individual and group coaching!
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Maureen Werrbach is a psychotherapist, group practice owner and group practice coach. Learn more about her coaching services here:
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.
Don’t miss an episode! Download The Group Practice Exchange Podcast on iTunes, Stitcher or Google Play and don’t forget to subscribe and rate TGPE
* The content of this post is intended to serve as general advice and information. It is not to be taken as legal advice and may not account for all rules and regulations in every jurisdiction. For legal advice, please contact an attorney.