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Episode 175 | How to Make the Best Leadership Roles for Your Group Practice



  • Episode 175 | How to Make the Best Leadership Roles for Your Group Practice 00:00


Hey Group Practice listeners! This episode is all about leadership teams: the creation of leadership teams, the expanding of leadership teams, and the roles that can be played within a leadership team.

In this episode I cover:

  • Benefits to having a leadership team
  • Stages of developing a leadership team
  • How leadership roles shift with growth
  • Leadership roles you’ll need as you grow

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, I hope you’re having a great day. Today, it’s just me on the podcast doing a solo episode. And I wanted to chat with y’all a little bit about leadership teams, the creation of leadership teams, the expanding of leadership teams, the roles that can be played within a leadership team, as this is something that has been coming up a lot for practice owners who are wanting to be able to take a step back, and people asking me questions around how I’m doing that as well. And so I want to start from kind of the beginning for those practice owners who are maybe in that beginning stage of creating that leadership team, and they don’t already have one established.
One of the biggest benefits of having someone who is in leadership, and once you have one person in leadership, whether it’s a supervisor, or clinical lead or a clinical director, you essentially have a leadership team. It’s yourself and that other person. And obviously, as your business expands and grows, that leadership team might continue to expand and grow as well. Some of the really awesome benefits to having the ability to create a leadership team, no matter how small it is, is that you’re able to provide growth opportunities for individual clinicians or administrators in your team to be able to move forward and grow in their skill and in their position.

Another really awesome thing that happens when you have a leadership team, if you’re doing it right and intentionally, is the ability to really share that power with a team versus you having sort of that ultimate decision making capabilities. There’s a lot of stress involved in being that ultimate decider on everything. But it also it doesn’t allow for the opportunity for your team to play a bigger role in the growth and vision of your business. And being able to have a team that can support you in sharing in some of that power, can really relieve a ton of stress on you as a business owner, and provides the ability for that person on your leadership team to do some of the harder things.
I always think about, you know, if leading a team was really easy, you wouldn’t need a leadership team to help you do it, right? The real benefit and having a leadership team comes in that they’re supporting you through the good and the hard. If, like I said, if everything was easy, there’d be no need to have a leadership team because everything would flow so easily, you could just do it all yourself. And when we create this team, even if it’s our first person on this team, what you’re essentially doing is being able to refocus your energy and time and mental load to the things that you’re actually good at. And that gives you, that fills your bucket, right. And you’re hopefully creating a position for someone that nurtures their own skill, right, that really aligns with what they’re good at. And so that they can feel energized by the work that they’re doing as well.

And so those are kind of my initial thoughts around why it’s really a great thing to be able to create a leadership team. Even if you have a small group practice and don’t plan on getting very large there isn’t, it’s not something that just is designated for large group practices, it really works amazingly well, even if there’s a single or two person leadership team on a smaller group practice.

Now, as we grow our businesses, you you’ll notice that there’s this need to shift, potentially rewrite the existing leadership roles that are there. Because as our business grows, and usually that’s every 10 to 15 employees, there’s a need for those that are in leadership to get even more defined in what they do. Because oftentimes, when when we’re a smaller practice, we might be bringing on that supervisor, clinical director, and you might be giving them kind of all of that clinical and leadership sort of role, right. But when you have 357 employees that they’re they’re leading, but as your practice grows, and like I said, on, like the estimate is sort of every 10 to 15 staff members that you bring in clinical staff that you bring in, you start to realize that you need to shift how leadership is done, and get even more micro with the roles that each of you on your leadership team play. And so you’ll find that what was once working for you as the owner of the group practice in the role that you were playing, and what the role of maybe that clinical lead was when you were a smaller practice, needs to shift naturally as the business grows. Just as organizational structures shift for larger practices and look very different than with smaller practices. And so that’s something to think about as you write up job descriptions for people in leadership. That it’s likely that if your business continues to grow, that those roles might look a little bit different and the job descriptions may need to be shifted a little bit, so that that leadership person, whether it’s a supervisor, clinical director, head of administration, is really getting more pinpointed on what they’re working on.

And you’re creating then more opportunities for additional leadership positions, so that each task, each role really has the full, like, the full attention of that person who’s leading it. And that’s the biggest issue that I see, is that people leave their leadership teams with the same roles, sort of indefinitely. And what that does is it causes that person in leadership to have, even though there’s not more being added to their list, by the fact that the business is growing, it takes more work to do all of the things that were once required. You know, an hour of their time with a larger group practice will require maybe five hours of their time. And that byproduct means that we need to be able to limit all the tasks that are required of that position and potentially–potentially create kind of sub leadership positions, right, whether that’s having going from having a clinical director to that clinical director, having supervisors who can then take some of that clinical workload off the Clinical Director, that’s a really good and common example in group practices. And so as we expand in our businesses, I want your takeaway for this episode to be that it is okay for roles to shift in your clinical team. And likely the guiding factor for that shift in roles or like actual tasks that they’re doing things that they’re accountable for, will shift based off of the need to really hone in on a handful of things that they should be working on and being in charge of, and shifting the rest to another person who can then have their focus be on the next handful of things, right.

The other kind of major thing to pay attention to as you’re looking at growing and expanding your team is the roles themselves, right. So obviously, as a practice grows, the need for extra or additional leadership team members is going to just naturally be there. But the next thing to look at is really the specific roles. And one of the biggest pieces of feedback that I got from Niki Ramirez, my HR consultant that sort of blew my mind at the time, was that you want to be really intentional about the actual role that the person is playing. I see so often, people having a clinical director or a clinical lead or head of, of clinical departments, I mean, different names, all for the same sort of thing, where what they’re doing is so obscure, and general, and their title doesn’t match what they’re actually doing. Because the business owner just wants to be creative with the title. And the biggest thing I learned from Niki, was that you want your job description, you want the employees title, the leadership person’s title to be very, very clear. And actually, the titles are not about your business at all. It’s about helping them in their future with employment, right? If you give them the title of a clinical director, when really they are not doing clinical director work, and they’re doing something else, it actually harms them because that what is what goes on to their job description, and helps the next potential employer look at what were they actually doing? Do they have the skills? Do they have the title? Have they worked in added capacity that I’m actually looking for in that person? And so if we get really creative with our titles, and we, you know, call someone a director of happiness and success, let’s say, when in reality, the very basic title of Director of Client Success, client satisfaction is more likely to help that next employer say, I’m looking for someone who can make sure that our clients are happy. They’re more likely to look at the job or the resume of that person. And I know we don’t like to look at at this from a perspective of that this is going to benefit them when they leave because we might not want people leaving, but that’s really what the benefit of it job title is not for the position that they’re currently in, it’s for the potential in another position, or in another job that they can look back and say, yeah, looks like you have exactly what we’re looking for in this current position correct. And so that’s something to think about, as you’re coming up with, what roles do you need in your business, you don’t need to get fancy, you want to be very clear in the job description, and the title of the of the role, what they’re doing. So that when they put that on their resume, that next employer is going to know, without a doubt, by just glancing at their resume, if that person’s a good fit, just based off of, you know, the role itself.

So the most common roles that we see in our industry tend to start off with either having like a clinical supervisor, or a clinical director, or a site supervisor, those are really kind of the initial starting points that group practice owner is going to go is someone who kind of leaves in the supervision, right. And as they grow, they might then shift that person into a clinical director position where they might be managing multiple locations, or multiple departments, or multiple supervisors who are leading the clinicians of their locations, right.
Other important roles that might be considered in a leadership team, role-wise is a person who is in charge of supporting new hires, and getting them on-boarded efficiently. And that might be just the supervisor, still, right of that location might be a part of their role is their onboarding. But as a business grows, oftentimes, if a site supervisor has 10+ staff that they have to lead as it is, it’s really hard to be able to really invest quality amount of time in onboarding that for that next person, for the first 90 days. It takes a lot more work and effort than in the first 90 days than it does once that employee knows how to do their job successfully. And so as you grow, it might become important that you have someone that can do that onboarding, and even potentially recruiting and interviewing those people. So that it aligns with whatever the vision or goals that you have for your business is, right? We have specific goals around how many people we want to hire in a year. We have goals around when staff leaves, making sure that we’re on top of things in and making sure that we’re recruiting and looking for new hires that can quickly take over that spot so that there aren’t gaps in our communities. As most as most of you know, right now, there’s a ton of need. And so you know, whenever someone leaves, that creates a bigger hole, a bigger gap for our community members being able to be seen and getting the care that they need.

There’s site supervisors, there’s likely going to be a department, administrative department that grows out of it. I know oftentimes, as a solo practice owner and a small group practice, you might be the person doing the administrative work, eventually, you might hire a virtual assistant, or part time person to do administrative work or even like a company that does administrative support or billing and reception support. But eventually, there’ll be a point where your practice is at a size where you need that full time, administrative support. And that person might be doing everything right, that might be kind of a catch all admin who does phones and does billing, and does all of the administrative work. And as you grow again, here’s where that team, that administrative team might need to expand. And you’ll want to make sure that there’s someone on the administrative team who can actually lead all of that, all of those administrators.

And so in my practice, we have someone who is the administrative lead, and that person has their own role on the day to day of what they’re doing. But they also lead the administrative team, which includes our our client care, our receptionist, our admin assistants, who support kind of all the departments, our billing department, our person who does payroll, and our benefits personally, as someone who just their role is completely to check benefits for potential clients and existing clients because we have such a large practice. And so there’s a ton of opportunity. And you really want to just make sure that you’re paying attention to the growth of your business and looking back at your leadership team on where it is. And if that also needs to pivot as your practice is growing, and it’s very likely that that needs to happen.

But what happens often is that we are adding people in response to a gap, as in leadership as the business grows, rather than looking internally at our existing leadership team and their roles and asking, do those roles need to be redefined? Or made more clear before we bring on another person just to fill in the holes, right? Because what ends up happening is as your business grows, you have a lot of people in leadership who all are kind of intermingled and don’t have complete autonomy, and might be stepping on each other’s toes, because you’ve created positions in leadership that are just based off of tasks that weren’t getting done versus clearly defined roles.
So I hope that’s helpful. If you’re a smaller group practice, it’s never too soon to create a leadership team. Like I said, a team involves you having one person leadership, because that is you and them leading, and that’s a team to me. So you’re able to start as early as you want. As soon as you need that extra support, that’s the time to start bringing someone into leadership.

And the second point is making sure that you’re looking at how those roles need to be revised, fine tuned, made more clear. And sometimes you realize that after that person is in that position, what’s working and what isn’t about that role. And it’s completely okay to go back to the drawing board and start making edits on the role itself, and the tasks that that person is doing, so that it meets the needs of your business in the way that makes the most sense, and is the most efficient and organized way to do that. All right. If you have a leadership team that you love, I would love to hear what those roles are. I always find it really fascinating how different each group practice is in terms of how they run their business, but also what their leadership teams really look like. It’s so different from practice to practice, even with practices that are at the same size. And so I’m always fascinated to learn about where other practices are at in terms of their leadership team, and how they make sure that the roles on their leadership team make sense and are very clear and in organized. Alright, have a great one and I’ll see you next week.

Thanks For Listening

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

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The Clinical Supervision Directory is a nation-wide searchable directory of state approved clinical supervisors for LPC/LPCP/LMFT residents – and all of the other alphabets that make up the counseling professional credentials – who have registered their own personalized listing. Each supervisor has full control of their own listing, and can update the content, contact information and availability at any time. Supervisors can be searched under multiple fields including state, specialty, setting and other areas. Additionally, every counseling, social work and allied health field program in the US will have free access to the directory for their students at graduation.

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Finding professionals is easy with the Productive Therapist Directory – the only business directory for therapists. Use the nifty search feature and you are one step closer to finding the services you need to grow your private practice.

If you’re a freelancer or company that provides services just for therapists, feel free to join the directory and create a listing. This is the best place to connect with therapists who are looking for your amazing services.

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

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Meet your host


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


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

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

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