Episode 253 09 Oct, 2024
Breaking the Cycle of Money Anxiety in Group Practice with Linzy Bonham
- With Linzy Bonham
Does just thinking about your practice’s finances send you into a spiral of stress? You’re not alone! If the idea of numbers, budgets, and profit margins makes you want to hide under a blanket, this episode is for you.
I sat down with Linzy Bonham, founder of Money Nuts & Bolts and host of the Money Skills For Therapists podcast, to dive into the financial side of running a group practice. And let me tell you—it’s a conversation every practice owner needs to hear.
Linzy and I unpacked the anxieties many of us feel around money and broke it down into simple, actionable steps to take back control. Whether you’re just getting started or have been running your practice for years, you’ll find tons of tips that can help shift your money mindset and give you the tools to lead your practice confidently.
Here’s what we chatted about:
- How the way you grew up thinking about money influences how you manage it in your practice—and what you can do to change those deep-rooted habits.
- The specific challenges (and yes, the perks!) that come with handling finances for a group practice.
- Why having a financial cushion is crucial for your practice’s stability and growth—and how to start building one, even if it feels impossible right now.
- How your personal experiences with money, your relationship to it as a practitioner, and how you think about it as a leader all play a role in the financial health of your practice.
- How to find the balance between taking care of your team and making decisions that keep your business financially strong.
This episode is all about helping you rewrite your financial narrative so you can feel confident in leading your practice. If you’re ready to ditch the money anxiety and get a handle on your practice’s finances, hit play now.
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Transcript: Linzy Bonham
Linzy Bonham 00:00:00 Profit has a bad name, but I’m a big fan personally of sustainability and stability. And your profit is your stability. Your profit is that extra money next month when an extra expense comes up that you’re like, oh, it’s fine because we have the extra money. And so having that clarity with your team and the ability to lead and set clear boundaries and expectations will make or break your business.
Welcome to the Group Practice Exchange podcast, where we talk about all things related to group practice ownership. I’m your host, Maureen Werrbach. This episode is sponsored by Therapy Notes. Therapy notes is my favorite EHR, and it’s one that I’ve been using in my own group practice since 2014. They’ve got everything you need to be successful in your group practice, and they’re constantly making updates and have live support. If you want two free months of therapy notes, go to Therapynotes.com/r/thegrouppracticeexchange.com.
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Hey everyone. Welcome back to another episode of The Group Practice Exchange Podcast. Today I have Linzy Bonham back. She was on our podcast. I feel like it was a few months ago. She’s the owner of Money Nuts and Bolts.
Maureen Werrbach 00:02:28 She’s a therapist and private practice owner turned money skills coach and supporter for people in the health care world when it comes to money mindset and money skills. So I’m excited to have you back because we’re going to be talking about how raising our rates isn’t the only thing that helps us thrive from a money perspective, so I’m excited to chat again.
Linzy Bonham 00:02:49 Yeah. Thank you so much for having me.
Maureen Werrbach 00:02:50 Yeah.
Maureen Werrbach 00:02:51 What’s new with you since the last time we chatted?
Linzy Bonham 00:02:53 Oh goodness. I’m in the middle of launching money skills for group practice owners, so that’s my. Yeah. Okay. probably relevant. So yeah, that’s my specific course a for group practice owners about financial leadership. So that’s really exciting. It’s always really exciting to get to like chat with different folks and mental health therapists. But also I have an SLP who just joined. I was just chatting with an acupuncturist and just to I just love the humans. So I’m really enjoying talking with people about their group practices and financial leadership and not being afraid of their numbers and understanding their numbers and what that can do for the group practice.
Linzy Bonham 00:03:26 Well that’s.
Maureen Werrbach 00:03:26 Awesome. Where can they find that?
Linzy Bonham 00:03:28 You can go to our website. I know this is evergreen, so if you head to our website, you’ll see courses and you’ll see money skills for therapists, which is my solo practice course, and you’ll see money sales for group practice owners. And then you can jump on the waitlist if it’s closed at the time. Or you can jump right in to learning all about it if we’re open.
Maureen Werrbach 00:03:43 Awesome. Sounds good. We’ll also put it in the show notes. Yeah.
Maureen Werrbach 00:03:45 Thank you.
Maureen Werrbach 00:03:46 Okay, so I want to start with money anxiety. When it comes to leaders, obviously it’s a very common challenge that I’m sure you deal with. What are the kind of pitfalls that you see happening with practice owners and leaders when it comes to finances, and what kind of shifts or cycles do you feel like need to be broken in order to get to, like, a better place from that perspective?
Linzy Bonham 00:04:10 Yeah, I mean, when we come into a leadership position in our business, when you’ve gotten to the point where you have a team, you know, it’s not just you anymore.
Linzy Bonham 00:04:19 Your money stories show up at three different levels. So it’s like as if it wasn’t hard enough to be a solo practice owner and all of the anxiety and shame or like, baggage you might have. What I’ve seen is with group practice owners, there’s these three levels. There’s you coming in as an individual who was raised with certain experiences around money, certain stories around money, the things that you saw your parents do, the things that they said, maybe your own experiences of poverty and not having enough or never having education around money like money’s kind of there. Then maybe it’s kind of not, you know, like children just absorb all of that, you know, like we’re just little sponges. So there’s your personal relationship with money and all the anxiety or shame or fear or stories that you might have. And then there’s your relationship to money as a practitioner, right. So what are kind of these stories or the baggage that you might have about taking money from people for helping them? Have you made peace with that? Can you own the value of the work that you’re doing and that your team is doing? Or do you still have doubts that maybe you’re tricking people, maybe ripping them off? Right.
Linzy Bonham 00:05:16 So there’s that level, and then there’s the level of your relationship to money. As a leader, how do you feel as somebody who is getting paid for some administrative tasks? You’re not just seeing clients with one on one anymore. Do you own that? There’s value in those administrative tasks. Are you basically volunteering? You probably see this a lot, Maureen. I see so many group practice owners where you run the math and they’re literally being paid $0 to run their group. They’re just being paid to be a clinician. And if they went off back in solo practice and just saw the people that they were seeing, they’d actually make more money than running a group. So have you owned the fact that you’re actually providing leadership and administration and marketing and HR and all of those things, and that those things are valuable? Do you recognize that you need to be paid for those things, you know, can you have conversations with your team members without being, like, wracked with guilt or a feeling of obligation to them, that you just want to give them anything that they want? You know, if they ask for a raise, do you actually have a process to think through whether or not that makes sense, whether or not it’s feasible? Or do you have this guilt that makes you give folks whatever they ask for or fear that they’re going to leave? So there’s just so many levels that come up.
Linzy Bonham 00:06:18 And the way that that tends to show up is in either avoiding the numbers. Right. Like doing the bare minimum of being in touch with your numbers, like looking at the payroll account, saying, okay, I think we’re going to be fine running payroll, but otherwise pretty much ignoring them or it shows up in those really emotional decisions where because you don’t really understand your numbers, you’re doing what feels right or seems right, but it’s not really strategic and it’s not really grounded, and you’re hoping that it’s going to work out. So I call that like the hope and pray method. And then generally there’s just kind of this like chaos that can be around group practice numbers, where it just feels like this big messy stew that you’re not really sure how it’s working, but if it’s working well enough, you’re just kind of hoping it will stay that way and focusing on the parts of the job that you like more, so it can be a big ol mess. There’s a lot of stuff in the mix there.
Maureen Werrbach 00:07:02 Yeah, and I feel like obviously your personal history around money and your experience affecting everything. But I also with the how you show up or how you see finances from a practitioner perspective. And as a leader perspective, I think also comes so much from stories we were told in our childhood about the value of money or your own value and things like this. And so I can see how intertwined all of those things can be. How do you start to like, peel that apart once you’re past like awareness that those are three areas that might impact how you connect with and engage with money as a business owner.
Linzy Bonham 00:07:44 Yeah. I mean, once you start to realize that these things are in the mix, awareness is always the first part of change, right? So it’s really slowing down and being with them. Like in the work that I do with group practice owners, I have them do reflective work on all three of those levels. So first, just do some some journaling, some exploring around what I did to learn about money growing up.
Linzy Bonham 00:08:02 What do I believe about money? When I say money is what is the next you know? What is the free associative phrases that come out? So taking time to be with all of those levels and really starting to be able to identify like, oh, there’s that scarcity story. Yeah, right. Which makes sense because when I was a kid, sometimes we didn’t have groceries. Right. So there is this fear of money going away that makes sense. Once you start to name them, then you can slow down and notice when they’re popping up, like when you look at your spreadsheet and a part of you starts screaming of like, the sky is falling runaway. You know, like book 12 more sessions for yourself, you can start to notice, like, okay, that’s my panic part that comes from these experiences, or this comes from not owning my expertise or like not catching up with the fact that I do know how to do math despite what my grade two teacher said.
Maureen Werrbach 00:08:44 You know, like.
Linzy Bonham 00:08:45 Then you can start to slow it down and some of those things, just by being aware of them and naming them and being able to like create space, start to resolve on their own. Right? Yeah. There’s the other stuff that really is fodder for therapy. There’s the stuff that you really do need to bring to your trauma therapist, to your somatic work, CBT, whatever, you know, your special mixes. Because some of these things really are deeply lodged in our nervous system and being aware of them or even talking about them with your business bestie or your partner is not going to make them go away. And the best thing you can do at that point is really attend to them in therapy and and resolve the root right. Because if you don’t resolve the root, we know it’s never going to go away.
Maureen Werrbach 00:09:23 Exactly. When we think about like beyond the mindset, like what’s actually happening in our business from a financial perspective, right now, we’re seeing a lot of financial fluctuation. I’m seeing so many group practices closing down this year specifically, that looks very different than in previous years as to the reasons why in previous years it felt more often than not.
Maureen Werrbach 00:09:48 Of course, there was burnout being a reason and other things, but a lot of it I could see it was coming from intentional and strategic, where they’re like profitability has increased, income is increased. And, you know, based off of the economy and where it’s at, it actually would be a good time to sell now. Right. Being intentional in that way, or of course, right now is not a great time to sell from a economic standpoint. But I’m seeing that a lot of practice owners are starting to bowl since like January to close down and income is actually depleting. Profits are deeply, which is like the opposite of what we’ve seen is like so many practices closing down on this downward trend financially. Yeah. So I guess I’m wondering like how can practice owners work through like that income roller coaster, get off of that? Because I feel like right now a lot are starting to jump ship, because the combo of the roller coaster being in the downward trend, along with difficulty in leading and managing staff and just workplace culture issues, you know, people are choosing to really step back or slow down.
Linzy Bonham 00:10:53 Like it’s just not worth it.
Maureen Werrbach 00:10:54 Not worth it. Yes, yes.
Linzy Bonham 00:10:56 Yeah. And with that, I mean, I’m a huge fan, always of buffers and business. First of all, you know, like large corporations, I’m talking like billions of dollars could lose $20 billion in a quarter. Right. But they’re fine because they have buffers, right? They have reserves. And I think in private practice and group practice, especially because we’ve been in a boom time, we’ve kind of gotten away without that. We were really in a boom time for therapy. And I don’t know if we all really clocked how much of boom times it was until it was over. And it was the same with the online education space. I’m experiencing the same thing in my own business where it’s like, yeah, folks are they have less disposable income. They’re going outside. Like there’s lots of reasons that there’s less demand for these services right now. And so now is the time that we’re going to be dipping into reserves.
Linzy Bonham 00:11:42 So if you don’t have those reserves and if you don’t have a few months of reserve, you can hit zero really fast. Yeah. And that’s a really scary place to be. And I can completely understand how somebody who sees their bank account plummeting or that they’re starting to lose money. And there’s these other pieces you’re talking about, like they’re not feeling great about their leadership. Maybe they’re not enjoying the role like they thought they did. It’s not going to be worth it, right? That is the time to just shutter it. Call it a lesson learned. Go build your next business or go back to solo practice. Yeah, but for folks who really do love being group practice leaders, and that’s who I love to work with, is people who are called to this, who are like, I love mentoring, I love leading. My Achilles heel is that I want to give too much to my team. I care too much about the folks that I serve, those folks who really have the heart of a group practice owner who should stay in it for them, building that stability so that there is those reserves.
Linzy Bonham 00:12:31 And so there’s time to be like, okay, we’re on a downward trend. We’re going to take strategic action. Now, whatever. You know, they identify. And this is where knowing your numbers is beautiful. You can identify do we need to cut back or other positions that are losing money. Like do we need to say goodbye to some clinicians who are only seeing three people a week and we love them, but really, they’re not really here anymore, and we’re losing money because we’re paying for XYZ associated with them. This is where having clarity on your individual positions is really helpful. Yeah. What position is making you money? What’s losing you money and what is that break even point? What is the minimum that folks need to be doing for your positions to be sustainable? Right. Because like it’s easy for folks to be just below that mark and they’re losing you money, but you like them and they’re close to where they need to be. But you’re not clear the fact that this is actually literally tanking your business.
Maureen Werrbach 00:13:14 We talk about this so much because just the culture of the workforce as a whole has shifted so much. You know, a new generation of people are coming into the workforce. And so mindsets are very different. And one of the things that we see a lot, I hear a lot other practice owners I speak to here a lot is like not meeting expectations, numbers, let’s say, right, clinical sessions. And like we’re salaried, right. My team at least is salaried. And so we base the salaries off of a certain amount of sessions being had that that salary would work with that amount. But there’s times where we have a lot of people who are just 1 to 3 short.
Maureen Werrbach 00:13:55 Yeah.
Maureen Werrbach 00:13:56 And I can understand from an individualistic perspective a non business owner perspectives like I’m only a couple short calm down. But when we look at it from like a collective standpoint, if I have 50 employees who all of them are 1 to 3 short, if we multiply that by 52 weeks, like that could be hundreds of thousands of dollars that was anticipated to be there to pay for those salaries.
Maureen Werrbach 00:14:17 Right? Absolutely. And so it’s really easy as a business owner to not even be aware of how much impact a small shift like that can have on your overall financial health.
Maureen Werrbach 00:14:28 Absolutely.
Linzy Bonham 00:14:29 And this is the gift. And the curse of group practice is everything is scaled, everything is multiplied. So sure, if you know, like if you yourself are just working solo, you’re one person and you’re seeing two people less, you’re like, okay, well my pay is a little bit less, but I’ll just adjust like it’s not a big deal. But as you say, if you have 50 folks who are all two clients short, that’s your profit. Like that’s your business is profit that’s gone. Right? Because, you know, the typical profit number that we see in most businesses is about 10%. So it is that last 10% of sessions. That is the buffer in the bank. And, you know, profit obviously we’ve been talking about for years. Profit has a bad name. We love profit first.
Linzy Bonham 00:15:06 But I’m a big fan personally of sustainability and stability. That’s my like highly sensitive nature where like I just love knowing that stuff is just going to ride it out like we’re fine and your profit is your stability. Your profit is that extra money next month when an extra expense comes up that you’re like, oh, it’s fine because we have the extra money. And so yeah, that having that clarity with your team and the ability to lead and set clear boundaries and expectations will make or break your business.
Maureen Werrbach 00:15:32 I mean, speaking from like the buffer standpoint, Covid at the beginning of Covid, with the decisions we made around allowing people to see less than they’re supposed to for a good year after depleted almost all of our I like, I think, $200,000 in a savings and all of it got depleted through just allowing people grace and space to see less and all of that. And that only comes with the ability to actually have a profit to put that buffer in there, you know. Yeah. And so I think people just forget about that as well.
Maureen Werrbach 00:16:06 Precisely. View that from a, especially as a lot of us are in this like anti-capitalist mindset, how you balance living in a capitalistic world with being anti capitalistic. It’s a very interesting dynamic.
Linzy Bonham 00:16:19 It is an interesting dynamic. And I think, you know, with all of it there is this painful. There’s one part of me that wants to say like growing up peace. And that’s not the right phrase, but you know what I mean? Like these concessions that we have to make where it’s like, I don’t like it. I wish it was different. I want to make it as different as I can. And also, these are the economic realities that I’m functioning within. And if I pretend they’re not there, we’re just going to lose the business. Like people just won’t be able to work here at all. We just won’t be able to be a team. The folks that we serve won’t be able to be served by us anymore. And that is it’s a hard pill to swallow. And for everybody where we draw that line and how we try to navigate that is going to look a little different.
Linzy Bonham 00:16:54 But that’s the strategic piece of financial leadership, right? Is having your feet on the ground enough that you don’t bankrupt your business, right.
Maureen Werrbach 00:17:01 So for those that are listening and are likely in the space of needing to do some financial mindset work, I think all of us do all the time. I don’t think any of us get to a place where we’re 100% secure in our financial mindset. For those that are listening to this and thinking, maybe going back to your first piece of information about the three parts where financial mindset can show up, maybe. What’s a suggestion for having a practice owner listening, getting started on working on one of those pieces?
Linzy Bonham 00:17:34 Yeah, I mean, that mindset work always comes first because if we don’t do that mindset work, our brain is hijacked by stress and trauma and we can’t learn. Right? So this is where I always suggest folks start as foundational in order to learn skills, the skills have to come second. But you can’t learn the skills unless your brain is actually calm and present and you have your full brain available to you.
Linzy Bonham 00:17:57 So certainly starting with, as I talked about, kind of the journaling, if journaling is your thing, talking, if you’re a verbal processor, talking with the people in your life, talking with your business besties because that in itself is countercultural, right? Talking to your business bestie and being like, hey, I’m making this much money, but I don’t know where it’s going, or I’m getting paid this much. How much are you getting paid? There’s a good percentage of people who will look at you like, what is wrong with you? Why are you asking me this? Like, this is such an invasion. But when you can find the folks who will have those conversations with you, that in itself is so illuminating and liberating and gives you so much space to heal and talk through these things, that that in itself is a really powerful first step. So whether that’s journaling yourself, having these conversations with yourself, starting to become aware, doing some free associative for the childhood prompts, like I said, money is is a good one.
Linzy Bonham 00:18:46 Just like, let’s go. Just totally, you know, universal. What is the first word that comes up? Is it bad? Is it those are not enough. Is it for other people? Not for you. You know, like just shoot from the hip and don’t censor yourself because we always too, I find therapists were so high functioning in certain ways that we really censor ourselves. We’re like, oh, but I know that’s not true. But not all of you knows that that’s not true. Right? And we need to really acknowledge and work with and take care of the parts of us that might be stuck in trauma time, might still be in the grade two math class, you know, might still be in your 20s where you had literally no food. Right? You have to take care of those parts, too, because those parts are hijacking the way that you can show up in your business and the way that you run your group practice if you ignore them. So they all get space in time.
Linzy Bonham 00:19:26 So doing those prompts around your childhood, then moving into as a practitioner, I believe that money is. Or when a client challenges me on my fee, I feel da da da da da da da. And then as a leader, you know, I believe that financial leaders should be. When my team talks to me about money dot, dot dot. Just let yourself be totally open because you will be surprised what comes up. like. I know when I started working my money stories probably about ten years ago now, I did the prompt Rich people are and I came up with like, rich people are shallow, they drive sports cars. They get like bad plastic surgery, like.
Maureen Werrbach 00:20:00 These ridiculous.
Linzy Bonham 00:20:01 Stereotypes that I know is not true as an adult. But I was still really carrying these kind of 16 year old beliefs. Right. And like, those were showing up and those are going to be affecting how I run my business, how I pay myself, what I do with my money. So let yourself embarrass yourself a little bit.
Linzy Bonham 00:20:16 Maybe admit some things that you don’t want to admit, because it’s only by doing that that you can start to actually shift them.
Maureen Werrbach 00:20:21 I love that. Thank you so much. Okay, so I know in the beginning you mentioned that you have something for group practices. What is this thing specifically? I know you said where to go to find it, but what is it for?
Linzy Bonham 00:20:32 So this is a course just for your practice. Owner is called Money Skills for Group practice Owners. It is a six month course where we walk you from feeling overwhelmed, underpaid, overworked, all the terrible things that could happen in group practice to being the confident financial leader of your group. So the course walks you through the mindset and the systems and the skills to get total financial clarity on your group practice. Be able to make strategic, grounded decisions. Look at your financial statements and understand exactly what they’re telling you. It’s a really special group of folks that comes together. We only run the course once a year, so it’s like a small high touch course that is six months with lots of coaching and coworking.
Linzy Bonham 00:21:07 I’m really proud of the course and we have some really beautiful tools, some spreadsheets that we have built that help you understand exactly how to build your group practice machine to make it sustainable, so you can keep doing what you love to do. And your therapist can also keep doing what they love to do.
Maureen Werrbach 00:21:20 I love it! Well, thank you so much for coming on again today and sharing your wealth of knowledge. And for those interested, the links and all of that will be in the show notes for you to go grab. So I appreciate you coming on.
Linzy Bonham 00:21:32 Yeah. Thank you so. much, Maureen.
Maureen Werrbach 00:21:34 Thanks for listening. Give us five stars on whatever podcast streaming service you use, and I’ll see you next week.
Thanks For Listening
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