Maureen Werrbach 00:00:00  I don’t think a lot of people spend enough time thinking about what role they want to play long term in their business. What’s your feedback for that for the first.

Jessica Lackey 00:00:07  Couple of years? It doesn’t matter. It’s after that. Once you’ve had some traction, then there are decision points to be made. And a lot of times we’re just so busy. When we get to that, I’m like, I need to hire. I need to keep growing, I need, I need more and more and more that that’s the time that’s least likely to sit down and say, what do I really want for my next chapter of my business? Because we’re just like, let me just get to the next break point. And of course, it never comes.

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 to another episode of the Group Practice Exchange podcast. Today I have Jessica Lackey who is a strategy and operations advisor who blends business strategy, practical application and a human centric approach to create sustainable businesses with a background in corporate leadership, McKinsey and Company consulting, and a Harvard business degree. Jessica knows a thing or two about hustle culture and what it feels like to judge success by the bottom line at all costs. Now, she combines her deep experience in consulting fortune 500 operations, leadership and coaching to help businesses grow without sacrificing the well-being of their clients, team and community. I’m so happy to have you. I’m excited about what we’re talking about today. We’re talking about building your practice around the role that you want to play as a business owner, which I think is such a relevant topic, especially these days. So thanks for coming on.

Jessica Lackey 00:03:17  Excited to be here.

Maureen Werrbach 00:03:18  Yeah. Okay. So tell us a little bit about I mean, I obviously did a whole nice bio on you, but tell me a little bit about you in terms of like how this topic is something that you like to talk about.

Jessica Lackey 00:03:28  Yeah. So I call myself a business and strategy advisor. And the most important topic in growing your business is designing your business first, because all of the systems and structures you run is all based on your business design. And we don’t talk about that enough. So it’s like we can make you more efficient at running a business that’s not the business you actually want to run. And you can try this tactic that’s not designed for your type of business. So I always like to start with what is the business purpose we’re aiming for? And then how do we become sustainable at that business?

Maureen Werrbach 00:04:06  I love that. I think it’s all too common that we start off building a business, or bringing about a business that is supposed to, like, support us and like throughout the years.

Maureen Werrbach 00:04:18  And as we bring people on our teams that all of a sudden we’re not as intentional about the direction that our business is going and our roles in it. So I love that we’re talking about this topic because as my listeners know, I talk a lot about sitting in that visionary role as a business owner, looking at the future of where our industry is going. So I can forecast and kind of see ahead on like what the trends are and where things are kind of steering so that things aren’t coming at us by surprise. And it helps me then be able to get creative about how we can adjust or pivot, to be able to make sure that our business and our teams can continue to thrive. So building my business in a way that is able to support me and having the time to be a visionary obviously required a lot of very intentional thought and a creation of a leadership team. That being said, I don’t think a lot of people spend enough time thinking about what role they want to play long term in their business.

Maureen Werrbach 00:05:15  What’s your feedback for that?

Jessica Lackey 00:05:16  I think it’s there’s the role you play at the beginning and then there’s the once you’ve gotten traction. There are some decisions to be made, just like you have done having a podcast that puts you firmly in this role of being a creator. But maybe you want to be a people leader, have a leadership team, or maybe you want to stay kind of small and still get to do your craft. Each of those have different parameters about like what’s required from a time management perspective of financial perspective to be successful. And for the first couple of years, it doesn’t matter. It’s after that, once you’ve had some traction, then there are decision points to be made. And a lot of times we’re just so busy. When we get to that, I’m like, I need to hire. I need to keep growing, I need, I need more and more and more that that’s the time that’s like least likely to sit down and say, what do I really want for my next chapter of my business because we’re just like, let me just get to the next breakpoint.

Jessica Lackey 00:06:10  And of course it never comes, right?

Maureen Werrbach 00:06:13  That’s that’s actually really true. I know you mentioned before, like different archetypes for what you should consider when you’re making decisions. Can you talk a little bit about that as it relates to being a practice owner and being a leader in the mental health group practice world?

Jessica Lackey 00:06:30  Yeah. So I split it up into like three for this audience, three sets of archetypes. Archetype one is where you are the service provider, you are the practitioner. And you know, again, that’s a model. There’s the agency model. A lot of times it’s like creative for creator practices, you know, like marketing agencies and things like that. The group practice here, it’s do I want to have, you know, a handful of of the therapists in one location, do I want to be bigger and have multiple locations? Do I want to be essentially people leader? And then there’s the creator side where I’m going to diversify my income courses, templates, tools, speaking, building a brand, more of the research.

Jessica Lackey 00:07:13  And so at that point you may say, okay, well, I want to have like maybe a location of therapists and practitioners, but then I want to have like a certification program or a some kind of like research backed, you know, I want to be a TEDx speaker or something like that. And those are all ways to diversify your income. Once you’re past that threshold point of like, okay, I now know who I’m serving and I’ve made some traction. Each of those things requires very different type of team on your plate and different way to spend your time, right.

Maureen Werrbach 00:07:42  What is your feedback on? I guess that piece, because I can imagine that that would be a really hard just figuring out the archetype, right? Like, I know talking to group practice owners, that one, I think through technology and social media, it can feel like there’s so many options out there for you that there’s a little bit of like fear of missing out or shiny object syndrome. What’s your feedback for people who might not yet know exactly the role they want to play more long term in their business so that they could start to navigate, like creating that path.

Maureen Werrbach 00:08:15  Yeah, I’d.

Jessica Lackey 00:08:16  Say pay attention to what of your role do you like and what skills are you willing to learn. So if you want to stay a smaller practitioner, hands in the craft, you’re kind of doing what you’re doing today. You have to get really good at time management. You have to put the blinders on and say, I’m not focusing on these other things because you don’t really have the time to do that. If you want to build the multi practice organization, that’s where you have to say, I have to get incredibly comfortable with team leadership and financial management, like your job shifts from being a practitioner to running a practice in a big way. And not everyone wants to learn leadership skills and have the responsibility of people. It sounds like your audience does, but even still, like, do I want to have multiple locations? How willing am I to like, literally get in the guts of my finances and do marketing? But the marketing for running a practice, it feels very different than in the The Third.

Jessica Lackey 00:09:12  The creator style is am I interested in doing real marketing? Like not kind of referral based marketing, but growing an audience, having a point of view. So even in that creator model, there’s more of the edu retainer type model where it’s kind of like Brené Brown style, where you’re developing an expertise and a point of view, and you’re doing a lot of writing, and you’re doing a lot of thought leadership and building like your personal reputation so you can get paid for talks. And then there’s the, oh, I want to build courses, I want to build training programs and things like that. That’s all very heavy on the digital marketing. And some people are like, I’m comfortable doing local marketing. I don’t want to be a quote unquote thought leader. So that’s where you start to say, where am I? Am I more comfortable in the marketing thought leadership side? Am I more comfortable in marketing for a local practice? Am I willing to learn the skills of business management or are neither of those right for me? And I want to keep running a small practice that makes me and my family money.

Jessica Lackey 00:10:10  Yeah.

Maureen Werrbach 00:10:11  I talk a lot about how we can’t do everything in our businesses. And, like, it’s once we get to a place where we can be humble and understand that we don’t have expertise in all areas of running our business, but it allows us then to be able to make decisions on hiring people or contracting people who are better at those things than we are. I think that also probably plays a pretty big role in opening up the doors for you to be able to think about, you know, what role do I really want to play? Because I think part of it is also this mindset thing of, I’m supposed to be able to do all these things or feeling like a sellout if they’re no longer a therapist because they like to lead and run a business, which I get a lot of people feel when they shift from practitioner first kind of role to business owner leader role. And so, yeah, I’m assuming there’s probably a lot of that mindset stuff that needs to be worked on to be able to even fully think through what role you want to have without, like, having some accidental filter come through?

Jessica Lackey 00:11:13  Yeah, there’s the fear of success and the fear of the grief of letting go.

Jessica Lackey 00:11:18  Not just of, like, the identity of being a practitioner, but imposter syndrome rears its ugly head. Well, I’m not good at this. Of course, you’re not good at it yet, because you weren’t trained into how to run, how to do hiring, and how to hire an operations manager, and how to do billing, and how to hire your first HR person. You weren’t trained in that. Like that’s I’m assuming that’s not what you learned in school, but it’s not imposter syndrome. It’s literally this is a new threshold in my business. I haven’t done that before. And what I also find is that you don’t have to decide this forever. I find that these business models tend to run in three year cycles. The first year you’re going from, I don’t know what I’m doing at this new level to like, I’ve kind of figured it out. Then in year two, you are like implementing, just running it and you’re through. You’re making it better. And then being like, all right, a lot of people at the third years, I’m kind of bored now with doing this.

Jessica Lackey 00:12:07  I need the next chapter being maybe I’m shifting. You have a different level of expertise about your client base, and maybe you have a different like if you double down on, you know, opening up a practice, maybe now you have enough financial security and enough kind of clout in the industry to go into more of the creator style practice or more of the speaking style. So it’s not a forever decision, but it is a for the next 2 to 3 years, trying to build more than one of these archetypes at the same time is really quite draining and really challenging, especially if your business is thriving. It’s easy to do when you have a lot of time on your hands, right?

Maureen Werrbach 00:12:42  I was to say as your as you’re talking about year one, year or two, year three and like kind of just entering these different chapters thinking about like as a practices growing and scaling, it can be really difficult, especially if growth is happening quickly to maintaining integrity and quality. How can practice owners adjust systems to make sure that they’re delivering quality services while scaling? Because we see that a lot happen, especially around quick growing practices.

Jessica Lackey 00:13:10  Yeah. And this is a little counterintuitive, I would say. A lot of times I would advise people to throttle the growth. Yeah. Just like if you don’t have enough cash, if you’re in a product space business, if you run out of cash, a lot of times you can grow to bankruptcy where so throttling it’s a it’s a counterintuitive why can I grow faster? Well, no, we have a waitlist. We’re going to turn some people away. This is how many we have. We’re going to be rock solid. We’re not going to hire too many additional practitioners too quickly because we don’t have the systems in place. And I think just the ability to say it will come back and have that faith. But being willing to throttle the growth, to say this is the growth we can afford right now. And that way you’re able to put in those mitigating factors at each step of the way.

Maureen Werrbach 00:13:53  Yeah, that makes sense in something I suggest to you mention growing your way to bankruptcy. And I don’t think people realize how easy it is to do that is to just grow so quickly that you haven’t been able to set up systems or revise systems to work in congruence with that growth.

Maureen Werrbach 00:14:13  And when it’s happening so quickly, a system might need to, like I always say, in our industry, every 10 to 15 clinicians that you hire, your system and your procedures within your business have to shift. And so if people are just bringing a ton of clinicians on and in one year going from just themselves as a solo practitioner to like 20 to 30 people, that looks like amazing growth. But so often I find that they’re struggling financially because they’ve just not had the ability to set the infrastructure up in a way that can support, you know, them going from 1 to 5, let alone from 1 to 30 so quickly.

Jessica Lackey 00:14:50  Yeah. And I think the metrics that you care about change, you know, when you’re a soloist, you’re looking at, you know, you’re looking at client attraction rates when you’re, you know, growing to five, ten, 20 people. You’re looking at churn rates and you’re looking at like uncollected billing and things like that. You’re looking at like utilization rate. Those are all very different things.

Jessica Lackey 00:15:07  And definitely God, I can’t believe people bring on like 20 people at a time because like, I’ve seen it.

Maureen Werrbach 00:15:12  Yeah.

Jessica Lackey 00:15:12  Oh that’s crazy.

Maureen Werrbach 00:15:13  Right?

Jessica Lackey 00:15:14  Yeah. That, like, makes my heart palpitating because there’s just, you know, no way to standardize to your point, like standard of quality to get your systems to make sure you’re collecting cash, setting targets.

Maureen Werrbach 00:15:25  Yeah.

Maureen Werrbach 00:15:25  I don’t think it’s happening as much right now because the hiring landscape looks very different this year than it has in previous years. But, you know, just even two years ago, that was not uncommon to see. And I always thought that has to be really difficult because you’ve yet to like, get a grasp on what it feels like to lead a team of five or 10 or 15.

Jessica Lackey 00:15:45  I think anytime you cross the threshold of span of control, five people is probably like the maximum that one person can really understand what’s going on in their business. Once you get past the five, maybe the seven mark. Yeah, that’s where you, you know, assistants and operations managers and like practice managers become important.

Jessica Lackey 00:16:02  And so that’s where it’s like really before crossing too many of those thresholds of span of control, pausing for a time at each level to say, okay, let me stabilize at five. Let me stabilize at ten, let me stabilize at 20. Let me stabilize it. One location. Let me stabilize it. Two locations. Those are the types of checkpoints that I would say at each of these cross points. There is new systems required and it’s a new business. It’s a fundamentally different business at 20 than five.

Maureen Werrbach 00:16:28  Right. Exactly. What kind of feedback do you have for people who are practice owners, who are maybe just toggling or struggling right now to really figure out what they want their role to be in this season of practice ownership. I don’t know if it’s questions to ask themselves, a tip or any sort of feedback.

Maureen Werrbach 00:16:49  Well, I.

Jessica Lackey 00:16:49  Would say don’t let your mistakes in hiring limit your choices of what you want to be. A lot of times we’re like, well, I can’t do this because I don’t have the right support staff.

Jessica Lackey 00:17:00  I think it’s figure out what you want to be in the business, and if you don’t have space for that, then I think we have another question of like, okay, what do you need to do to carve out the space and then decide too many times I see, well, I can’t do this because I don’t have the right support staff, I don’t have the right person, people under me. and I would say like, figure out what you want or yin and yang, figure out what your yang is and then craft the yin around it. It may be that you truly need, at some point, a full time general manager for your practice, so that you can do whatever it is you want to do with the rest of your time. And that comes with a financial kind of financial modeling decision. But I think it’s really important to say, don’t let your dreams be kind of dictated by the current hiring and staffing models. You have one of my clients, she’s like, I don’t know if I want to scale this particular program.

Jessica Lackey 00:17:46  I’m like, well, that’s because you have the wrong person administering the program. And so you’re sucked into the details because you don’t have the right staffing. Yeah, that doesn’t mean you don’t want to scale the program. You’re just terrified to, like, step into that role and then lose control because you don’t have the right support system around it. A lot of times that’s going to potentially come with more training in a slightly higher price point for who you hire. But how do we like not let the current state of our teams dictate our dreams?

Maureen Werrbach 00:18:11  Yeah, I love that. If people are interested in learning more about you and what you can do to support them, when maybe if you want to share a little bit of that and also where they can find you.

Maureen Werrbach 00:18:21  Yeah.

Jessica Lackey 00:18:22  So I work with business owners to help them again, design their future businesses and put in place the structures and systems for that growth. I write a newsletter every week about how to design an expertise based business, and they can find that at Jessicalackey.com/welcome.

Maureen Werrbach 00:18:36  Awesome. I really appreciate you coming on and sharing some of that feedback and just knowledge around helping people really think about what role intentionally, what role they want to have in their business, because I think that tends to be put on the wayside in lieu of like putting out fires that are coming up for them. And so this was a great episode for people to just kind of sit back and think less about the fires and more about how they intentionally want to show up in their business long term. So I appreciate you coming on. Thanks for listening. Give us five stars on whatever podcast streaming service you use, and I’ll see you next week.