Episode 259 01 Jan, 2025

Adapt and Succeed with Patrick Casale and Gabrielle Juliano-Villani

group practice ownership, hiring challenges, staff retention, leadership development, values-based recruiting, job descriptions, recruitment strategies, screening processes, interviewing techniques, employee satisfaction, leadership structure, cohesive leadership team, burnout prevention, turnover rates, core functions, Adapt and Succeed event, collaboration, shared knowledge, practice culture, communication of expectations, candidate quality, job postings, practice values, supportive environment, growth opportunities, clinical leadership, practice management, effective leadership, professional development, group practice owners

Adapt and Succeed with Patrick Casale and Gabrielle Juliano-Villani

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  • Episode 259 | Adapt and Succeed with Patrick Casale and Gabrielle Juliano-Villani 00:00

Have you ever thought, “No one seems to want to work anymore”?

If you’re struggling with hiring and retaining staff in your group practice, growing it might feel like an uphill battle. 

You’re definitely not alone! In this episode, I sit down with Patrick Casale and Gabrielle Juliano-Villani to tackle one of the biggest challenges facing group practice owners today: building a team that aligns with your mission and thrives alongside your practice.

And the best part? We’re giving you a sneak peek into our Adapt and Succeed event, where we’ll go even deeper into these topics to help you turn challenges into opportunities.

Here’s what we chat about:

  • Why values-based recruiting is the secret to finding the right candidates.
  • How to craft job descriptions that are clear, engaging, and set the tone for success.
  • The role of leadership structures in boosting employee retention.
  • Real-world struggles (and solutions!) for finding qualified candidates in today’s market.
  • How aligning job roles with your practice’s core values leads to long-term success.

This episode is packed with actionable tips to help you adapt and succeed in a constantly evolving industry. Don’t miss out—and don’t forget to join us for our Adapt and Succeed event, where we’ll share even more strategies to help you build a thriving group practice.

LINKS:

Adapt and Succeed event – January 21st-23rd, 2025

Need extra support? Join The Exchange, a membership community just for group practice owners. 

The Group Practice Exchange Programs + Courses

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SPONSORS:

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GreenOak Accounting: An accounting firm that specializes in working with group practices. Mention TGPE to get $100 off your first month!

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Transcript: Patrick Casale and Gabrielle Juliano-Villani

Maureen Werrbach 00:00:02  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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Maureen Werrbach 00:01:11  Green Oak is set apart from the rest by their deep industry knowledge and top notch advisory and CFO services. Plus they offer traditional accounting services like bookkeeping, tax prep, valuations and so much more. Here’s what’s in it for you: peace of mind, financial clarity, and the potential to significantly grow your practice and profits. In fact, Green Oak has the most impact with practices looking for financial guidance when leveling up thanks to their CFO services. And they’re not just about crunching numbers. They also offer a mix of resources like the therapy for Your Money podcast, The Profit First for therapists book, and self-guided courses to keep you informed and empowered and growing your practice. Ready to transform your practices financial health visit greenoakaccounting.com/tgpe to explore all that they have to offer. Green Oak Accounting, your partner in financial prosperity. 

 

Patrick Casale 00:01:55  Hey everyone. Welcome back to all things private practice. Today we are going to do a special podcast episode where we are also hosting this on Maureen’s Group Practice Exchange podcast, which is cool because we are talking about some things that we are seeing in the group practice landscape, the struggle areas, the concerns that people are bringing up, a lot ways that you can overcome them. And I think it’s a really cool idea to do it this way. And having Maureen Werrbach and Gabrielle, Juliana Vellani, who I don’t think I need to introduce because they’ve both been on here multiple times and you know them elsewhere.

 

Patrick Casale 00:02:28  So yeah, this is a cool event that we are about to get ready to host at the end of January.

 

Maureen Werrbach 00:02:33  Thanks for setting this up, Patrick. I’m excited about it. Just because we have three whole days of pretty cool content between all three of us that we’re doing, and so I don’t know, we figured we would just chat for those that want a little bit more context about the event before jumping in and purchasing, we figured we could talk a little bit about some of the topics that we’ll be discussing during the event. So but we got for you, Patrick, two of them that like I think we can start with, which is retaining and supporting your team and like values based recruiting and hiring because I feel like those two kind of flow really well together. And of course, we’re seeing this in our own group practices, but also all three of us with people that we coach. Just the struggle of getting the right people into your practice and retaining them.

 

Patrick Casale 00:03:21  How often do you all hear there’s nobody out there who wants to work.

 

Patrick Casale 00:03:25  We can’t hire anybody and we have no applications coming in.

 

Gabrielle Juliano-Villani 00:03:29  Yeah. Yep. I hear it every day. Every day.

 

Patrick Casale 00:03:33  I hear it every day as well. Not just in like, social media spaces, but even when I’m in, like, retreat hosting mode and people who are attending our group practice owners, I hear it from them as well of like our advertising, like we’re on LinkedIn, we’re on indeed, we’re on Facebook. Nobody’s applying. And the people were hiring. None of them want to work. And I admittedly will say, like, I call bullshit on that completely, and I just don’t think that’s true. I think it’s oftentimes like your job advertisement or your job posting is really vague or generic and it doesn’t like list out pay. It doesn’t really define company culture. It looks like you just copied it off another indeed page or a ChatGPT page. So I see that as an issue a lot of the time. And I also see there are plenty of people who want to work, and there are plenty of people who want to join group practices.

 

Patrick Casale 00:04:27  I just think that sometimes the messaging is not feeling congruent with the values of the practice.

 

Maureen Werrbach 00:04:33  Yeah. I also think that our screening process as a whole might not be very good either. Even if you get to the point where you’ve really looked at your job description and what you’re posting out there, I think there’s a lot missed in the interviewing process, because a lot of times people will if they’re really looking for a job and need a job, we’ll sometimes agree to things that if they weren’t in a space where they had to, like right now, get a job they might not agree to. And so I think there’s some lost space in the interviewing process, too, of like, how do we make sure that the stuff that we have in our job application, we’re actually talking about during the because a lot of people will kind of skim through and just sort of assume that all practices are made the same and then really miss out on the opportunity for discussing what was in that job description to make sure that there’s real buy in to it.

 

Patrick Casale 00:05:28  Absolutely. I think that’s a big piece, and I think that leads directly into retention as well. I think you were going to say something though, Gabriel, I was.

 

Gabrielle Juliano-Villani 00:05:35  Thanks, Patrick. I was going to say this also makes me think of what I’m speaking about, which is more like CEO mindset because I Patrick, I use your website all the time as an example to some of my clients because that’s what they do. They just put in ChatGPT write wrote me a job description and it’s very generic. And I’m like, if I go to Patrick’s website and I look at who you’re hiring, I know exactly. And the person who’s coming to that and who is looking at that, they know who they are and they know that they are the right fit for that. So do that stuff from the beginning, instead of just slapping shit together and not really thinking it through and trying to do it the easy way.

 

Maureen Werrbach 00:06:17  Also, go ahead and use ChatGPT, but then do the work at creating a GPT that knows your voice.

 

Maureen Werrbach 00:06:25  You know, don’t just go in there and ask for, you know, I’m a group practice owner. I need a therapist. Build me a like, do the work initially to create a GPT that knows your voice at least. So just to as an aside to not hate on GPT because I use it but hours to yes, I spent hours building a GPT that knows my voice, that knows my values, so that when it creates the content for me, it makes sense.

 

Patrick Casale 00:06:51 Yeah I think it’s like such a wonderful resource. I even use ChatGPT to respond to email. Sometimes I’ll be like, respond to this with this type of tone and this type of impression. But yeah, I think it’s about making it your unique, making it your voice, but more importantly, like really getting clear on what your voice is, really getting clear on what your values are as a practice. Right. Like what do we stand for? What do we believe in? What is our mission statement? Who are we trying to support? Why do we care about supporting this population? Like all of those things are super important because otherwise you’re really just like casting this net for employees.

 

Patrick Casale 00:07:28  And like Gabrielle said, anyone and everyone can apply. And like you said, Maureen, if you need a job, you’re just like throwing your name out there. But unless you get really clear on who your practice supports, what the niche is, what the values of the practice are, what your leadership style is, you’re going to just hire people just to hire, and you might blame it on them when they transition out a couple months later, because it’s just not a good fit.

 

Maureen Werrbach 00:07:53  Yeah, I see also an overpromising under-delivering on the job descriptions being like, we’re offering all of these amazing things. And then clinicians coming into the practice feeling like, well, those things aren’t really being delivered, you know, whether it’s workplace culture or flexibility, right? Those are a lot of these like key terms that are used now is like work from home flexibility, the ability to control your schedule and all these things. And then when you are in the practice, you realize the flexibility is that work, just as that is an example is.

 

Maureen Werrbach 00:08:25  So what does flexibility mean in your practice? For one practice, flexibility can mean you completely can control your schedule. Work from home whenever you want for another practice. Flexibility might mean you get to work two days out of your week from home that you have to predetermined like choose. And those are the two days, right? Both mean flexible but mean something different. And if it’s not explicitly listed, a clinician who’s applying might wrongly assume what flexibility or whatever means. And so I see that a lot too, where practices are adding all this, like these, this jargon and these offerings and these like things that are in their business that really aren’t there once you’re in there. And of course, that creates kind of resentment and turnover by clinicians. Okay. So we were talking about retaining values based hiring in that frame of mind. I’m talking about creating a leadership team. Because of course as we grow our businesses, there’s going to be a point where having just a clinical director or one other clinician who’s helping you lead isn’t going to be enough.

 

Maureen Werrbach 00:09:32  And there’s this real need for you to be able to create a cohesive leadership team that can really help manage all aspects of your business, especially as you scale. So that’s something I’m going to be talking about. Did you have a leadership team when you had your practice, or did you sell before you got to that point?

 

Gabrielle Juliano-Villani 00:09:48  I did. I was like just starting to implement that actually when I sold. But I think that’s really important because that was something that actually came up in the masterminds that I was doing for the group. Practice exchange is a lot of I actually was very surprised at how few of them had like real leadership and how much they were still doing, and very big practices like 25 plus clinicians. And you’re the practice owner and you’re still seeing clients and you’re still doing supervision, and you’re still worrying about like the water delivery. And if the snacks got delivered. And I’m like, why are you doing this shit?

 

Maureen Werrbach 00:10:30  And similar to I did the same thing. I think it’s almost feels like a natural progression if you’re not intentional and very aware of your next steps, but it is really easy to just get to a point in your practice where you’re like, I just need a little bit of leadership support and you just bring someone on and you kind of think of the tasks that you don’t want to do anymore and hand off.

 

Maureen Werrbach 00:10:50  And then as it grows a little more, you’re like, I need a little bit more. And then you hire someone else, and then you realize you have all these like, siloed, random people who kind of do a little bit of different leadership stuff. I can understand how we can get to that point where then things fall through the cracks and we’re doing random things still, like needing to make sure that the water delivery is happening on time and things like this. And so one of the things that I talk about, which is something I didn’t do and wish I would have, is create a set of roles and the core functions that those roles have from the beginning, because those roles all exist. Every group practice has pretty much the same roles. Of course, when we diversify services, we can differentiate ourselves a little bit, but we all have the same core roles, and it might just be that us as group practice owners are still in all of the roles, and maybe we aren’t even doing all of the roles, but they still exist, whether they’re being neglected or not.

 

Maureen Werrbach 00:11:42  And so I feel like one of the easy first steps is before starting to just throw a new clinical director role out there, and just handing off some random things is to really get a sense of like, what are the core functions in your business and what things go within those functions, like what are the main things that they do? Because then it becomes easy to like, hand off a whole role with a whole set of functions connected to it versus like, I just need some help. Why don’t you start supervising? You know, I don’t know if you’ve seen this, but in Facebook groups, I see it all the time where people are like, what does your clinical director do? And then everyone says things that are so different. And I’m like some things that people are listening, like, that’s not what the role of a clinical director is. And for other people it just is so different. Or practice manager, you see that and everyone’s practice manager does completely different things. And I think this is where kind of putting together a set of roles and what those core functions are within those roles helps you kind of keep people in the right lanes.

 

Patrick Casale 00:12:40  I also think to your point, Maureen, and I’ve talked to you about this before of like not just promoting someone to clinical director because they’re a good clinician.

 

Maureen Werrbach 00:12:50  Yeah. 

 

Patrick Casale 00:12:50  And how your accountability equation really does a great job of mapping out roles and responsibilities, because it’s so easy to say, like, you’re a great clinician or you’re a great supervisor, but that does not, again, mean that you’re going to be a great clinical director or a great office manager, etc..

 

Maureen Werrbach 00:13:08  Yeah, that’s probably one of the biggest areas of concern that I see happening in the leadership realm is elevating a really great clinician into a leader of clinicians role, because they think, I just want more of you replicate yourself. And, you know, if you teach these people to be like you, then they’ll be like you. But in reality, a person who has knowledge on something doesn’t necessarily mean that they’re going to be a good teacher of that knowledge. And so similarly, someone who’s a great clinician may not be the greatest supervisor or teacher of clinical theory and how to be a clinician and all that stuff.

 

Maureen Werrbach 00:13:45  And so, yes, it’s probably one of the most common errors that we make in our industry when it comes to leadership growth is putting the wrong people in the wrong roles. And so, yeah, we’re going to talk a little bit about that and the adapt and succeed as well. The last day we’re doing a panel discussion. So obviously we each have some topics each of these days that we’re going to be talking about from leadership to selling our practice, burnout, hiring and retention. But then on this last day, US three are going to come together and sort of do this panel discussion on diversifying services. We want to talk about that.

 

Speaker 4 00:14:19  Well, yeah.

 

Gabrielle Juliano-Villani 00:14:21  I mean I’m actually I think I’m most excited for that day because all of us have diversified services, added other income streams, started other businesses. And I think it’s just I don’t know, I think it’s exciting, especially for those of us who have ADHD and like to do a million different things. I mean, I think it’s really easy to see on the outside or even I know people who follow my social media and they’re like, oh my God, you have 15 streams of income, which I do.

 

Gabrielle Juliano-Villani 00:14:51  However, they did not just all appear overnight. And so I think group practice owners need to remember that you are also entrepreneurs, and there are lots of other things that you can do within like clinical group practice, ownership, stuff that can add more income or just change how you’re working to prevent burnout.

 

Maureen Werrbach 00:15:14  And when I look at like us three right now because we’re on video, it’s wild. We actually have I think you started Gab’s with saying this that we all have like different things. But it is wild actually. We all touch almost every single diversified service I can think of between having retreats right with Patrick and you, with your 8 million streams of income. I mean, you just have figured out how to take every piece of knowledge that you have and, like, turn it into something that can create consistent revenue. And then for me, more internally in my group practice diversifying services with other provider types and other wellbeing at work programs and things like this. We cover so much in the diversifying services realm and then books, right, Patrick and I well, yeah, I mean I just out you on that.

 

Patrick Casale 00:16:03  No, not at all. I’m just like waiting for like finalization, you know, so it’s like walking on eggshells on my end. But yeah, I’m excited for that as well.

 

Maureen Werrbach 00:16:12  Yeah. Oh a whole nother diversified service for us right. It’s book sales. So that’s what we’ll be doing on the last day is sort of having this panel discussion on what ways we can diversify services, how do we get there and like how do we make the decisions about it? Of course, as you mentioned, all three of us being neurodivergent, that plays a role in like our decision making. And, you know, I know with me having ADHD, I’m just like wanting to throw 800 things against the wall. And it’s like, what process do we go through to ensure that we’re really throwing the right things out there and not all the things. So I’m really excited.

 

Patrick Casale 00:16:46  Super excited too. And I think it’s value packed for three days for us to sit there and really get hands on with everyone who’s going to be attending, which I’m really excited about.

 

Patrick Casale 00:16:55  I like doing that stuff where we can really do some breakout and some processing about stuff that comes up for those who are attending and really break stuff down and give tangible action steps to step away with to. Because I know when I go to trainings and it doesn’t feel engaging, I check out and I probably don’t revisit it, and that’s just not my style whatsoever.

 

Maureen Werrbach 00:17:17 Yeah. I also like that all three of us each create content and courses and things on our own. But there is something about collaborating not only from like abundance mindset. I always have loved, and that’s something that I’ve had a hard time with. Our industry of coaches and consultants as a whole is like, everyone likes to stay very siloed. And I’ve always been like, oh my gosh, we have so much knowledge when we put our stuff together, but I also think it makes the actual like events better when there’s multiple people. So I’m excited about it. So we’ll both be putting in the footnotes or whatever it’s called, the link to it.

 

Maureen Werrbach 00:17:51  But if you’re anything like me and I’ve never looked at show notes once in my life for a podcast, just Google, adapt and succeed the group, practice, exchange or adapt and succeed any one of our business names I have looked when I wrote TJP adapt succeed, it shows up right at the top of the page for you to learn more about it. So if you don’t want to go to the show notes, just write, adapt and succeed and one of our business names and it’ll show up on Google. Yeah.

 

Patrick Casale 00:18:17  And the event is January 21st to the 23rd. It’s going to be recorded. You’re going to get lifetime access to the replays so that you can continue to circle back to it when you need support or accountability. And we definitely still have a few spots left. So make sure that if this resonates with you, then get registered and we will definitely see you in January.

 

Maureen Werrbach 00:18:40  Yeah. And it’s a great way to start off a new year.

 

Patrick Casale 00:18:43  It is a great way to start off a new year.

 

Gabrielle Juliano-Villani 00:18:46 Oh I think a lot of us I mean most of us, all of us being group practice owners, I mean the world has changed. We know this. We know that things are changing. And I haven’t really seen too much. Anything like this actually, at all were like, multiple people are coming together and giving you a space to talk about that and giving you like expert advice and Q&A is where you can really set yourself up for how things are going to be in the future.

 

Maureen Werrbach 00:19:13  I agree.

 

Patrick Casale 00:19:13  Well said.

 

Maureen Werrbach 00:19:15  Well it was nice chatting with you guys about this.

 

Patrick Casale 00:19:17  Yeah. Hudson has been howling for the last 15 minutes. That’s why I’ve been, like, super quiet and staying on mute because, like, he just stopped. So I’m going to wrap it up before he starts again.

 

Maureen Werrbach 00:19:27  I haven’t heard him yet.

 

Patrick Casale 00:19:28  I’ve been on mute, but like, yeah, he’s been non-stop for 15 minutes. It’s like I’m sitting here, I want to jump in, but I’m like, I cannot meet myself.

 

Maureen Werrbach 00:19:38  So is that a dog back there?

 

Patrick Casale 00:19:40  Oh, yeah. That’s Lucy scurrying.

 

Maureen Werrbach 00:19:42  Around like a little a little cat.

 

Patrick Casale 00:19:45  That’s like a gremlin.

 

Gabrielle Juliano-Villani 00:19:48  She is a gremlin. Poor thing. She’s got so many problems. And she’s sleeping. She’s happy today.

 

Patrick Casale 00:19:55  So when you take this three day event, you’re probably going to hear Hudson howling. And you’re probably going to see Lucy scurrying around looking like Gollum from Lord of the rings. And you might see Maureen’s cat slinking around somewhere. Who knows?

 

Maureen Werrbach 00:20:08  I don’t know where they’re at right now.

 

Patrick Casale 00:20:09  Anyway, we all have all that information in the show notes. Like Maureen said, if you Google, adapt and succeed in any of our names, the event will pop right up. It will be in the show notes. It’ll be in the social media post that we make from this episode, and we will see you in January and everyone have a Happy New Year.

 

Maureen Werrbach 00:20:26  Thanks for listening. Give us five stars on whatever podcast streaming service you use and I’ll see you next week.

Thanks For Listening

Thanks for listening to The Group Practice Exchange podcast. Like what you heard? Give us five stars on whatever platform you’re listening from. Need extra support? Join The Exchange, a membership community just for group practice owners with monthly office hours, live webinars, and a library of trainings ready for you to dive into. See you next week.

Resources

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

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Therapy Notes

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*Need a good EHR for your group practice? TherapyNotes is it. I’ve been using it for years in my own group practice, and it does really well when it comes to having the features group practice owners need. Try it out for FREE for 2 months by clicking here.

* 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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