[00:00:00] Megan: The investors and the founders at times look into the mental health system and they see all these therapists who are working at a community mental health system and being wildly underpaid they’re seeing, the dollar signs kind of fly away. I think the mistake they make is that the therapists themselves do not also see those dollar signs flying away. Therapists are not idiots. They know exactly how much they’re worth. It’s not an inefficiency, it’s an intentional donation.
[00:00:23] Linzy: Welcome to the Money Skills for Therapist podcast, where we answer this question: how can therapists and health practitioners go from money shame and confusion to feeling calm and confident about their finances and get money really working for them in both their private practice and their lives? I’m your host, Linzy Bonham, therapist turned money coach, and creator of the course Money Skills for Therapists.
[00:00:50] Hello and welcome back to the podcast. Today’s episode is with Megan Cornish. Megan Cornish is a social worker turned writer who works with some large, venture funded online platforms and in her work has really become aware of the way that some of these large platforms who we are not going to explicitly name in this episode, to be clear, are exploiting therapists and are a risk to therapists and the impact on the therapy industry. So today, Megan and I talk about how these companies tend to work. These are venture backed, where there’s lots of funding that’s going into these large companies, that make mental health care accessible, but don’t necessarily pay therapists.
[00:01:31] We talk about some of the risks that come with working with these companies. If you are working with these companies, how to get the most out of it, right? What are productive ways that you can work with these companies to protect yourself? How to be savvy about what companies to work with, what not to, and we talk about her online community, which is about sharing this information to make sure that therapists, we protect ourselves, from large tech that is coming into our space and isn’t interested in mental health outcomes and isn’t interested in our wellbeing but who answers to their investors? and that is what they are set up to do. So a very informative conversation today. We cover a lot of ground. Megan brings in a lot of knowledge about startups and tech and how these venture capital businesses work. That has certainly been new information to me, and I think will be new information to most folks listening helpful for us to understand who’s coming into our space and how they work and what their metrics of success are, and what we can do to work with them productively, and also protect ourselves and our industry against them.
[00:02:26] Here is my conversation with Megan Cornish. So, Megan, welcome to the podcast.
[00:02:40] Megan: Thank you. Thank you for having me.
[00:02:41] Linzy: I am very excited to have you here. We have had our kind of pre-chat thinking about having this conversation a long time ago and so it’s been on my mind but before we dig in, and there’s so much to dig into,
[00:02:52] Megan: Yes.
[00:02:52] Linzy: Can you tell folks a little bit about your trajectory and what you do?
[00:02:57] Megan: Yeah, absolutely. So I’m a licensed clinical social worker. I started with my bachelor’s degree in social work and worked in nursing homes and stuff, and very quickly was like, I need to go get my master’s so I can do more direct kind of care type things. So I got my master’s and I spent several years finding out where I wanted to land and landed in my social work dream job, which was embedded in a school district doing therapy with,middle schoolers and high schoolers and I was on a teacher contract so I didn’t have to deal with insurance.
[00:03:23] It was a dream and then covid happened, which is a line in most people’s stories. My husband, who was a charge nurse of an ICU in the northwest, decided that he wanted to go back to school, to increase his skillset. So we moved across the country to North Carolina, and we sold our house to fund that move and I had two kids at the time, couldn’t really find a social work job that I could just jump right into that would pay as much as I would pay in childcare. So we’re kinda like, I’m going to try and just live off this budget that we have for three years and see, I’ve always kind of had a writing side hustle just to make like coffee money and stuff. You know, it was always just like, I’ll write your blog for, you know, a hundred bucks and,so I was like, I’ll see if I can expand our budget with this. Started doing that, was writing a lot of random stuff,and was looking at all these mental health companies that were arriving on the scene and reading some of their blogs and their emails andI was pretty sure that they did not have a therapist on the team because they would make these really obvious mistakes or these statements. I’m like, a therapist would not and should not ever say that.
[00:04:23] Linzy: Yes.
[00:04:24] Megan: I just started reaching out and said, Hey, like, I noticed you said X. Really, you should say Y. Here’s y. Can I help you? And they were like, “yes, please.” So I started getting a lot of interesting work writing blogs, just doing some research on new topics and interviewing therapists and they were presenting that view, and that’s kind of how I got my start. Now I’ve gotten to work with a lot of interesting companies like Elios and Alma, and, I’ve had like short term contracts like ULA and Grow, just mostly writing content,like blogs and or, um,occasionally I get a fun consulting job where I get to tell them everything they’re doing wrong. So I like that one.
[00:05:01] Linzy: Fun. Yeah. And all these companies, ’cause I’m actually not familiar with this whole landscape all the companies that you’re naming are, how would you describe what these companies are?
[00:05:09] Megan: So there’s a wide variety of companies. I actually have a Venn diagram hanging up here. On the left are companies that you work for. On the right are companies that work for you, and in the middle are companies that kind of work for you and you work for them. So on the left we’re going to talk about, like, Headspace. Those companies you work for, or Charlie Health, you’re going to get hired. They’re going to provide everything. You’re going to do things according to the way that they want it done. On the right are tools, like simple practice or out practice or mental health match, all these companies that are going to help you with different parts of your practice. And in the middle you’ve got Alma or Octave, where they’re going to give you some tools and you’re going to be a contractor, but also you’re going to probably have to do some marketing yourself or that
[00:05:49] Linzy: Okay.
[00:05:50] Megan: So I’ve worked with all three categories.
[00:05:52] Linzy: Yes. Okay, and all of these categories, if we were going to summarize, like they’re kind of like tech in the therapist space.
[00:06:00] Megan: Yeah. Mental health tech.
[00:06:02] Linzy: Yes. Okay. Mental health tech startups. Okay so that’s kind of the umbrella. And as you said, it’s everything from companies that create the container that you can work within. Like basically kind of almost like an online group practice to like the tools that we use to this kind of blend, this blend in the middle. There’s been a lot of discussion about these kinds of companies, which I feel like is a lot of discussion that sometimes we are emotional and confused, but not necessarily clear on what is happening with these companies.
[00:06:26] What is the story here? And so I’m curious from your perspective of having worked with many of these companies and being a therapist who’s also interfacing with kind of the business side of these companies, like why should therapists care about the fact that these tech companies are coming into the therapy space?
[00:06:45] Megan: This is a great question. Therapists should absolutely care,and pay attention to what’s happening because the more that I see what’s happening, the more I’m convinced that these companies don’t actually have to succeed for very long on their own merits. They just have to outlast private practices,because they’re putting a ton of money into marketing. So let me explain how a startup happens. Venture capital is the name, this form of investing that says we need to find the Googles.
[00:07:11] Linzy: Mm-hmm.
[00:07:11] Megan: Ubers and invest in them so we can make a lot of money, but there’s a problem that there’s a lot of startups who say that they’re going to be Google and like you’re not really sure if it’s the right time or right place, or even a good idea. So they end up giving tons of money to hundreds of startups,and only one or two of them need to be the next Google to make back all that money and more. But as a rule, they have to throw only money at startups that profess to have the potential to make that kind of money. Otherwise, if you don’t think you can make that kind of money, then why would they give you investment dollars? And the amount of return that these investors want is like,they want to see that you have at least an 80% profit margin. That’s like what they’re shooting for, which is wild, especially in healthcare.
[00:07:56] The reason why venture funding has gotten any traction at all, even outside the mental health space, is there are a lot of really good ideas that only work if you have a lot of money to start. With social media being an example,no one’s going to be on Facebook if the only people on Facebook are in your neighborhood Like say, Hey, get on Facebook. They had a really good idea. They got some some traction., but to make it really explode the way it did, they had to have advertising dollars to get everybody on it, and that’s what made it valuable
[00:08:23] Megan: Or if you have a tech that’s highly expensive to produce or to design. And then you can replicate it. So, software especially is like that. Software might take a lot of money to design the first time, but then you can sell it an infinite number of times. So that’s kind of the model that they’re looking for.
[00:08:37] Linzy: Right. So there’s this huge front end investment of money that goes into that.
[00:08:41] Megan: Exactly. So mental health,tech especially the ones that provide therapy. I think they are just having to doubt less private practice because I know that the amount of money they’re spending on marketing is not sustainable. I mean, anyone who’s listened to a podcast these days had just heard an ad for a certain company, I won’t name because I don’t want to.
[00:08:59] Linzy: Yeah. Me neither.
[00:09:00] Megan: They spend so much money on advertising. They’re not making that much money back. They are assuming that they’re going to get the corner on the market, drive everyone else outta business and then they won’t need to spend as much on advertising because they’re going to be the biggest or the only player in the space.
[00:09:13] Linzy: Right. So it’s kind of a plan to become a monopoly, right? Outspend everybody at the beginning, be the last company standing and then you can do whatever. ’cause you don’t have competitors.
[00:09:21] Megan: Exactly. Exactly
[00:09:23] Linzy: Which, yeah.
[00:09:25] Megan: I hate what’s happening because therapists deserve better. They work hard. That’s their license on the wall. I am trying to find and understand more and explain more the ways that therapists can outlast these companies instead,as well as the companies only succeed.with therapists. It’s a total moral injury situation where it’s like, okay, I have to pay my bills. So do I work with this company or do I stand on principle? I know that everyone has to decide that for themselves, but as a group collective, there’s a lot more protections, especially if we move our work towards companies that are doing it, quote unquote the right way and away from companies that are determined to just slash and burn and take profit and all that.
[00:10:05] Linzy: Yeah. ’cause like the companies that are doing it the wrong way, who we will certainly not name because we don’t need that in our lives.
[00:10:10] Megan: A lot of litigation dollars too.
[00:10:12] Linzy: So those companies, what do you see are some of the moves that they start to make that hurt therapists? Because at the beginning I’m hearing there’s tons of advertising. There’s like this big, like the party’s over here, like everybody comes here and so they’re also, I’m assuming, going to be maybe treating their therapist a little better at the beginning. It’s a bit of a honeymoon phase, right? Like they’re trying to like, get everybody into the party. How does that sometimes play out, in the life of these companies?
[00:10:35] Megan: So, they start getting some traction as they move through their series. startups have series rounds. Which is funding, and they start with seed, which is just a little bit to get started. In every round you’re supposed to get a valuation to say how much you’re worth. And based on that, the investors will say, okay, well I’ll give you, you know, million, however many dollars for however many shares.
[00:10:59] To prove their valuations, to get those higher, they have to show their profit and loss. So the further they get, the more pressure they are from previous investors and potential future investors to prove that the value is high. So that means that they’re going to start cutting wages or try to increase productivity of their therapist by increasing caseloads and that’s the biggest thing I see. I mean, I heard someone, brag that their therapist had the option to go as low as 25 clients,
[00:11:28] Linzy: Wow.
[00:11:29] Megan: And I was like, I’m not so sure. You should be so proud of that.
[00:11:32] Linzy: Yeah. Yeah, yeah,
[00:11:33] Megan: That’s like, hard stop, almost high end. I mean, I’ve known a few therapists who just do tons and love it and, more powerful to them, but most people I know can’t manage that.
[00:11:41] Linzy: Oh, no, no, no. Yeah, yeah, certainly when I was a therapist, 16 was my max. yeah and that was like, I am done. I am toast.
[00:11:48] Megan: Yeah, it’s totally different they want to play, I think, by the healthcare playbook, but I can go to a cardiologist and the next week I can go to different one and the next one I can go to a different one and they’ll just glance at my chart. They can pick up right where the last person left and therapy is not like that.
[00:12:02] Linzy: No.
[00:12:03] Megan: Your therapist needs to remember and be present and I mean, I always tell people, can you imagine if you told some of your deepest darkest secrets in the next week? They were like. Like, I can’t remember what we talked about or like, can you Yeah.
[00:12:16] Linzy: Yeah, yeah, what you, what you have to hold is huge. I remember a friend of mine,went to a therapist and had a first session and talked about her life and talked about her moms and growing up, you know, having two moms and then the next week she comes back and the therapist was like, so, like, your mom and dad, dah, dah, dah. She was like, what? Like, you didn’t listen to anything I said, and yeah, the vulnerability that our clients bring to us, there’s so much labor that goes into the work that we do outside of that hour. To, hold and retain and process and be able to open up that page again when that client comes back in to do effective therapeutic work.
[00:12:49] Megan: Yeah and not to mention that having stress lowers our ability to carry that.
[00:12:54] Linzy: True story. Okay. So. I’m really curious. This piece about the 80% profit is sticking in my brain ’cause I’m like, what? That’s my initial response. ‘Cause when I think about the work that I do, say with group practice owners,who have practices that are in the hundreds of thousands or maybe low millions,when I’m talking to them about what a sustainable business looks like, I am encouraging them to hit that 10 to 15% profit.
[00:13:18] Right, like just that sustainable, like the oxygen normal I always tell them, if you’re higher than that, something’s going to break, right? Either you’re going to break, you’re underpaid, your team is underpaid, your systems are underdeveloped. You don’t have a big enough admin team. There’s something that’s breaking, is my impression. You know, if you start to be above that, like 15% max, we’re talking about businesses that are aiming for 80% profit. How do they even do that? Like, I’m thinking about the sessions, for instance. Are there therapists getting paid less than 20%? Like, help me understand how these numbers could even possibly work.
[00:13:51] Megan: It’s a question I ask, I, I told an investor once, I was like, I think that some of these founders are just taking you guys
[00:13:57] Linzy: Yeah.
[00:13:58] Megan:Like that’s in these pitch sessions. There’s just no way so there is some logic to it. not great logic, but some of these companies have been able to negotiate higher rates because of system effects, because they’re not having ghost networks, that kind of stuff that, originally insurers were really excited about. And so insurance payers did not want to run afoul of these,parody laws, and they saw these companies as a good way to just in one fell swoop. Let’s just pay higher rates for these companies. They’ll take care of our access issues that are making it hard. At a certain point last year, it seemed like the payers realized that people having access to healthcare meant that people were going to indeed access use healthcare
[00:14:39] Linzy: Yeah.
[00:14:41] Megan: We’re like, wait a second, we actually don’t want to pay for this and so then they started retracting their higher rates,that’s still kind of up there. Some are still getting higher. Some are like losing their higher rates. It’s a market force that is just so unpredictable right now. So that’s one of the ways that they are justifying it. There’s talk about doing outcome-based reimbursements with payers, that kind of stuff, again. I wouldn’t say it’s a complete racket. I would say,occasionally there is a business that I know is just not going to work out and that any therapist with any brains would be able to say it’s not going to work out. There are some companies that I feel like are doing a really great job, and they’re just really trying to run it like shoestring budget for support as much as possible and that’s their angle and if they can make that work, more power to them. I’ve learned that I shouldn’t publicly state a company is good because a week or two later they’ll do something and then people come after me.
[00:15:36] Linzy: Yes. You are not, you are not part of those companies, and therefore you don’t control what they do.
[00:15:40] Megan: There are, there are a few that I have seen consistently try to make good decisions. So, there’s that.
[00:15:45] Linzy: Yeah, because just when I think about even that as a goal. 80% profit. And when you mention payers, just to clarify for folks listening,payers refers to insurance companies, right? So that’s the business phrase for it. I had somebody the other day I was chatting with, he was like, and it’s all about payers. I was like, sorry, what’s payers? He’s like insurance companies. I was like, oh, okay. so there’s this level of business speak that we don’t actually speak as therapists, right? Because we’re on the other side of the business equation. Like in the service delivery. There’s this whole world of the way that money moves between these companies that therapists we are totally disconnected from. and I feel like the term payer is a great example of that, so that’s where the money is, but yeah, ’cause like, I’m just going to stick here for one more second then I promise we’ll move on. If it’s 80% profit, let’s say a payer is compensating, an insurance company is paying, I dunno, $130 for that session, right? For the service that’s rendered, does that mean that the wage that the company is setting for the clinician is less than 20% of that reimbursement?
[00:16:49] Megan: So that stat that I got, it’s from behavioral health business and it’s a quote from an investor who says 60, like that traditional, VC funds look for 80% business margins, but they will occasionally go down to 65%, which still
[00:17:03] Linzy: It’s still crazy, right? Yeah, because it’s just a great illustration there. I think of, first of all, as you say, some of it is a racket like that’s never going to work, but also it’s so disconnected from how healthcare works, right? And how the therapy industry works, where like the heavy lift of that is on the worker, the therapist, right? And we’re not doing work that is light and repeatable and that somebody else can just step in. We’re building therapeutic relationships with people that have to last for years sometimes to have effectiveness, certainly at least months and as we mentioned earlier, you have to remember if somebody has two moms or a mom and a dad, like stuff, like, that’s really important.
[00:17:36] The compensation for that work has to be high. Like we can’t work 40 hours a week. Yeah, we can’t even work 25 hours a week, most of us, without eventually just like, literally dying. That’s how I feel about it when I think about 25 hours a week. I’m like, oh, I could not. And so it kind of feels like they’re trying to cram a square peg in a round hole. Our industry doesn’t fit these rules of these unicorn companies that end up having like a billion dollar valuation. Healthcare is not very profitable and it shouldn’t be.
[00:18:03] Megan: Yeah,
[00:18:04] Linzy: Because it’s not something that you can just copy paste a thousand times, right? Like, it’s not, like you said, like a software that you can make and then sell a hundred thousand times. It’s very specific, every single session is different and individual and catered and takes a huge amount of energy from the therapist. So it just seems like such a mismatch.
[00:18:21] Megan: A mismatch. Yes, it really does. I was talking to someone about this concept and they were explaining that,founders they’re looking for inefficiencies in systems and to solve that problem and in some way that also is profitable and I think what happens is the investors and the founders at times look into the mental health system and they see all these therapists who are working at like community mental health system and this being like wildly underpaid they’re seeing, the dollar signs kind of fly away from that situation. I think the mistake they make is that the therapists themselves do not also see those dollar signs flying away. Therapists are not idiots. They know exactly how much they’re worth, and they are intentionally donating their value to their
[00:19:06] Linzy: Mm-hmm.
[00:19:07] Megan: Like it’s not an inefficiency, it’s an intentional donation, which is why, it always cracks me up when founders are so confused at why therapists are mad. Well, because if someone is getting rich off our work, it better damn well be us.
[00:19:19] Linzy: Yes, right, exactly,and that’s, such an important distinction to make is, you know, folks will choose to work for insurance companies or work in community mental health because they want to be accessible, but they’re choosing to earn less money in order to contribute to their community.
[00:19:34] Megan: Yeah, and to live according to them.
[00:19:35] Linzy: Yeah, but that’s very different from watching some bro in California buy a second yacht off of your work. That doesn’t give you quite the same touchy feely loveliness that you might get from, you know, being able to work pro bono or in community mental health. Interesting. Okay, yes, so as therapists that are maybe already working with some of these companies, considering working with some of these companies. I often see this as a way that people are saying, I just want to get started in my practice. It’s scary to learn how to market and do finances and all these things when I can just plug myself into this platform that already works. If people are considering working with these companies already, how can they be savvy about navigating this landscape?
[00:20:16] Megan: Yeah. I think the most important thing is that therapists need to have their parachute ready.
[00:20:20] Linzy: Yeah.
[00:20:21] Megan: These things changed so quickly. Even the people that wrote the contract that you signed today might not be employed by that company in a few months. Things are going to change. Use the companies to serve your business, but always know that it’s your business and have your backup plan. If you’re going to work with them, identify the skills that are deficient enough that you feel like you have to work with them and be intentional about increasing those skills during your time there. Just be ready to leave and not look back when it becomes clear that they’re no longer setting you and your clients up for success. Your mileage may vary on this piece of advice, but I have recently started telling therapists,when you first start meeting a client, you should have your own website, first of all. When you first start meeting a client,just say, my clients are very important to me. I want you to know if ever there’s a time where I am abruptly gone from this company, that it may not be in my control, and you can reach out to me at my website.
[00:21:12] Linzy: Yes, yes.
[00:21:14] Megan: Because they’ve got weird non-compete agreements and you may not have access to your systems and stuff like that. I’ve heard stories of therapists literally logging on to find that they don’t have access anymore and there’s been an email sent out that says,your therapist is no longer with the company, but here’s three more therapists you can meet with as if they’re just interchangeable so that’s kind of like a safeguard
[00:21:32] Linzy: Right. Just like plant that seed from the beginning
[00:21:34] Megan: Exactly. Like, come find me online. Yes.
[00:21:38] Linzy: And I’m curious, you asked if my morals vary on that. Do you see folks feel like we should have a kind of allegiance to those companies and not tell people how to find us?
[00:21:48] Megan: No, I just,the miles may vary because I don’t want to tell anyone. I don’t know what the contracts say. I don’t want to give any advice that might get someone sued, but I think there’s probably ways to do it in a non
[00:22:02] Linzy: I think so and I think that, that, um, that beautiful, just in case, just so you know, if one day planting that seed,I think is very strategic and I, I love what you’re saying about have your parachute ’cause it makes me think about in the book, Radical Candor, she talks about like kind of two types of employees. There’s rock stars who stick around. They’re very loyal, like they’re there for the long run and then there’s shooting stars who are people who are passing through and what I’m hearing is you should always be a shooting star when you’re using these services. Like be part of that platform, because as you say, you’re like, okay, marketing is really hard for me.
[00:22:32] I need to hit the ground running, so I’m going to work for this, but then I’m also going to work on my marketing skills. It’s not actually a stable environment where you know that you can stay even if you want to. Let this be your pathway towards private practice to support you on that journey, but don’t, don’t plan to live there because what I’m hearing is like the furniture might get rearranged and there might be things totally changed overnight. You don’t have control over that business at all.
[00:22:53] Megan: Yeah, and often even the founders don’t. They might start with great intentions, but once investors get involved, there’s a board and you have to abide by the decisions of the board.
[00:23:02] Linzy: I’m thinking about that um, who was that AI guy, who got fired suddenly and then I think they brought him back. Yeah, yeah, yeah, yeah, it’s like, it can even be like your brainchild but once you get investors involved, they’re like, I don’t know. I think we need new leadership. Like, yeah,these are such fickle creatures.
[00:23:16] Megan: They bring in their tech bro playbook, which I’m sure worked really great if you were building tech, but mental health is another beast.
[00:23:24] Linzy: So for folks who then,already have a practice or know, like, okay, I’m working with these platforms now, but yes, I do want to get into my own practice. How can we protect our businesses and our practices against this larger force at play, right? Where there is like super cheap therapy available online. So conveniently, like, we have a lot of marketing to compete with, if nothing else. What can we do to protect our practices from this?
[00:23:48] Megan: I think that’s a good question.
[00:23:50] Linzy: So I started a Facebook group. It’s called Fit Check for Therapists. It’s not a burn-the-system-to-the-ground place, even though some people want it to be. It’s a “share information so that we can be wise about the companies that we work for” place.
[00:24:05] Megan: So if you have a question about a company you’re interviewing with or you have information you want to share, you can hop on there. Hopefully I can keep that running as long as possible. I think doing your research asking good questions is good because strategically we need to outlast companies that don’t have our best interests in mind. So continuing to move towards companies that only make decisions that we agree with, who only make concessions that we can understand. And for the sake of clients or for the sake of sustainability. Not for the sake of profit.
[00:24:38] Linzy: If you’re going to be with these companies, be savvy, think about: what is the model here?
[00:24:43] Megan: Yes, some companies, there’s two companies in the middle that I talked about that work for you and you work for them and one of them charges Mm-hmm. And a lot of people are like, well, I go to the one that doesn’t charge because why would I pay for it? But one of the things I think is important to remember is that if you are not paying, then you’re not a customer. And it’s easier for a company to communicate, keeping you happy to investors if you are a customer. So there’s a value in paying a company,because it means that part of the business model is keeping you happy and around and not just extracting as much value as possible.
[00:25:16] Linzy: Well, and it makes me think too about the phrase about social media, where it’s like, if you’re not paying, then like you are the product.
[00:25:21] Megan: Yes,
[00:25:22] Linzy: If it’s free, then how are they making money from you if you’re not paying to be part of it?
[00:25:27] Megan: Exactly.
[00:25:28] Linzy: Yeah. It’s those hidden costs. In terms of, you know, folks who are outside of those systems who are like running a private practice and,having to compete, like what do you suggest about how therapists we should be thinking about this issue? Like, should we be talking to each other? what do we do here? When I feel like it’s like we’re on the playground and there’s some really big tech bro bullies who come on the playground. And we’re like, Who’s that? They’re so mean. I don’t even know all the words for all the ways that they’re mean. All this language that we don’t even think about. ’cause we don’t think about maximizing profit. We think about taking care of people, right? What can we do to kind of protect our industry, protect ourselves?
[00:26:02] Megan: Yeah. I’m trying not to be defeatist. I’m not saying it’s all going down. I just wonder if we’ve gotta break the system before it will all be fixed.
[00:26:08] Linzy: Mm-hmm.
[00:26:10] Megan: I was very much all for like, taking insurance, that kind of stuff. The more I see how much of a problem payers are in the system, the more I’m like, why should their business success be built on the backs of our vague sense of guilt around access? I am more and more on: go private pay if once you’ve got the pipeline of referrals and intentionally reserve two or three, either sliding scale or pro bono slots, that’s the game plan. I know that access is going to go down because of that, but hopefully that will put pressure on the system enough that they’re going to have to increase reimbursements, right?
[00:26:45] Linzy: Right, I’ve talked about this with therapists over the years, and eventually I’ve kind of come to the phrase of like, you can’t break yourself to fix the system because when we break ourselves, we’re not even fixing the system. In fact, like if you are working for, for example, an insurance company directly or through one of these platforms and you’re underpaid and exhausted, they’re profiting off of you. There is profit, it’s just you’re not seeing the profit. Like there is money that is being made,but it’s not being made by you. and so that actually is just upholding a system where people have figured out how to make money off of healthcare without paying healthcare workers well, and we’re actually just participating in that system.
[00:27:17] When folks come into money skills therapists, sometimes I think people are scared that I’m going to tell them, you have to go off insurance and you don’t. Because I believe that every private practice has its own equation of how to make the money work and for some folks. They can offer a blend of insurance or private pay, or they can offer all insurance because their mortgage is paid. They live in a low-cost area. There are so many scenarios where insurance can be part of a healthy picture, but for many folks it isn’t and when we’re sacrificing ourselves, we’re not actually changing the system at all. We are just upholding the system as it currently exists.
[00:27:50] Megan: Yeah, there’s a lot of places that have low paid at the bottom, service workers, like I think about like fast food, and I don’t think that they should be paid super low either, but in those situations, the company is providing the product but therapists show up fully equipped with everything they need to do therapy. The company is not providing anything other than occasionally like administrative assistance and occasionally a client pipeline.
[00:28:12] Linzy: Right? Yes.
[00:28:13] Megan: So just maintain that sense of self-assurance in your license and that you’re providing the product that this company is selling, so making sure that they are reimbursing.
[00:28:24] Linzy: You are the value. If you weren’t there, they don’t have anything without you really connecting with that power that you have.
[00:28:30] Megan: Yes,
[00:28:30] Linzy: Yeah. That’s a great point to end on. Thank you. Thank you so much, Megan. This has been so informative. If folks are interested in getting further into your world and what you do, tell us again about the Facebook group and where else they can find you.
[00:28:43] Megan: Well, you can find me on LinkedIn, Megan Cornish. I also have a Facebook group. Let me just double check that link is front and center so that anyone who’s looking to join the Facebook group can just click on it and get
[00:28:52] Linzy: Perfect. Okay, wonderful. So yeah, you can check out The Fit Check For Therapists Facebook group where you can just get information. This is the closest that we can maybe get to unionizing at this moment. Which is at least openly talking about what you’re getting compensated for: where is it good to work, where isn’t it? Thank you so much, Megan, for doing this work and for bringing this information to therapists. ’cause this is not what we live and breathe. So it’s nice to have this information to understand kind of how folks are thinking about us outside of our space. Thank you so much.
[00:29:20] Megan: Cool. Thank you for having me.
[00:29:31] Linzy: This conversation with Megan has my wheels turning in multiple ways, but one of the things that I think about is how I often talk with therapists about how we end up reluctantly becoming business owners. Rarely do therapists go into private practice or health practitioners go into private practice because we wanted to own a business and we have an MBA, and we love business. We tend to go into a private practice because we want to serve our clients and we want to do it our way, right? And so we accidentally become business owners and the work that I do with therapists is helping us with that. Foundational financial literacy that’s what we do in my skills for therapists. Really just understanding how business finances work, working on your own relationship with money, getting your really like your feet under you. And then with the group practice course, I help folks with that financial leadership of what do strategic decisions around money look like, but all of these pieces are actually, I would say almost like a drop in the bucket compared to the kind of business knowledge and savvy and expertise that these massive companies are bringing into our space, right?
[00:30:28] Like they are operating on a very different set of rules and even a different set of ethics than we are when it comes to business and. therapists becoming educated and clear on money and how it works and our value and the value of our work, and doing the things that we can do, as Megan said, to make sure that we have our parachutes, that if you are working for a large company, that might change on a whim, that you have your private practice ready to go, that you’re working on those skills that you know are a deficit area for you.
[00:31:01] We need to do these things to be able to preserve ourselves in this landscape, right? Like we have. It feels like there’s some kind of big kids who come on the playground. They’re playing by a different playbook than we are. and we need to make sure that we have the financial literacy and the clarity about our own values and skills to hold our ground and make decisions that are good for us, and make decisions that, as Megan said, might shake up the system. By refusing to be exploited by these large companies, which include insurance companies too, that make money off of us, and hold our ground and, learn enough about business, become competent enough with business that we don’t end up basically serving these large companies at our own detriment.’Cause whenever therapists are not doing well, whenever we are tired or depleted, that is also translating into our work with our clients, right? We are not showing up as our best selves. We are not able to be fully present. We are not able to be our most creative and responsive and dynamic, when we are exhausted and tired and stressed about money.
[00:31:59] And so there’s just so many ripple effects that come from us being plugged into these larger systems that don’t care about us, but certainly. A huge part of the answer is that we need to develop the literacy and the confidence to be able to run our own businesses successfully so we don’t get swallowed up by these larger systems. And so that if we are choosing to participate in these systems, we’re doing so because we’re clear that this is actually sustainable for us and our family can be okay and our own financial health will be okay even if we’re working with some of these systems that don’t compensate us well and we’ve made a conscious decision that it’s worth it.
[00:32:29] So many pieces here. I so appreciate Megan coming and bringing this knowledge to us today and certainly check out her Facebook group. If you want to be part of conversations about where are the better places to work, what is happening in these different companies and in this industry and check her out on LinkedIn to get into her world. So thanks to Megan for coming on the podcast today. If you are enjoying the podcast, you are welcome to leave me a review. We have a beautiful link in the show notes that will take you to whatever platform makes sense for you to leave a review.
[00:32:58] That’s a really helpful way for folks to find us, whether you just want to leave a star rating or share what you appreciate about the podcast, that’s always a really lovely thing. A lovely way for you to support the podcast and if you are interested in working with me. The way to do that is through my two courses, either money skills for therapists for solo practitioners, or money skills for group practice owners, and we will put the link in the show notes, for how to get into both of those worlds. I would be happy to support you in having your business finances actually work for you and getting that grounding and financial confidence so that you can be well and you’re financially taken care of and somebody else is un-profiting off of you. So thank you so much for joining me today.
