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Building a Group Practice That Reflects Your Values Coaching Session

Episode Image Building a Group Practice That Reflects Your Values Coaching Session

“Is it possible to have a sustainable group practice that is also value-aligned in terms of being anti-oppression oriented? It’s just challenging to strike that balance.”

~Leah Cohen

Meet Leah Cohen

Leah Cohen, LCSW (they/them) is a psychotherapist and the owner of Kindred Therapy LLC, a private therapy practice serving queer, gender expansive, and neurodivergent clients through an anti-oppressive, trauma-focused lens. Leah supports people who feel constantly overwhelmed and “different” to embrace their innate strengths and adapt life to fit their needs; instead of trying to mold themselves around their environment. 

You can connect with Leah on Instagram @kindredtherapyllc or at https://www.kindredtherapyllc.com.

In This Episode…

How do you manage the numbers when starting a group practice? In this practical coaching session, Linzy and Leah dig into real numbers for a new group practice to figure out how to make the finances work for both the group practice owner as well as the clinicians within the practice. They also explore the importance of aligning with your values as a business owner and providing benefits to employed clinicians. 

Listen in to hear how to think about everything that goes into establishing and running a successful group practice and how the developmental stages of business impact the decisions we make. Don’t miss these concrete tips if you’re looking to expand your practice. 

Want more support with your private practice finances?

Want to work with Linzy? Check out her masterclass, The 4 Step Framework to Getting Your Business Finances Totally in Order, where you’ll learn the framework that has helped hundreds of therapists go from money confusion and shame to calm and confidence, as well as the three biggest financial mistakes that therapists make. At the end, you’ll be invited to join Money Skills for Therapists and get Linzy’s support in getting your finances finally working for you. Click here to find a masterclass time that works for you!

Episode Transcript

Leah [00:00:04] But is it possible to have a sustainable group practice that is also value-aligned in terms of like being antioppression-oriented and it’s just challenging to to strike that balance. 

 

Linzy [00:00:28] Welcome to the Money Skills For Therapists 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. Hello and welcome back to the podcast. So today’s episode is a coaching episode with a current student in the course – they’re about halfway through Money Skills For Therapists – Leah Cohen. Leah is a psychotherapist, they’re the owner of Kindred Therapy, which is a private practice therapy that serves queer, gender expansive, and neurodivergent clients. Today, Leah and I really got into this kind of ethical dilemma that I think so many therapists feel when they want to be really good group practice owners of How do you balance taking care of your therapists who are working with you and running a healthy, sustainable group practice? I know this is something that so many of us struggle with because therapists tend to be caring people and we usually don’t want to be exploiting other people. The best group practice owners don’t want to exploit other people, I should say. We think about other people’s experiences. Sometimes we overly think about what’s happening for other people, maybe try to do a little bit of mind reading and it can be really nerve wracking when you’re starting a private practice and you’re trying to set it up well, make sure that your folks are paid well, make sure that you’re taking care of them in the way that you want to, but also needing to make sure that you’re not driving your business into the ground and you’re not setting things up in a way that is unsustainable and will mean that you go out of business and can’t serve anybody. So Leah and I get into their numbers today, but more importantly, we get into their values and the ways that they can be supporting their first employee that also go beyond how much they are paying that employee. Here is my coaching session with Leah Cohen. Leah, welcome to the podcast. 

 

Leah [00:02:44] Thank you. 

 

Linzy [00:02:45] So, Leah, you are a student in Money Skills For Therapists. Are you still with us now or have you finished up? 

 

Leah [00:02:51] I am. I’m still in the middle of it. 

 

Linzy [00:02:52] Yes, in the middle. Okay. So that’s where you’re at in terms of course content. And with our time together today, what do you want to dig into during this coaching session? 

 

Leah [00:03:03] Well, I think that the most pertinent issue that’s been coming up lately in the practice is the fact that I just hired a, well, my first clinician. As if money wasn’t complicated enough when it was just me. Now I’m adding to the picture. Somebody else who’s an employee and trying to reconfigure some of the financial piece to support other therapists. 

 

Linzy [00:03:33] Yeah. Okay. 

 

Leah [00:03:33] And wanted to just get your thoughts on that. And if you have worked with other people who’ve made that transition from solo to group. 

 

Linzy [00:03:41] Oh, absolutely. Yes. Yes. Okay. So this is your first hire. And how long is this person been working with you now? 

 

Leah [00:03:47] Really not very long. Like their first day was June 20th, so that’s a couple of weeks. 

 

Linzy [00:03:55] Okay. Well, yeah. Really fresh. Okay. Yeah. So tell me, you know, with bringing somebody else into the practice, what do you notice coming up in terms of financial questions or feelings? Thoughts? What’s going on? 

 

Leah [00:04:07] Sure. Well, I can imagine that other therapists that have joined your course did so because there’s this avoidance that you talk about. Right. With regard to like looking at the numbers, sitting down with making those plans. And I’m not immune to that. I think early on in my practice, I was a lot more on top of it. Had some of those routines in place already that you talk about in the course that sort of like fell to the prioritization of everyday life. But now that it’s not just me, I really want to almost reestablish some of those habits. And the big question that’s been coming up for me is- so in doing some other work around money mindset, I raised my fee about three months ago and the question of fee setting has been challenging in general, more specifically because – I think it is for all of us – but I see, you know, like I sort of specialize in a very particular population. So I support mostly queer and gender expansive and bipoc individuals who are healing from trauma and who are often neurodivergent or highly sensitive. So given sort of a lot of the multiple marginalizations that I see coming through my office, fee setting is complicated, you know, wanting to make sure that I’m making enough to support myself and that this question of accessibility is still like within reach, which is really just a challenge that I’m grappling with every day, but now with like additional expenses of being a group, I’m concerned about like how to make sure that I’m not hemorrhaging money, I guess is like a big concern. 

 

Linzy [00:06:05] Right. Yeah. How do you have a group that’s sustainable? 

 

Leah [00:06:07] Right. 

 

Linzy [00:06:08] Also honoring your values and the folks that you serve and thinking about accessibility. Yeah, those are a lot of things to try to balance. 

 

Leah [00:06:15] And is it possible I mean, I’m sure that it is, but is it possible to have a sustainable group practice that is also value-aligned in terms of like being antioppression-oriented and it’s just challenging to to strike that balance. 

 

Linzy [00:06:34] Yeah, absolutely. And with your own fee, and the decision you made about your own fee, tell me, first of all, what fee did you end up setting for yourself when you did that fee increase? 

 

Leah [00:06:44] I set a full fee of 200. And it’s probably on the higher end of what’s available in my area. You know, we’re always sort of talking about location, but I am EMDR trained and you know, I’m a multiply marginalized therapist myself. 

 

Linzy [00:07:05] Yes. That’s right.

 

Leah [00:07:06] And so I figured that that was a good decision. You know, I do have a like a reduced fee program. So most people are not paying that full fee, but setting it there felt good. 

 

Linzy [00:07:20] Yes. And financially, what have you noticed the impact has been for you of having that higher fee as kind of the full fee that you have? 

 

Leah [00:07:27] Well, it’s so it initially had an impact where, you know, I kind of immediately increased my revenue. But that lasted maybe one or two months before I decided I actually needed to reduce my caseload to be able to do some of the more administrative things. 

 

Linzy [00:07:49] Like running a group. 

 

Leah [00:07:50] Yeah. And so I have been sort of slowly, not super intentionally, but slowly reducing. And so I won’t say that there’s been like a financial benefit from specifically that fee raise because I then like reduced the number, right? Yes. 

 

Linzy [00:08:10] But I’m curious if you had not done that fee raise and you did those reductions, would you still be in the same place financially or would you be making more than you are now? 

 

Leah [00:08:18] Oh, I’m sure that I’m making more than I would. 

 

Linzy [00:08:20] So although you’re not like- it’s not like a huge abundance that’s come upon you because you have decreased. It’s still had a financial impact for you. Yeah. So with your clinician who’s come in, what have you done so far in terms of the numbers that you’ve set with them? 

 

Leah [00:08:34] We had a lot of preliminary conversations about setting fees and about how they were going to structure, like balancing their caseload of people who they would see with reduced fees versus full fee. They did not feel comfortable with a $200 full fee, even though I think that they could definitely have that fee and justify it. It just wasn’t comfortable, being somebody who was coming straight from community mental health, which I can sort of understand. You know. They have a full fee of 150, which I feel fine about, particularly because we’re trying to fill them versus me. 

 

Linzy [00:09:18] Sure. Yes. That is strategic, you know, to have them at a lower fee than you. So their full fee is 150 and yours is 200. Okay. So, I mean, with these numbers, what have you noticed so far in terms of how well these numbers are working? Like, first of all, how much is your clinician making? Are they making a livable income? No. Okay. 

 

Leah [00:09:40] And I mean, they’ve been with me for only a few weeks. 

 

Linzy [00:09:43] Yeah, that’s true. Yes. 

 

Leah [00:09:45] I think I anticipated that they would have more of a caseload waiting for them than actually, like, ended up being the case. 

 

Linzy [00:09:56] So they’re taking a while to fill up, which is normal. That usually takes a little while to fill a caseload. So have you done the math here to see, based on the split that they have with you and their fees, the way things are kind of falling for them so far, what they will be able to make once they’re working full time. 

 

Leah [00:10:14] Yeah. So if they were seeing the full time caseload then they would make… I have a spreadsheet for this. 

 

Linzy [00:10:24] That’s one of my favorite sentences. 

 

Leah [00:10:28] Essentially, like, let’s say 20 sessions. Times 50. Times 4. 

 

Linzy [00:10:35] Because they get paid $50 a session. 

 

Leah [00:10:37] They’ll be $50 a session. Yeah.

 

Linzy [00:10:39] Yep. Okay, so let’s just do that math. Yeah. So that’ll be $4,000 is what they. So $4,000. 

 

Leah [00:10:46] Gross. Yeah. 

 

Linzy [00:10:47] So 4000 gross. And then are they like a W-2, like an employee with you? 

 

Leah [00:10:52] They’re an employee, yeah. 

 

Linzy [00:10:53] Yeah. Okay. So there’ll be some taxes taken off of that, and you’ll also be paying some taxes on their behalf as the employer. So 4000. So that would make their kind of salary like if you were, you know, a company offering a salary. 

 

Leah [00:11:06] 48, right, is what it comes out to?

 

Linzy [00:11:06] That’s right. 48,000. 

 

Leah [00:11:08] And I think it’s probably with taxes like more like 45. 

 

Linzy [00:11:12] Yeah, I would expect it to be actually less than that. Yeah. Yeah. Like generally income taxes, I mean, a safe number to assume is like 30%. That’s high. Most people I see pay somewhere around like 20-25%. So but 30 is kind of like that safe number. But let’s just say 25 and let’s say 20 because 48,000 is not a high tax bracket. So times point eight. So about 38,000 is what they would take home. If we divide that by 12, that’s a cash paycheck of about 3200 a month. 

 

Leah [00:11:43] Yeah. See, I don’t feel good about those numbers. 

 

Linzy [00:11:45] Yes. That’s important. 

 

Leah [00:11:46] And I think that is what I’m struggling with. 

 

Linzy [00:11:48] Yes. Okay. Okay. 

 

Leah [00:11:50] I really don’t feel good about those numbers. 

 

Linzy [00:11:52] So your gut reaction is not a good one. 

 

Leah [00:11:54] That’s not good enough. Yeah. 

 

Linzy [00:11:56] Yeah. Okay. Okay. So that’s important, right? Because that’s a- probably that’s a values feedback from your system of like, no, that’s not what I’m going for. 

 

Leah [00:12:06] There’s a part that’s like, Uhhhh What? 

 

Linzy [00:12:08] Yes. Okay. 

 

Leah [00:12:09] So I knew these numbers when I was setting the fee. I did sit down with an accountant to do this. And we had established this flat rate specifically because they wanted a flat fee. So we sort of negotiated that. Yeah, because the sort of stability of that felt better to them. But we talked about it as being something like with the potential to grow. 

 

Linzy [00:12:33] Right. And that $50 a session that they’re getting paid, they get paid that do they get paid that for full fee sessions and insurance sessions or how does that work in your practice? 

 

Leah [00:12:43] We’re currently not in network with insurance. We’re in the process of credentialing with one insurance company. Currently it’s a flat fee for- depending on where the- it’s this weird hybrid pay model that I- that we sort of came up with together, frankly, because it’s my first employee and we’re colleagues. We’ve known each other for several years, but so we just decided on a flat fee for sessions that where they were charging $100 and up and anything that they wanted to do on a slide lower than 100, that we would do a fee split for those. It was sort of a way of compromising, whereas I wanted them to do less sliding scale. They wanted to do more. 

 

Linzy [00:13:29] I see. Okay. So if they do more sliding scale, they can do so, but. 

 

Leah [00:13:32] They can do it. But it’s a 50- 

 

Linzy [00:13:34] Yeah. That will impact their split. 

 

Leah [00:13:36] Yeah. It would be a 50% split for anything under 100. 

 

Linzy [00:13:41] Okay. Okay. Okay. Interesting.

 

Leah [00:13:42] And then anything above that it’s like- 

 

Linzy [00:13:44] I can see totally see the wisdom of that. 

 

Leah [00:13:46] Does that make sense? Does it? 

 

Linzy [00:13:48] Absolutely does, yeah. Okay, great. 100. And so the number that you gave me then is that assuming that they’re doing 20 kind of like non sliding scale sessions that are above 100 sessions. So they may also be doing some below 100 slides depending on their clients. 

 

Leah [00:14:05] Yeah. And I would imagine it would be not that much lower than 100, maybe 85. 

 

Linzy [00:14:11] Okay. So, yeah, so they could be getting paid less than that 48,000, depending on how they’re choosing to manage their fee. Okay. Tell me that sigh that just came out. What was that? 

 

Leah [00:14:20] There’s definitely parts that come up that are like, this is not what you wanted. 

 

Linzy [00:14:25] Yes. 

 

Leah [00:14:26] From being an employer. Yes. And there’s definitely this huge like polarization between the part of me that feels really crappy about that number. And then the part of me that, like, sees the reality of what I’ve been able to do so far and what the expenses look like and everything like that. And it’s just. 

 

Linzy [00:14:52] Yes, because this is, you know, the kind of this puzzle of trying- in some ways, you’re trying to do it all. Like, how do you do as much as you can? How do you be a good employer? Right. And take care of a clinician who I’m assuming is within the folks that you serve, who’s also a queer, gender expansive, bipoc person. So you don’t want to be exploiting somebody. They’re supporting folks who, through marginalization, are not going to be earning as much as folks who are privileged and favored by the system. And at the same time, you have to be covering business expenses and making sure that you have a sustainable practice. 

 

Leah [00:15:27] And one of the reasons why we said, you know, that I decided to set the fee at where it is, is because something that was important to me as an employer was to have the potential for employees to get health insurance through my practice, which is typically a benefit that people do much later, but that I did first. 

 

Linzy [00:15:52] Okay. Right. So does your employee have health benefits? 

 

Leah [00:15:56] Yeah. I mean, the applications processing. Yes. 

 

Linzy [00:15:58] Okay. But that’s under in the works. Okay. Yeah, because that’s something else to think about as you think about your values on building a practice that is like, yes, this is why I’m doing this is what are the other nonfinancial benefits that folks are getting or that you’re providing that make it a good place to work and that in some ways might be more valuable to folks than earning, you know, $500 more a month. Right. I’m hearing one of those things is health- 

 

Leah [00:16:22] People don’t generally join group practices to make the most money that they can. Right? It’s sort of, you know, well-known that you can make- do you want to make the most money you can that means solo is probably the best way to go. 

 

Linzy [00:16:36] For sure. That’s the most lucrative path because you’re not sharing the money with anybody else. Yes. Okay. So what I’m hearing then is your clinician didn’t join you to make as much money as they possibly could. 

 

Leah [00:16:46] They join the group practice intentionally. We talked about the differences. 

 

Linzy [00:16:50] Yes. Okay. Yeah. Yeah. And why did they join the group practice? What was their actual motivator. 

 

Leah [00:16:55] For the stability, for being able to like share responsibility, I think, or not have as much responsibility for like aspects like administrative tasks and all of the sort of back end stuff that I do. 

 

Linzy [00:17:14] So you’re creating that, that structure that they can plug themselves into. They don’t want to be kind of running the more business-y admin parts. 

 

Leah [00:17:20] Right. They’re not really like interested in business so they’re able to just be a clinician and that’s what they really want to do.

 

Linzy [00:17:29] Okay. And you’re providing health benefits. Is that something that was important to them or is that more something it’s important to you? 

 

Leah [00:17:36] It was something that was really important to them. 

 

Linzy [00:17:37] Okay. Okay. 

 

Leah [00:17:39] And it is to me, too. I mean. 

 

Linzy [00:17:41] So they’re getting the support of the structure. They’re getting health benefits. What else are they getting by being part of your group practice? 

 

Leah [00:17:47] So reimbursement for like certain licensing fees, like application fees and some reimbursement for CEUs. There is also a paid earned sick time. 

 

Linzy [00:18:03] Mm hmm. Okay. Okay. 

 

Leah [00:18:05] Because New Jersey actually has some regulations around that and Pennsylvania doesn’t. But because we’re a two-state practice, I just sort of made everything across the board. 

 

Linzy [00:18:14] Okay. Yes. So I’m hearing that there are lots of what would have some financial benefits, like paid sick time is a financial benefit and health insurance is a benefit that if you weren’t paying for it, they may eventually pay for their own out of pocket, that are coming along with this $48,000 salary. When you notice that, what does that do for your feeling about the number? 

 

Leah [00:18:36] Well, it’s why I was able to get here, number one, because we’re talking about one person. I’ve talked to them in depth about what’s important to them. Right. And so I feel confident that the things that I’m offering are the things that they have said. This is what I’m looking for in a job. 

 

Linzy [00:18:53] Okay. Okay. 

 

Leah [00:18:54] And also, big picture wise, I think that people come to group practices. I created a group because I wanted to be supportive. So I want clinicians to be able to focus on clinical work if that’s what they want to do in an environment that isn’t exploiting them and you know, like not providing any amount of security. 

 

Linzy [00:19:23] And it sounds like you are doing that. 

 

Leah [00:19:26] Hopefully. I mean, I. I think so. 

 

Linzy [00:19:29] Yeah. Yeah. 

 

Leah [00:19:31] So I fear, I guess, is that I will over commit. 

 

Linzy [00:19:35] Mm hmm. Yes. 

 

Leah [00:19:36] And then it won’t be very stable because then it won’t be sustainable. 

 

Linzy [00:19:40] Yes. And so this would be the next piece of it. Right. Is starting to understand your practice numbers, not just in terms of the fee, like your clinician’s fee, that they’re getting paid for the work, you know, which is one equation. But the cost of the benefits, assuming like let’s say they did take all their sick time. You know, what would that cost your practice on a monthly basis since they’re going to be paid for that time? Do you have that information anywhere yet, Leah, where you can see the full cost of running your practice? 

 

Leah [00:20:06] I do. 

 

Linzy [00:20:07] Okay. 

 

Leah [00:20:08] So the employer. Yes. Do you want those numbers is not what you’re. 

 

Linzy [00:20:12] Yeah. What is the total per month. If you could give me an overall number. 

 

Leah [00:20:17] And so the sort of like cost per clinician between expenses and benefits is- not including like salary. 

 

Linzy [00:20:28] Okay. Yep. 

 

Leah [00:20:30] Is  969.50. 

 

Linzy [00:20:35] 969.50. Okay. Yeah. And that includes assuming that they’re taking sick time. 

 

Leah [00:20:39] So I think I included like one sick day per month because of the way that the hours accrue. 

 

Linzy [00:20:47] First of all, it’s great that you have these numbers and I’m hearing you sat with an accountant, you know, to to set the fee. And that shows. Right. Because this is actually really concrete information that you can work with to see not just what happens with this clinician, but what happens when you add a couple of conditions, right. Like what that would do and I don’t know what your your plan is. Do you want to grow a group practice that’s a certain size? You want to stay small? What’s your vision? 

 

Leah [00:21:12] I would like to bring on a few more therapists. And my vision, I suppose, is to become whatever size I need to become to be so that it’s like a mutually beneficial arrangement for everyone. And I don’t know what that is right now because I think there is more control of the numbers than I could do there. Right. Sort of what you’re getting at. Like I won’t say that I’m, like, looking to expand greatly. But I would like to bring on a few more people once I have, I guess, like some of these things more in place. 

 

Linzy [00:21:49] Yeah. Yeah. I mean, I wonder if, like, that you’re being very thoughtful and strategic about this. That’s what I’m hearing is like a lot of, like, thought in terms of like, you know, thoughtfulness about your values and who you want to be as an employer and the environment that you want to create. But also thinking about your numbers and like what is sustainable and what will build a practice that can last and keep employing, you know, other clinicians and yourself and like serving your folks. I can really hear that in the way that you’re talking about this. 

 

Leah [00:22:19] Appreciate it. 

 

Linzy [00:22:19] And, you know, thinking about kind of where you’re going, I would say, you know, you probably could run those numbers for a little bit. There’s always going to be the growth and costs that come. But one way you could think about that is like, you know, your cost per clinician and then figuring out your operating expense cost of like what are those other costs that go with running a practice? And then especially if you’re an online practice and there’s not rent involved, which rent is like a big stepping expense where you’re like, I was paying for one office and it was 1400 and now we’re paying 2800 because we’ve got a second office. Those are big steps. But often online practices have like kind of simpler expenses where it’s like you just add another person to your simple practice or you add another Zoom subscription. They tend to be smaller. And so something that you could play with as you’re thinking about numbers and kind of where would the numbers start to shift and changes. Running these numbers forward and assuming that your operating expenses will kind of like grow proportionately with the folks that you hire unless there are any big step up expenses. And then just start to be curious of like where does there get to be a point where there’s kind of extra money left over after operating expenses and after you cover staff based on them working a certain caseload? Because, as you say, like profitable practices become more profitable as they get bigger. And that’s where you have kind of the ability to be an even better employer because they’re just you’re generating more resources among you that then can be shared between your staff. Right. And there’s kind of like an equation there. And it’s figuring out based on how you set it, you know, what that number is. But, you know, going back to where we started in terms of like setting your fee and what you’re paying your clinician, what are you noticing now that we’ve talked about it and talked about kind of those other pieces of what you’re you’re providing as an employer and as a culture in the work that you’re creating, like the workplace you’re creating. 

 

Leah [00:24:05] I think that one thing that as I really examine some of this money values and barriers like mental blocks to certain things, I think about how I am just one of those people who feels like it’s never enough. And I don’t think that I’m alone in that. As a therapist, there’s I’m like, We’re not doing enough. We’re not helping enough people. We’re not. And I don’t want to perpetuate that mindset. Like, part of why I became a group practice owner was because I wanted an environment where therapists, like, didn’t have to be steeped in, you know, Be as productive as possible and do as much as you can for other people. And just this like continued narrative around us being essentially like public servants or almost like- I had a coach who once referred to it as like we treat our profession like we’re monks, almost like in a monastery, that are having all their expenses paid for, that are having their meals and lodging taken care of so they can focus on their work.

 

Linzy [00:25:18] Doing good, right? Yes. 

 

Leah [00:25:20] That’s not the reality that we live in. Certainly not. So whenever I sort of hear like parts come up, or stories come up around not doing enough. First of all, I usually have to say to myself, like, okay, it’s one step at a time. And I think that’s the the hardest thing for me is to start at one and to start, okay, what can I do for this one person? And then to think, okay, more resources means I can offer more. And it’s just that ability to hold myself back, which has just always been an issue. 

 

Linzy [00:25:59] Yes. Right. Yes. Yes. And also, as you progress through the course, through Money Skills For Therapists, and you get into module five and get into profit first or creating those separate accounts, you’re also going to start to see over the course of your practice in the next few months what the money’s doing, how much money is building up, is there extra that’s building up, is there room to pay your clinician a little bit more, or is there room to offer a different kind of benefit that you can’t offer right now but that, you know, like your next benefit on the list, you’re going to see how the numbers shake out as they shake out. Right. But right now, also, you have such like a a baby private practice. 

 

Leah [00:26:33] I know it’s such a baby. 

 

Linzy [00:26:34] We can’t ask too much of a baby. You know, like the baby’s still, like, crawling along, trying to figure out how to stand up. You know? And so as your numbers start to solidify, you’re also going to get a lot of feedback as to how the system. It’s kind of like in a way I think about it when we build a business or building a machine in some ways. You’re setting up, okay, when this happens, this gets divided like this, the money goes here, you’re going to see how your machine starts to work as your clinician starts to fill up and find their folks and, you know, see people regularly and you’re seeing folks and there’s money flowing into the business and it’s flowing out. You’re going to start to see basically how well it’s working and where there’s room to add things or where there’s room or where there’s requirement to be like, okay, we actually have to hold back on this thing that I wanted to do for a while, or we actually do need to bring on another clinician because that’ll change our numbers in the following way, which will get us closer to where we want to be. 

 

Leah [00:27:24] It’s a good reminder that having to change things as you go along isn’t that it doesn’t mean you did something wrong. 

 

Linzy [00:27:31] No, no, no, no, no. Absolutely not. And I think especially when you’re building, when you’re building something that’s bigger than just you and you’re bringing in other people and you’re figuring out how to work with those folks. Like I certainly know in my business, it’s not a group practice, but you know, like things like H.R. policies, like, you know, benefits, all these things have kind of evolved as we’ve gone along and we’re like, Oh, we’re like kind of standing up and working now. Maybe we can think about official policies around these things that maybe informally we’ve done some things, but you start to grow up right, like businesses do grow up. And it does make me think about this thing that Joe Sanok said when he was on this podcast, just to counter this maybe a little, like, don’t call your business your baby, because sometimes you have to like kill your business and you don’t wanna feel like you’re killing your baby. So we don’t want to be too precious about our businesses, but at the same time, they do go through developmental stages. 

 

Leah [00:28:20] Developmental stages. I’m getting that point there. 

 

Linzy [00:28:21] Yeah. So it’s just being in the stage that you’re in and thinking about what are your values at the next level, the next developmental stage. Because when we first start, we can’t give somebody an amazing salary and health benefits and all the vacation time. And like all of these things that we want to do when we want to be good employers, the money’s just not there. But it’s thinking, being really aligned with yourself. And I think you already are. And clear on what’s next. You know, as the business grows, what are the next things you want to be offering? Maybe it is a raise, maybe it’s a different type of benefits. Maybe it’s some other kind of beautiful thing you’re going to bring in. Like I don’t even know, as some one of my coaches said the other day, like giving people like a book fund where it’s just like every month, like-. 

 

Leah [00:29:03] Oh! I love that! 

 

Linzy [00:29:04] -and it’s like but it’s like, yeah, finding those things that light you up and that are going to light up the folks that work with you. Because for some folks, those things are more valuable than money. People who really want to earn a lot will either go into private practice right away or they’ll get there as soon as they can because, you know, maybe they have to be. Maybe they’re a breadwinner or maybe they live in a very expensive place. 

 

Leah [00:29:22] I’m sure there’s many reasons. 

 

Linzy [00:29:24] So many reasons. But folks who are more interested in being part of a community and having supports and having like support both like interpersonally and business support, they’re often looking for other kinds of benefits that are not just a salary. 

 

Leah [00:29:38] Sure. Because also the salary in some ways stays pretty stable around the same kind of setting. Right. You have group practices. There’s a range, sure. But it’s it’s not anything like it’s not like another practice. 

 

Linzy [00:29:51] Wildly different. 

 

Leah [00:29:52] So much more, right? Or so much less. So what kind of sets the workplaces apart, I would imagine, would be the different things that you offer. 

 

Linzy [00:30:01] Yes. And something that I’ve noticed for our business as we’ve gone through some developmental stages and grown up a little, is how good it feels to also think about like, what do you really want to offer? Like when we looked at our benefits for Money Nuts & Bolts, we looked at Scandinavia because even though in Canada we have much better benefits than in the US, I was like, I want to do so much better than Canada. 

 

Leah [00:30:21] Scandinavia! 

 

Linzy [00:30:24] And we looked and like truly all of our policies. And my partner is really good at policy. He’s a politician and he works in Money Nuts & Bolts and he wrote our policies are based on Scandinavian leaves and we have all sorts of leaves that have had to do with things that have happened in our business, like we have bereavement leave and caregiver leave because one of our employees has a loved one who has a terminal illness. 

 

Leah [00:30:46] How do you kind of create benefits? From one system while operating in the Canadian system, because some of the ways that Scandinavian benefits exist are also like I would imagine the structure that exists around. 

 

Linzy [00:31:04] Yeah, there’s some governmental structure there and that’s the thing like you have to think about what can you actually sustain as a business? But for us, it was just offering more than the minimum. 

 

Leah [00:31:13] More than the minimum. 

 

Linzy [00:31:14] Yeah, we’re like the minimum is not even remotely good enough. So minimum vacation time to two weeks a year, like fuck that. 

 

Leah [00:31:20] Two weeks a year is not enough. 

 

Linzy [00:31:21] But that’s also like thinking about the values of your business. And as your business grows up, your values will also become clearer and clearer. And one of our values is live to work, not work to live. So we live that out by having a lot of vacation time and being like, No, go on vacation, don’t talk to us. We will see you when you get back. Have a life, right? Like we don’t want this to be your life. And so we’ve cut that in because those are our values. But for another business, that might not be as important, right? But you get to do these things and then you get to think about them strategically, right? Because of course, we want to give the moon in the sky, to the folks that work for us who we love and we want to support and we want them to be well and you get to roll- that’s why the gradual rollout makes sense. As you see your numbers and you see kind of the buffers you have to work with. You get to decide how to use them to take care of yourself and take care of the folks who are working with you. How does this land with you, Leah? 

 

Leah [00:32:12] Great, great. I think it comes at a good time. Like, really. I know we had to sort of move things around a couple of times, but this is I really appreciate it because I do think that as as solidified as you can be in your values day to day, you know, imposter syndrome starts creeping in or like not good enough-ness starts creeping in. And it was just a it was great to talk to you and remind myself why I am doing what I’m doing. 

 

Linzy [00:32:45] Yes. Yes. And not you know, I think, Leah, like not everyone who goes into group practice comes at it from the heart, heartful place that you are. Like the whole hearted place, I will say that you are coming at it from. And I think that that is going to show in the ways that you build a practice that really is about creating good environment for the folks who work with you. And if you create a good environment for the folks who work with you, that’s sustainable, you know, balancing these things, folks will stick around. They will want to be there because most group practices, unfortunately, are not like that. So, Leah, what are you taking away from our conversation today? 

 

Leah [00:33:18] Oh, wow. Well, I am taking away the fact that I am doing things better, technically, logistically, financially, I guess, in terms of like at least knowing these numbers than I thought, because the voice that says you have, you know, dyscalculia, like you hate math and numbers and everything that has to do with like that, but want to be a responsible and good boss, but also business owner. And I’m not doing as badly as I thought I was doing. 

 

Linzy [00:33:56] No, not even close. 

 

Leah [00:33:58] And and also just that like roll out slow is important. And it doesn’t mean that I’m not ahering to like an ethical business or a value based business because I’m not able to give everything upfront. Because it’s so new. The business is a baby. 

 

Linzy [00:34:17] Business is a baby. And babies can’t give everything.  

 

Leah [00:34:21] No. And they’re not supposed to, right? 

 

Linzy [00:34:26] Well, thank you so much, Leah, for joining me today. 

 

Leah [00:34:28] Thank you. 

 

Linzy [00:34:42] One thing that sticks out from my conversation with Leah that is maybe true of many of us is I think that Leah underestimated just how well they’re doing at this. They already had spreadsheets that had numbers. They had sat down with an accountant to work things out in the first place. They had been very thoughtful, not just about the salary and making sure the numbers were sustainable, but already including health benefits and sick time and all of these things that so many group practice owners don’t think about till much later down the road. Leah’s values really showed in the way that they prioritized those benefits upfront and made those available to their employee from the get go, even when the practice was still getting off the ground. And I think it’s so easy as therapists and business owners to underestimate ourself or downplay how thoughtful we have been about something. Right. Or the efforts and the strategy that we’ve put into things. And I definitely saw that with Leah. They were way further ahead than they thought they were. And also that piece that we got into about developmental stages. I do just find that such a helpful way to think about business in general, because it’s so easy on day one of our practices to want to be like a ten year practice and to have everything established, you know, whether you’re in solo practice and it’s that you want to like have that full caseload, you know, have that perfect way of speaking about things, have all of your policies perfect. It’s so easy to want to be ahead of where you are. And so much of business and life is a process that we’re figuring out as we go. And that’s okay, right? You put the foundation in place from the beginning and doing things like Leah has done and is doing of like running her numbers, getting the support through Money Skills For Therapists and working with other coaches to build a healthy foundation from the beginning is so essential. And also our businesses develop as they go and has kind of new levels and new problems arise. We can solve them and we can trust our future selves to solve them and to be able to change and adapt things as we go. We don’t have to figure it all out today. So if you feel like you do, I encourage you to release yourself of that burden. Let your business grow naturally, like everything grows naturally. Be thoughtful and strategic about it. And with your clarity about your values and clarity about your numbers like Leah has, you will be on the path to build a great place for other people to work if a good practice is what you want to do. If you want to hear more from me, you can follow me on Instagram @moneynutsandbolts. We are posting emotional and practical money content on there all the time and if you’ve been enjoying the podcast, please jump over to Apple Podcasts and leave me a review. It’s so helpful, such a good way for other therapists to find me who want to be having these conversations alongside you and I. Thanks for listening today. 

Hi, I'm Linzy

Hi, I'm Linzy

I’m a therapist in private practice, and a the creator of Money Skills for Therapists. I help therapists and health practitioners in private practice feel calm and in control of their finances.

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