Episode #599: 3 Reasons To Stay On Insurance, feat. Tiffany McLain

Summary

Abundant Practice Podcast Summary
Episode #599: 3 Reasons To Stay On Insurance, feat. Tiffany McLain
Release Date: December 4, 2024
Hosts: Allison Perrier & Tiffany McLain

---

Introduction

In Episode #599 of the Abundant Practice Podcast, host Allison Perrier engages in a thought-provoking conversation with her business best friend, Tiffany McLain of Lean and Make Bank. The episode delves into the nuanced decision therapists face regarding whether to stay on insurance panels or transition to a cash-based private practice. Contrary to Tiffany's usual stance advocating for premium fee, cash-based practices, this episode explores compelling reasons to remain within insurance networks.

---

Reason 1: Considering Your Season of Life

[03:54 - 07:51]

Tiffany McLain emphasizes the importance of aligning professional decisions with one's current life circumstances:

• Life Phases Matter:
  "We need to think about what season of life we're in... What phase of life am I in? What's my bandwidth?"
  ([03:54])

  • Practical Considerations:
    • Bandwidth: Emotional, financial, and personal capacity to handle significant changes in practice.
    • Family Responsibilities: Therapists with young children or other personal obligations might find stability in staying on insurance panels.
    • Unexpected Life Events: Allison shares her experience of moving cross-country due to her mother-in-law's illness, highlighting how insurance panels provided necessary financial cushioning during turbulent times.
      "I knew I just needed to get on panels to make my life easier with a one-year-old moving cross-country with a sick mother-in-law to make it make sense."
      ([05:09])

• Strategic Planning:
  Allison recounts the necessity of having a clear strategy when staying on insurance panels, ensuring there's an exit plan when circumstances stabilize.
  "I got on insurance panels to make my life easier... and then when things had settled down some, I got off the panels because that's what I wanted to do."
  ([06:11])

• Reflection:
  Recognizing that different life seasons may prompt different choices, Tiffany advises therapists to be honest about their current capacity and future aspirations.
  "Be honest with ourselves about these things... whether you want to stick with insurance or leave at some point."
  ([07:51])

---

Reason 2: Preference to Avoid Marketing Efforts

[12:09 - 17:09]

The second reason centers on therapists' desire to minimize or eliminate marketing responsibilities:

• Choosing Ease Over Marketing:
  If therapists prefer not to engage in marketing activities—whether due to lack of interest or fear—it may make practical sense to stay on insurance panels.
  "You simply want clients to come to you, even if it means you see more people... That is a price you're happy to pay to not have to get into this whole marketing world."
  ([12:35])

• Distinguishing Motivations:
  Allison clarifies that the decision to avoid marketing should stem from personal preference rather than fear:
  "I don't want that to be a fear-driven decision... I want everyone's decisions to come from what they want instead of what they're afraid of."
  ([13:19])

• Clinical Implications:
  Tiffany connects marketing avoidance to clinical effectiveness, suggesting that avoiding personal challenges in business may hinder therapists' abilities to fully support their clients.
  "If you're not marketing because you're afraid... that is, sorry to say, you're a less effective clinician because you're avoiding those parts of yourself in your journey."
  ([15:08])

• Market Realities:
  Allison notes that staying on insurance can be more financially advantageous than agency work for many therapists:
  "Many insurance panels in most of this country are paying you more for a lot less work than you made in agencies."
  ([13:19])

• Encouragement and Support:
  The hosts encourage therapists to evaluate their motivations and ensure that decisions around marketing and insurance are aligned with their true desires, not external pressures or fears.
  "If you're saving with the insurance, that could be a slower journey... but it's something to consider."
  ([18:09])

---

Reason 3: Scaling and Potential for Practice Sale

[18:39 - 22:09]

The third reason discusses the strategic advantage of staying on insurance panels for therapists aiming to scale their practices:

• Group Practice Scaling:
  For those looking to expand into group practices with the intent to sell, maintaining insurance panel participation is often essential.
  "If you're trying to grow a private practice, a group practice, and scale it so that you can sell it... you have to take insurance to sell that practice to one of these big conglomerates."
  ([18:39])

• Operational Benefits:
  Large group practices benefit from bulk reimbursements and can afford to hire administrators, making insurance participation more feasible and profitable at scale.
  "Insurance panels at scale make sense in a way that insurance panels as an individual practitioner doesn't always make sense."
  ([19:23])

• Challenges of Selling:
  Many therapists opt not to sell their practices even when offered lucrative deals from venture capitalists, primarily to preserve the integrity and culture of their practice.
  "Most of my friends have decided not to sell... they really love what they've created because once things are bought by VC, it's all about the investors."
  ([20:07])

• Maintaining Values:
  Tiffany highlights the importance of preserving the practice's heart and values, which can be compromised when sold to profit-driven entities.
  "A VC backed group practice is not going to have the same heart or intention or presence as a therapist owned group practice."
  ([21:20])

• Financial Sustainability:
  Group practices on insurance panels can offer competitive salaries to therapists, providing financial stability that might not be achievable in single-provider practices.
  "They can make 80, 100,000, 60 to 80 hundred thousand a year... You as a business owner can be able to sell your business ultimately."
  ([19:24])

---

Reflections and Conclusions

[22:10 - 27:09]

• Personal Responsibility:
  Both hosts stress the importance of therapists taking full responsibility for their practice decisions, ensuring choices are intentional and aligned with personal and professional goals.
  "Be fully responsible for the choices you're making and the results that come from those choices."
  ([23:07])

• Tools and Resources:
  Allison recommends utilizing resources like Tiffany's "Fun with Fees Calculator" to help therapists determine appropriate session fees based on individual needs and circumstances.
  "Doing that calculator helps people understand... it's actually easier to stand behind too."
  ([25:24])

• Empowerment Through Choice:
  The episode emphasizes that there is no one-size-fits-all answer. Therapists are encouraged to assess their unique situations, desires, and capacities to make informed decisions about insurance participation.
  "Nothing is right or wrong... It is your practice. And I want each therapist to be fully responsible for the choices that they make."
  ([23:52])

• Community Support:
  Allison and Tiffany invite listeners to engage with their communities and resources for further support, emphasizing the collaborative nature of building a successful private practice.
  "Join the Abundance Party and I'll see you in there. We'll have Q and A and actual live... how do we actually do this thing."
  ([26:46])

• Final Encouragement:
  Therapists are empowered to make decisions that best fit their current life circumstances and long-term goals, whether that means staying on insurance panels for stability or transitioning to a cash-based model for greater autonomy.
  "Be the captain of your ship... Always be willing and ready to reflect."
  ([26:21])

---

Key Takeaways

1. Align Professional Decisions with Life Phases:
   Assess your current life circumstances and capacity before making significant changes to your practice structure.

2. Understand Your Motivation for Marketing:
   Decide whether avoiding marketing is a strategic choice or driven by fear, and recognize how it impacts your clinical effectiveness.

3. Strategic Growth and Scalability:
   Staying on insurance panels can be advantageous for those aiming to scale their practice, particularly if considering future sale or expansion into group practices.

4. Empowerment Through Choice:
   Therapists have the autonomy to choose the path that best aligns with their personal and professional goals, supported by tools and community resources.

5. Continuous Reflection and Adaptation:
   Regularly evaluate whether your current practice model aligns with your evolving needs and aspirations, making adjustments as necessary.

---

Notable Quotes:

• Tiffany McLain:
  "What phase of life am I in? What's my bandwidth?"
  ([03:54])

• Allison Perrier:
  "I don't want that to be a fear-driven decision... I want everyone's decisions to come from what they want instead of what they're afraid of."
  ([13:19])

• Tiffany McLain:
  "A VC backed group practice is not going to have the same heart or intention or presence as a therapist owned group practice."
  ([21:20])

• Allison Perrier:
  "Nothing is right or wrong... It is your practice. And I want each therapist to be fully responsible for the choices that they make."
  ([23:52])

---

For therapists contemplating their position on insurance panels, this episode offers a balanced perspective, highlighting that staying on insurance can be a strategic and beneficial choice depending on individual circumstances and professional goals.

Transcript

[Allison]

Hi, welcome to the Abundant Practice Podcast. I'm Allison from Abundance Practice Building. I have a nearly diagnosable obsession with helping therapists build sustainable, joy filled private practices, just like I've done for tens of thousands of therapists across the world. I'm excited to help you too. If you want to fill your practice with ideal clients, we have loads of free resources and paid support. Go to abundance practicebuilding.com links all right onto the show, try Therapy Notes, the number one rated electronic health record system available today with live telephone support seven days a week. It's clear why TherapyNotes is rated 4.9 out of 5 stars on Trustpilot and has a 5 star rating on Google. TherapyNotes makes billing, scheduling, notetaking and telehealth incredibly easy. And now for all you prescribers out there, TherapyNotes is proudly introducing E Prescribe. If you're coming from another EHR, TherapyNotes makes the transition incredibly easy, importing your demographic data free of charge so you can get going right away. Find out what more than 100,000 mental health professionals already know and try TherapyNotes for two months absolutely free. Just go to therapynotes.com and enter promo code Abundant at checkout. Try it today with no strings attached and see why everyone is switching to Therapy Notes now featuring E Prescribe.

[Tiffany McLean]

You really wish grad school had covered how to fill a private practice. In grad school you had a professor you could ask questions, someone who could tell you what you were doing wrong and how to fix it. You had classmates working towards the same goal. Think of Party plus like that grad school class you wish you had. You get individual consultation about your specific practice with clear feedback and guidance.

[Alison Perrier]

You get group calls with other people.

[Tiffany McLean]

Building their practices who have your back. We cover everything from marketing to mindset and you have access to everything in the Abundance Party. All the courses and trainings that have filled thousands of therapists practices. Thanks to the feedback, the support and.

[Alison Perrier]

The clear step by step, people in.

[Tiffany McLean]

Party get full faster. The majority of party members fill their practice in three months. Check out Party in the link in the show notes and join the interest list if you're ready to build what you've been dreaming of.

[Alison Perrier]

Welcome back to the Abundant Practice Podcast. I'm Alison Perrier, founder of abundance practice building.com. i'm here with my good friend, my biz bestie Tiffany McLean of Lean and Make Bank. Com. Y'all should know Tiffany if you don't already. She's gonna sort out your money. Shit. Yeah, what do you. Did you just raise your I'm just.

[Tiffany McLean]

Waving hi to the people.

[Alison Perrier]

Got it. So we're actually going to talk about reasons to stay on insurance, which you hear most consultants railing against getting off insurance. And these are some really important things to consider before you jump ship. So. And yeah, I mean, Tiffany's the queen of premium fees, so this is kind of different from her usual talk on here. So thanks for being here.

[Tiffany McLean]

Thank you. I definitely am. You know, if people have any familiarity with me, they're like, tiffany, you want every therapist to be off insurance panels. Why are you talking about staying on them? And I don't, I don't want people to have the misconception that I think every therapist should be cash pay, premium fee. Although I do wish every therapist was cash pay, premium fee. And I'm also aware that therapists have reasons to be on insurance panels. They're not the devil. Even though I railed against them, I like the idea of kind of taking the other side for a little bit and thinking about what, why would it make sense to stay?

[Alison Perrier]

Yeah, I love this. So let's talk a little bit about. Let's talk about reason number one. They've heard us talk about reasons. They've heard other people talk about reasons to get off. What's reason number one for you to stay on?

[Tiffany McLean]

When we're thinking about getting off insurance panels or staying on, we need to think about what season of life we're in. This is something as I've grown up, had children, really had to deal with all of the things that life throws at us. I'm like, oh, there are times when it doesn't make sense to make use changes, when it does make sense to choose ease in our professional life instead of shaking everything up. So I, I think it's really important for therapists to consider ask themselves, what phase of life am I in? What's my bandwidth? Emotional, psychic, financial? How much bandwidth do I have to make a big change in my practice? Maybe even if you have family money. Some people have family money. Some people have a spouse who has a lot of money. If you're in a particular season of life where you can actually just chill out and you don't need to make changes in your practice or you cannot, we don't have to.

[Alison Perrier]

Yeah, I think there can feel like a lot of pressure as friends get off panels and things like that and they're making more money and they're like, no, really, you can do it, you can do it. But there are times when life is hard enough and we don't need to add hard on top of it.

[Tiffany McLean]

That's right. I don't know. So I know where this is coming out in December, early December. The time we're recording it is election time. And even on this election day, I'm feeling so much tension.

[Alison Perrier]

Yeah.

[Tiffany McLean]

Like, oh, I don't want to make any big change today. And some people have that for a month, a quarter, a year where something's happening in our lives where a big change, it's just not the time for it. And it's okay to have it not be the time for it.

[Alison Perrier]

Yeah, yeah. I mean, I think about my local therapist here in Asheville. We had the hurricane last month. Last month wouldn't have been a great time to decide to get off panels because like we're still, we don't have water still. It's been a month. So like there are times, there are times like when your kids are really small. I've worked with students whose kids are really small and they're like, I have to get off insurance because I can't pay for daycare if I don't. And so there were sometimes compelling reasons to get off insurance, but sometimes there are compelling reasons to stay. So phase of life is such an important one. I think it's important for people to be honest with themselves about these things. I know when I moved from Seattle to Asheville, I got on insurance panels here because I knew it was going to be a big enough shift and like I needed to hit the ground making money. We moved kind of sooner than we wanted to. We wanted to stay in Seattle for a long time, but we moved sooner because my mother in law was sick. And so like we didn't have months and months or a year or whatever we would have done to save up to make whatever cushion I need, because I need a cushion, a big cushion because anxiety. And so I knew I just needed to get on panels to make my life easier with a one year old moving cross country with a sick mother in law to make it make sense. And then when things had settled down some and I felt like I could, I got off the panels because that's what I wanted to do.

[Tiffany McLean]

I love what you're talking about in terms of you had a clear plan. I'm not just going to get on panels and then that. I don't know what's coming next. You were like, I need a cushion. I'm willing to work a lot of hours at the beginning to save up this cushion so I can prepare myself for the next phase of my business. You are Clear on your strategy. And so I think when we're talking about phases of life, it makes sense to both be in reality about what's my bandwidth like right now, and also be honest with yourself about if you want to get off, what's your exit strategy? If you don't want to be here forever, what are you going to do? And if you're working, seeing 40 clients a week, 32 week, if you have little kids at home, it's really easy to get complacent and get stuck in that four years. If we're not really being conscious about. Conscious and intentional about what our, what our plan really is, what kind of life do we really want to have? So, yes, phase of life. Yes, season of life. And also have somewhere in the back of your mind awareness about, is this something I want to stick with or do I want to get off at some point in my practice, in my career?

[Alison Perrier]

And I think, like, there's a parallel process with leaving an agency job too, while you have a private practice on the side of you can stay working 60 hours a week, doing both for a long time, or you can be like, okay, once I hit 10 clients in my private practice, I'm putting in my notice with as long as I have some consistent referrals. So, yeah, we can't just keep going on and on and on without examining what's working for us and what's not and maintain a healthy life and practice.

[Tiffany McLean]

That's interesting. So what I'm curious, what have you noticed when working with your students are pivotal points in which they pop their head up and say, oh, let me examine whether this is still working. What seasons of life have you noticed that?

[Alison Perrier]

So it's interesting. So I have, you know, my newbies who are starting private practices or are plateaued somewhere in between. So that's like one set of people that we work with. But we also, in limitless practice, work with people who are full and miserable. So they're making these big changes. So I always think about them first when you ask a question like that, because all these people have raised their hand of like, I am working my tail off and I am making not as much money as I need to make to be able to retire. So I'm thinking a lot of them have kids who are no longer babies, like they're toddlers, but it's like maybe a more manageable version of toddler where their, their brain is back in a way that it wasn't initially with an, with an infant. They're getting more sleep. So I phase of life wise, I see a lot of people who have toddlers or younger kids. I see some people who, they just kind of realize like they were exposed to people who are not on insurance through consultants, through social media, through whatever. It's kind of like they're waking up to that being a thing. Because what I see, and I think you probably see this too, is people who take insurance tend to clump with one another and therapists who don't take insurance tend to clump with one another. And so it just feels like it's what everybody's doing. So they start to get exposure to other people who are not taking insurance and realize they don't have to. And I guess it's not necessarily a phase of life as much as just like wearing down and eroding of bandwidth with insurance companies that are not paying, that are not, you know, they're not paying in a timely way. They have to spend a lot of time and energy or money on an assistant to get the payments that they need and that they've earned. So. But we're talking about keeping people on insurance. I don't want to spend too much time on that, but you can stay.

[Tiffany McLean]

So I'll just use that to talk about. It's interesting because the very season that might lead one person to get off insurance panels is the season that might bring someone else to stay on. So, you know, some people might say, I'm pregnant, I'm going to have a kid, let me stay on insurance panels. For security, we have students who do the opposite, which is, I'm pregnant, I'm going to have a kid. Let me use this time to actually get off panels and come back after mat leave without being on insurance panel. It may be cash pay. So really, again, it comes back to being honest with ourselves, having a really assessing what do we need for ourselves now and where are we going in the future and then trusting yourself to make that decision.

[Alison Perrier]

Yes. And not leaning on other people, not asking other people what they think you should do because they're coming at it from their lens too. So I think you know yourself best. And while for some people, getting off insurance during mat leave and starting their practice then is the way to go, for others, that's just adding so much more work and so much more anxiety to being a parent of an infant. So, yeah, knowing what you need and if you do eventually want to get up panels, having a really clear path for that, that feels safer for you because that's, I'm a, you know, me, I'm a pusher. Right. And I want to like move people along really fast. And I have to remember that. And I've had some really great students that helped me realize that my pace is not the pace, that people are going to move slower sometimes. And that is what is right for them. And that's the support they need is to support that pace.

[Tiffany McLean]

Yes.

[Alison Perrier]

Yeah. And if you want to stay on insurance forever because it makes sense for you, that's great. Which I think could lead into that second reason to stay on insurance panels.

[Tiffany McLean]

Yes. The second one is if you just are the kind of person, you have just made a choice in your life that you are not going to market. You don't want to learn how to market. You don't want to be out there marketing. You don't want to spend your money that way or your energy that way. You simply want clients to come to you, even if it means you see more people, even if it means you're working more hours. That is a price you're happy to pay to not have to get into this whole marketing world. That's another reason to stay on panels.

[Alison Perrier]

And I don't want that to be a fear driven decision. Like I'm afraid of being seen or I don't know how and I feel like I'd look stupid, that kind of thing. I want the to be a decision based on I've learned some marketing things and it's just honestly not how I want to spend my time. And it's not worth it to me to spend that time for more money. Because the truth of the matter is many, many insurance panels in most of this country are paying you more for a lot less work than you made in agencies. So it's still an upgrade. And I want people to hear that if the marketing piece is what's been holding them back, it's still an upgrade from most agency work to take insurance in your own private practice and see 25 clients a week.

[Tiffany McLean]

That's right. It's not, you know, people like me, people like you, we're like, get out there, market. You can do it. All those things are true. And it still takes time. It's not like you're going to be suddenly seeing 20 cash pay clients a week easy $200 as soon as you get off insurance panels. It's a process. It takes time and energy. You have to be able to play the long game, figure out what works for you. There's no quick and easy magic bullet solution. And so if you're somebody who, who is saying like I just don't want to play that game, stay on insurance panels. You don't have to play that game if, if you don't want to.

[Alison Perrier]

Yeah.

[Tiffany McLean]

Actually, let me ask you this. In terms of marketing, I want to come back to this. You mentioned briefly, you know, if people are not marketing because they're afraid or they're, they don't be seen, I wonder about those people. Like, if those people are like, I just know I don't want to show up in the world or I don't want to be seen. I'm, I like, you want to push them. There's so much on the other side of that. There is something you'll come to know about yourself by putting your yourself in the world. And what about the people who are like, I just don't want to know that thing?

[Alison Perrier]

I think that's a difference. There's a distinction between the people who are like, I don't know, I just don't really care, and the people who are like, I don't want to look stupid, I don't want to look stupid people. I want them to push themselves because there's good, juicy emotional work there, right. That could lead them to a better practice if they want to work through it, or could just lead to feeling really good about not being afraid anymore. I just don't want any of our decisions to be fear based. Right. In an ideal world. Not that, not that all my decisions are free and clear of fear, but I want everybody's decisions to come from what they want instead of what they're afraid of.

[Tiffany McLean]

The thing I really appreciate about that is what I heard in that this is going to be challenging to some therapists out there listening. But also, I think about it clinically from a clinical lens. If you're not marketing or you're not growing your practice out of fear, then that is impacting your clinical work. How can you fully show up? How can you fully support your clients in their transformation, helping them lean into fear, helping them move through the hard stuff? If you're actually avoiding that in your own life or your own business. So that's another way for those of you who are like, well, I don't want to market because it's scary, or I don't want to be seen or I'm embarrassed, that is, sorry to say, you're a less effective clinician because you're avoiding those parts of yourself in your journey.

[Alison Perrier]

And not necessarily less than other people, but less than you could be.

[Tiffany McLean]

Yes, 100%.

[Alison Perrier]

For you, I mean, it's Similar for those who are like, well, this is different. Like, not all of us are business people. It's the same exact thing as you not have having that conversation with your mother in law that you need to have, but encouraging your clients to do it all the same. Like avoiding tough conversations when that's what you're preaching. So versus the person you bring up who's just like, I just really don't care, like, I really don't care to learn how to do SEO, for instance. That doesn't mean I'm not going to do SEO. It means I'm going to pay somebody to do my SEO. But like, I really have absolutely no interest in it. And if that's the way people feel about the entirety of marketing, which I find hard to believe because marketing includes so many different things. But if it, if it's the way you feel about the integrity of marketing, yeah, okay, that's cool. Insurance will help get you full. We have more therapists out there in private practice now, so it might be a slower journey than it might have been a few years ago. And I'm starting to see, I don't know if you're seeing this in your students, a slight drop in the rate of referrals that people are getting. It's looking more like pre pandemic now in terms of like frequency of referrals for the average therapist versus post pandemic, where it was, it was a lot easier to get full faster in, you know, the 3ish years after the pandemic.

[Tiffany McLean]

Yeah, we're seeing, we're seeing similar, like people still can do it, people are doing it. And it's not pandemic times when people are just rushing out, clients are rushing out to find their.

[Alison Perrier]

And I'll say for people who are like, oh no, I just wanted to start my, my practice this month. It's still fine. We're, we're seeing it with our students who are in our high level, our mentorship, for instance. We're seeing it more in six months than in three months. So it's still happening relatively quickly. But it's not, it's not as easy as it was two years ago, for instance.

[Tiffany McLean]

Yeah, really interesting to think about that. So people who. It's interesting because you and I were kind of fighting ourselves back into just go market. We're kind of like, if you never want to market, it's fine, keep your practice on insurance. And we're asking the questions, are you avoiding marketing because you're afraid? Are you avoiding marketing because you don't want to be seen. Are you avoiding marketing? Are you just avoiding marketing or are you simply making a determination? I'm not interested in that. Really important thing to ask yourself as you're reflecting on how you're running your business that you have chosen to embark.

[Alison Perrier]

On and it ties back into the phase of life like you might be like, I don't have any sort of bandwidth or interest in marketing right now while I've got a toddler and a baby. No thank you. Totally get that. Or you know, I've got parents who are aging and I'm sandwich generation or I'm taking care of my parents or I'm getting married next month or whatever huge big thing can be going on that's going to impact your energy and your desire to market. And unless you have systems in place already, it just might not be the place to pick it up.

[Tiffany McLean]

So yeah, the third reason we're going to go in the entirely opposite direction, the third reason to stay on panels or to have an insurance based practice is if you're trying to grow a private practice, a group practice, and scale it so that you can sell it or keep it, but you want to scale it big. But especially if you're thinking I want to build a practice and then sell it. From what I've seen and from people I've talked to, you have to take insurance in order to sell that practice to one of these big conglomerates who are buying up group practices everywhere. A private practice. Insurance panels at scale make sense in a way that insurance panels as an individual practitioner doesn't always make sense.

[Alison Perrier]

Right.

[Tiffany McLean]

If you have a group practice, you can have an administrator, a manager, you're having bulk reimbursements and so you can actually pay your, your own therapist relatively well. You can give them a good salary, not like they could have as a cash pay in their own private practice, but you know, they can make 80, 100,000, 60 to 80 hundred thousand a year. And you as a business owner can be able to sell your business ultimately?

[Alison Perrier]

Oh yeah, I have a lot of friends in this position, a lot of friends who've been approached by these VC firms, venture capital funds, wanting to buy their practice for a lot of money. So far most of my friends have decided not to sell at this point even though they were offered enormous amounts of money because the way that things would change within their practice, which is like a baby of theirs, you know, like it's, they really love what they've created because once things are are bought by vc, usually it's all about the investors and what they want, which is their money back and not so much about the people doing the work or the clients. So that's the tough part. And I haven't figured out a way around that with any of my friends. I don't know, I've had a lot of conversations about it where it's just like, I just don't want, I don't want my people to get pay cuts. I don't want the direction that they were wanting to go with vc. Now I don't know every single situation. So there are some groups that might approach a group to purchase them, that are wonderful and that are interested in maintaining systems as they were created. It depends on the profitability of the business ultimately. But it's something to consider if you were like, ooh, I'd like to be bought out for millions of dollars with a group practice. If that was your first knee jerk reaction to be like, yeah, and just think through the whole process first. It's not right or wrong. Just think through the process and kind of like being on insurance or not. What's your plan? What's your plan? Ultimately, that's right.

[Tiffany McLean]

A VC backed group practice is not going to have the same heart or intention or presence as a therapist owned group practice. And if you have scaled your group practice or if you're working to scale a group practice to the point where it's very profitable, you can get someone to come in and run your practice, make sure they're still running by your values and be profitable 100%. I think a lot of therapists who come from agency background where the agency takes insurance, they just automatically assume I'll go into my private practice and I'll also take insurance. Without realizing that the scale factor, that having a lot of people on insurance is what allows that agency to run and be profitable and it doesn't translate to quality of life ease, financial abundance, usually in a one to one private practice setting, but you can recreate it in your group practice. So that's a reason to use insurance.

[Alison Perrier]

Absolutely.

[Tiffany McLean]

I think if I were, I was never on, I never took insurance, but I certainly had low fees in the early days of my private practice. And if I were listening to this conversation, I might be feeling pushed or challenged or defensive. Well, wait a minute. So I'm encouraging people to listen. If you're listening and feeling like, yeah, this makes sense, I feel easeful. I love that I'm an insurance. Based on what Allison and Tiffany are saying, it makes sense for me to stay on right now. Yay. That's the goal. If you're feeling a little stressed or called out or pushed or called in, then I encourage those of you to think about, oh, maybe there is a part of me that actually is resonating with bucking against wanting to experience an insurance free private practice, a cash based practice. So if that's you, yay, welcome. I encourage you to listen to those parts. Wrestle with us in this conversation, fight with us in the comments, and we can kind of help you think about what makes sense for you at this season of your life.

[Alison Perrier]

Yeah. Because nothing is right or wrong. I mean, I think you and I have both always had this tenant of like, what a therapist chooses to do with their own practice, that's their choice. There's no bullying people in one way or the other. I mean, like, certainly happens on the therapist Facebook groups. Right. But not in our paid, paid groups where people are in our programs. So it's interesting how people feel pressured on both sides depending on who's around them, who's talking to them. And ultimately it is your practice. And I want each therapist to be fully responsible for the choices that they make in their. In their practice and not victims of the choices they make in their practice. And that doesn't look just one way.

[Tiffany McLean]

I love that. Be fully responsible for the choices you're making and the results that come from those choices versus a victim to the circumstances. That's, as always, yeah, very empowering.

[Alison Perrier]

You're the boss, right?

[Tiffany McLean]

The boss. And when you hear, by the way, Allison or I, we have strong opinions, we will put things out forcefully. And when we do, we're talking to the people who resonate. If you're hearing that and you're like, that's not me. How dare you. Everybody can't live that way. We're not asking everyone to live this way. So I really, I love this conversation. That gives you the freedom to take responsibility for the choices you're making and the outcomes that come from that, the results of those choices. And always be willing and ready to reflect. Yeah. Check in and see if this is still working for me. And if it is, keep it up. If it's not, you have so many options about how to change so much support and going in another direction.

[Alison Perrier]

Absolutely. Yay. Well, I should say one of the supports is Tiffany over at Lean and Make Bank. Com. I have all of our students do your fun with fees calculator. I recommend it for all of our, especially our. The students we work the closest with and limitless in the mentorship because Knowing what you need to make per session. It may be. Insurance covers that. And then you can rest a little. It may be. And so doing that calculator helps people understand. Instead of just basing their number off what they hear in their area, it's actually easier to stand behind too, when it's like, I need this fee in order to put away for vacation, in order to have sick time, in order to send my kid to camp.

[Tiffany McLean]

You know, those kinds of things, say, for retirement. I mean, I'm thinking about that. I'm sure you are too. Like, are we. Are we going to be taken care of? And then we see our parents. So definitely. Having a clear number grounded in each person's unique set of circumstances and desires is vital when making a decision around, do I want to stay on panels, do I want to leave, how many hours do I want to work? And also, what's my long game? So someone might do the fun with fee calculator and there'll be a link. You can drop a link for them. Someone might do the fun with fee calculator and get a number that feels just way out of what feels possible for them. And I encourage you to think about, okay, maybe not today, but what would it look like for me to take the next five years to figure out how to make that my reality? So at least you're grounded in what's true for you, what your desires are, and not kind of just living in this gray. I don't know what. Back to this idea of victim to your circumstances. You got to be the captain of your ship.

[Alison Perrier]

Absolutely. Yay. Well, thank you, Tiffany.

[Tiffany McLean]

My pleasure. And I'll also direct people. If you like podcasts, we have our podcast back the money sessions. After like a two year Tiffany, having children, raising those children to three and five hiatus, they're back. So people can also go check out the money sessions.

[Alison Perrier]

Absolutely. And you're also doing a training for in the abundance party, so I'm psyched about that.

[Tiffany McLean]

Oh, yeah, folks, get in the abundance Party. If you're not in the abundance party, A. Well, maybe you're one of those therapists who never wants to market, but if you are willing to push yourself and learn more, definitely join the abundance party and I'll see you in there. And we'll have Q and A and actual live. Like, how do we actually do this thing? Which is going to be fabulous.

[Alison Perrier]

Yeah. Love it. Awesome. Well, thanks. I'll see you soon.

[Tiffany McLean]

Thank you.

[Allison]

If you're ready for a much easier practice, therapy notes is the way to go. Go to therapynotes.com and use the promo code abundant for two months free. If you're Listen, probably need some support building your practice.

[Alison Perrier]

If you're a super newbie, grab our.

[Allison]

Free checklist using the link in the show notes. I'd love for you to follow rate and review, but I really want you to share this episode with a therapist friend. Let's help all our colleagues build what they want.