
Maureen Werrbach, LCPC of joins me to dive into the current challenges therapists and group practice owners are facing—like rising competition from big tech platforms. Maureen highlights the critical role of strong leadership and staff management...
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Hi, welcome to the Abundant Practice Podcast. I'm Alison 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. Some of y'all aren't sending HIPAA compliant email and it's a problem. Even if you're paying for a business Google Workspace account and have a signed BAA, your emails still aren't 100% compliant. That's where Palbox comes in. You can connect Palbox to your Google Workspace or Microsoft 365 email one time and you're completely covered. No one has to sign into portals. It sends and it shows up like any other email behind the scenes. Powbox software checks the security settings of the recipient and ensures that the email is sent properly so you're not violating HIPAA in the ways you may accidentally be. Now, I know HIPAA isn't sexy, but we don't avoid compliance in an Abundant practice. We check the boxes we need to check and this is the easiest way to do that with email. Check out my friends@powbox.com that's P A U B O X Use Code abundant to get $250 off your first year of Palbox. That makes it less than $100 for your first year. Again, that's P A U B O X.com use code ABUNDANT so I've talked about TherapyNotes on here for years. I could talk about the features and the benefits in my sleep. But there are a couple things I want you to know about therapynotes that doesn't typically make it into an ad script. First is that they actually care if you like their platform. They don't only make themselves available on the phone to troubleshoot so you don't pull your hair out when you get stuck. They also take member suggestions and implement those that there's client demand for, like Therapy Search, an included listing service that helps clients find you internal and external secure messaging clinical outcome measures to keep an eye on how your clients are progressing. A super smooth super bill process, real time eligibility to check on your client's insurance. In my conversations with the employees there at all levels, they all really believe in their product and they want you to love it too. Second, they are proudly independently owned. Why should you care about that because as soon as venture capital becomes involved, the focus shifts from making customers happy to making investors happy. Prices go way up, innovation plateaus. Making more money with as little output as possible becomes the number one focus. With over 100,000 therapists using their platform, they've been able to stay incredibly successful. And they don't have to sacrifice your experience to stay there. You can try two months free@therapynotes.com with the coupon code Abundant. Welcome back to the Abundant Practice Podcast. I'm your host, Allison Pereir, and I'm here with my good friend Maureen Morbach. She is one of my business besties and brilliant, absolutely brilliant about group practice. And she is who I learned everything about group practice from. So we're going to talk some about starting a group practice. We're also going to talk about starting a group practice in the context of this special time. We'll call it a special time because our solo people are feeling it too.
A
Yeah.
B
But we'll just, we'll go from there. So thanks for being here.
A
Yep. I'm happy to be here again. It's been a while. I feel like.
B
Yeah, a really long time.
A
Yeah.
B
I'm glad that we have our text messages to hold me over.
A
I know. Yeah. As you said, it is a very special time as therapists, business owners.
B
Yeah. So do you want to kind of set the stage for what's different now from a few years ago?
A
Sure. I think this translates across solo practices and group practices. Seeing this shift, I know you've been around as a provider for over a decade, just like me as a business owner provider. And I feel like so much has changed. It feels so interesting to see how different it feels to run a business now than it did even five years ago. Of course, one of the major things I think was Covid. It opened a lot of doors and opportunities for people because pre Covid, it was very, very difficult to start a solo or group practice without having a physical brick and mortar location. I know, of course there's outliers. There were telehealth providers back in the day, but very few and far between. And I think Covid opened the doors to another method for providing therapy that became more just well known, telehealth. And in that, it also created the space to be able to have more flexibility to provide services from home. But it also then provided easier opportunities for people to start their own businesses, which I think is great. With essentially no need to have any money to do it. You know, really could just see your clients from your laptop in your Bedroom. And so I think we've seen since COVID a big shift as group practice owners, more difficulty in finding therapists who want to work in a group practice versus just, you know, going for it. Right from, you know, right when they get out of grad school and trying it on their own. There's been a shift in. I don't know, I'm assuming this was similar for you back in the day, but like our parents generation, I think they had a job and they sort of had that same job for their whole life. And so. Yeah, yeah. And so they sort of ingrained in our generation because we're in our 40s. Your. Your resume needs to show that you are working for at least a good period of time. Like, I don't think we were taught that we had to stay at one place forever, but we were taught we should stay somewhere for years. And it needs to be very intentional and purposeful. And like, even if you don't love it, you stay. And now another, I think great thing, but has impacts is that that's completely gone. There isn't this expectation. So there's a lot of people coming and going much more quickly, which just makes business a little bit more difficult for group practice owners. And then the. The impact that that has is that we're seeing solo and group practices having a much harder time in the past year or so with getting referrals because this visibility that was easier among the solos and group were around is now it was much lower. You know, there's. There were more group practices that people worked in and fewer kind of solo practices. And now there's. If I had to figure out the math to it, I'm sure our numbers have shifted to a point where group practices are almost the minority and there are just five times the amount of solo providers than there were five years ago pre Covid, which just makes it more difficult for each individual solo provider and group to be seen in their community and online.
B
Yeah. And we also have big tech in there, which we're not going to name any names because they love to sue people. Like, you can't even say anything about not liking them without them sending you a letter. So we're not going to name any. But when we say like big mental health tech.
A
Yeah.
B
Think about the podcast you listen to and the ads that come on. They have to do with therapy. And so you also have a lot of providers who, even if they're not in a solo practice on their own, maybe are with these companies that aren't our favorite.
A
Nope.
B
I don't find them to be ethical in the way they treat patient data, in the way they treat their therapists, in the way that they frame their business, which is a tech company and not a mental health company.
A
Right.
B
So we also have a lot of care being provided through those because these big tech companies have a lot of money that are gonna take up, you know, a lot of space on the Internet when people are searching. Those of you who are listening, do not panic. Like, this is not a panic point. We're just laying a foundation for how things are different now than they were a year ago. We do know more people are seeking mental health services now than they ever have. Like way more than during COVID and right after Covid. I don't know if after Covid exists, but you know what I mean. So there are a lot of people, a lot of people seeking therapy. And the problem as we're defining it is visibility.
A
Yeah.
B
So what do you. Well, let's talk about starting a group practice. Let's do this first.
A
Okay.
B
If somebody wants to start a group practice, they want to be a great boss. That's always not. They just want to make money.
A
Right.
B
But they want to be a great boss. They want to create great opportunities for other therapists, and they want to help their community in a specific way. These are people who are going to be great group practice owners and they want to make money too, because this is a business.
A
Yeah.
B
What do they need to think about in their startup? Maybe this person is full or close to full. They have referrals coming in. They really feel like they could support at least one other clinician at first. What do they need to think about?
A
No, I would say beyond what you've said, is that they want to lead. I feel like that's a big thing that gets overlooked because a lot of people will start a group practice. And this was, me included 13 years ago when I started my group of being like, I'm going to be more hands off and like, you know, find great therapists and just like let them do their own thing. And I think for a lot of people that's a mask for a fear of leading and feeling like you can somehow have a business and a group of people where you don't have to like, lead and give evaluations and potentially fire like that. You can have this like very, you know, cool, laid back vibe where everyone is just doing their work without having to be asked and you won't have to lead. And that just isn't the case. So I would Say, because it's one of the biggest stress points for burnout for group practice owners is just like staff management and you know, you'll never be able to make everyone happy. And so you have to be able to emotionally regulate and be okay with making decisions that not don't necessarily make every single person happy, but will ensure the health of the business as a whole and everyone in the business as a whole. And so if leading people and having difficult conversations and leading those difficult conversations is something you don't want to do, I would be thinking about if owning a business that employs people is something that you want to do. Right.
B
It's really like just not being responsible for the business.
A
Yeah.
B
To not lead.
A
Right.
B
This laid back, it's kind of like being the cool girl. Like it doesn't exist. Yeah, no, the laid back boss who like lets everybody do their thing doesn't really exist as a boss. It's part of why I Dave busy. It's part of why so many people come to me to start their own practice because they either have a micromanaging group practice owner or one who is like so laissez faire. They don't know the boundaries and then they get in trouble for things because the boundaries were never set properly.
A
Right.
B
No sort of communication about expectations.
A
Yep. And so if, if leading, like really leading also feels like something you're wanting to do, then I guess the next thing to consider is what the current pain points are for business businesses like ours so that you can, you know, kind of jump into leading and owning a practice with the awareness of what things you are going to have to be focusing on like, more than others. So like 13 years ago, when I started my practice, marketing wasn't something I actually had to focus on much. It was more like figuring out how, how to actually lead. That felt like a bigger issue or thing to tackle than marketing. Because like 13 years ago, everyone had wait lists, just long wait lists. And so filling them up wasn't something that I had to even focus on learning how to do. Whereas now, like you're seeing so many solo and group practice owners who didn't have to do this, scrambling to be like, what marketing methods are going to work now in this environment? Because the marketing methods of 5 years ago don't necessarily work now, you know. Right. Our environment shifts, so does how things work shift. And so my assumption, based off of everyone that I talk to and my own experience as a practice owner too, is that marketing and recruiting are two of the more difficult things right now. When it comes to having a group practice and so just ensuring that you have the time and focus to be able to invest time, I guess, into those two areas because it takes some work and trial and error to see what's going to work for your particular business in terms of getting visibility in your area when visibility is just so low. Yeah.
B
And this is something we've been talking about at Abundance for probably about a year. It doesn't mean you're not going to be successful. It just means you have to be a lot more intentional with your marketing in order to be successful. And it might take a little bit longer for you to reach your goals than it did before. We had people in our like high touch programs who were getting full in three months previously and now it's taking about six months. And those are our programs with like a lot of mentorship and a lot of handholding.
A
Yep.
B
So you have to be really clear about what your marketing strategies are and you have to actually do them and not just think about them or do.
A
Them next week and do them consistently. I see that too is like when people get into a space of anxiety or like they're freaking out because all of a sudden their referrals are really low, they start to throw like a hundred things against the wall. And what I see in that is like it's nearly impossible to know what works when you throw a hundred things at the wall. But two, if they are feeling like something's not working, they stop doing it right away and move to the next thing. When business ownership is a lot like a big ship, anything you do does, whether you're small or really large, takes a little bit of time for you to see the, I don't know, the success in something. And so just because you start, you know, do a week of a ton of social media and doing videos, doesn't mean that it's going to translate to you getting any new clients from it next week. A lot of these things take time. And so I always say, especially in these cases with marketing efforts is I suggest doing one thing at a time all in for around six months so you can actually see if that thing is working. And throughout those six months, if you see traction happening, what like looking deeper into what's making it work, doing more of that, looking at parts of that that maybe are helpful, removing those things so you're not wasting efforts and like really just focusing on that one thing before you start to shift to sort of marketing method.
B
Absolutely. We go into fix it mode. Right. Like, so I totally understand the Impulse to do everything. And then there are lots of shiny objects out there, and the people marketing them are good at marketing them, you know, so it's easy to feel like something's a magic bullet, but nothing is a magic bullet. Not a single thing is going to be a magic bullet that works for everybody.
A
Yep.
B
Unfortunately, I would really love a magic bullet sometimes, wouldn't you?
A
I would, too. I feel like whenever people will sometimes assume that because I've had a group practice for so long, that I don't struggle with any of the things that people who are newly starting a group practice are struggling with. And that's not necessarily the case. My practice in Chicago also has less referrals than it did last year. Just like 99% of the others. It's just a matter of, you know, me being aware of it and engaging in and some act to change it versus, like, sort of sitting back and feeling despair and, I don't know, closing your ears and your eyes and being like, it'll change on its own.
B
Yeah. And that's one of the things, like, people will come to me and be like. I saw in this brief Facebook group I'm in about how everybody's slow, and even these people who've been established forever are slow. And I'm like, yeah. And they're posting about it in a Facebook group instead of doing something about it.
A
Mm.
B
So if you don't want to be like them.
A
Yeah.
B
Then get out of those groups because they don't help. And most of the information is not great anyway.
A
Yeah.
B
And do the things that have worked for you in the past and see if those work first.
A
Yeah.
B
Most of the time they will. If it was like a really well thought out strategy.
A
Yeah.
B
And then add something else if you need to. Now, I'm curious, are you seeing a difference at all? Is there. And it might just be a slight difference or none at all between group practices that are niched and group practices that are more generalized in terms of referrals. Is it easier for one group over the other? Right now?
A
That's a good question. I mean, if we assume that both of these practices are well established and it's not because they're new that, you know, because then they'll both struggle for the same reason initially if they're both established. I don't think there's necessarily that big of a difference, even though I do talk a lot about, as a way of forecasting and, like, being able to weather the future storms, that a niche practice is a great thing to have I guess my question would be if it's a multi disciplinary practice that can support the whole person. Those are like, it's not necessarily two sides of the same coin, but those two things are, are two types of group practices that have the easiest time when it comes to marketing and recruiting. If you're a group practice that's not intentionally multi specialty treating the whole person, but just kind of like a hodgepodge of just hiring random people, I think those are, those are the practices that struggle the most. But if you're very niched one, you have an easier time knowing who your ideal audience is, which a multi specialty practice doesn't because they pretty much serve everyone Right. Which is more difficult in terms of marketing. But what the multi specialty practice has is the ability to work with more businesses in order to get new referrals. Because they have. If they're a larger practice that can like sort of treat the whole person, they have just more flexibility in being able to see more types of clients. Like I said, the, the issue comes to those practices that say they're multi specialty when reality they're, they're more rand. Right. They're just hiring anyone who comes in and they don't have like an intentional sort of process for who they're treating as a whole. My practice is multispecialty. We have psych testing, med management therapists that treat different parts of the lifespan so that when a family member comes in, our practice can pretty much treat anyone in that family. Each therapist has a specialty and that makes it then easier to market as well. A little more difficult than a very niched practice because there you only have to focus on one issue, you know. But I find that those two options, like an intentional whole person multi specialty practice or a very niched one are the two types of practices, group practices that'll weather kind of the storms that we're kind of seeing right now.
B
I ask because when I think about just marketing in general, niched is so much easier. Like it just gives you.
A
Yep.
B
It gives you your copy. It gives you everything.
A
Yep.
B
So that was my suspicion.
A
Yeah. So when we market in my practice, it's like we have to gear our marketing in a lot of different directions to reach the couples therapists that we have to reach the child therapist we have. But we. As long as you're intentional about like having a sort of through liner process for each one, then it's the same as having, I guess like multiple niches. It's just.
B
Yeah.
A
A little bit more effort and about like how do you highlight each one of those things individually without watering down the other ones? Right.
B
And that relies on your individual therapists each having a niche?
A
Yes, yes.
B
Because otherwise it'd just be chaos.
A
Yeah. 100. And that's the difference between like an unintentional practice that says they're multi specialty. When everyone just doesn't, like every therapist just sees whoever and they don't have their own specialization and niche themselves, then yeah, that's the practice that'll have the most difficulty standing out.
B
So hodgepodge practices are out for 2025.
A
Yeah, they've been out for a while, but yeah, for sure for 2025. Especially as like referrals are just a little bit more difficult getting niched, whether as a whole practice or making sure that each of your individual therapists is very clear on their bios and all of that in terms of who they see is going to be what makes it easier.
B
Yeah, yeah, absolutely.
A
And what I've always found. So this doesn't necessarily, this hasn't necessarily changed in the over a decade that I've had a group is that I find. And of course there's outliers to everything. I always feel like any, anytime I give suggestions I'm like, of course there's outlying situations where what I say like people are successful outside of that. But I find that the way to grow your referrals is through relationship building and less through like trying to get every single person to know you exist. So in my group practice, each location that I have, we focus on three relationships that in the community, whether it's a school or a hospital or another business, health care related business, we focus on three relationships that we nurture indefinitely. Of course the byproduct as we become known through with other people. But we look for three types of businesses or places or local businesses that support our ideal clients in that location. And we nurture those three relationships. One, it makes it much more manageable than like feeling like you have to spend every day like outreaching to like every business all around you and having coffee with every other practice owner around you or you know, chiropractor and dietitians all around. But like three, I always say three good relationships. And you can look at your existing clients and see like where are they going? Who are their doctors? Like what are they doing? Do all your clients go to this local yoga studio? Okay, maybe that's like one of the places. But to then, you know, reach out to those three and then spend your time throughout the years nurturing those three Relationships, literally, it's so simple, a lot less stressful. But if you focus on that, you're going to have that reciprocal relationship. And I always say, start with a networking perspective more than a marketing one, in that you want to ask about them. Like, everyone wants to talk about their business. If you go up to them and are like, wanting to talk only about your business, it tends to have, I think, a little less success than being like, I have a lot of clients that come to your yoga studio or that come to see you for chiropractic work. I wanted to get to know, like, what kind of stuff do you guys do so that when we get new clients, if that's a need, I can refer them to you. You're more likely to get interest from that person who is like, oh, she knows about me. She knows about my business. My ideal clients as a chiropractor seem to be going to her practice. Now. We can start this relationship.
B
Yeah, you know, we have this in common. I've always preached, like, networking is the thing that built my practice. And I tell people, like, five marketing strategies, one of which is a website, one of which is networking. Like, those two are set in stone. And I understand it when people don't understand what networking is, but there is some resistance to networking. So I love that they're getting this reinforced, that it can also fill an entire group practice. How many clinicians do you have working for you at this point?
A
Like, 50? Yeah.
B
So, like, it can fill a group practice when you are focused on really just forming a relationship. That's all you're doing. You are not selling yourself. You are not being salesy.
A
And I'm an introvert. You know me. I am. You and I are opposites in these ways. I don't like talking to people. I don't like meeting new people. And so that was one of the things that I struggled with most, was having to get in front of people. And like I said 13 years ago, when I started my group, marketing wasn't as big of a an issue because referrals were so high. So I lucked out as a person who doesn't like to meet new people. I lucked out for a long time. And. But that's the one thing I love about networking over marketing. I don't love either. So at the end of the day, for those that, like, don't like it, you cannot like it and still do it. What I find is that marketing is. Feels too salesy for me. I can hire people that can do it for me, right? But I prefer to create relationships which marketing doesn't do. Networking does. And networking is is less about trying to sell yourself. It's more about getting a relationship with someone where you both mutually are helping a certain population in your neighborhood.
B
Yeah. Amazing. Thank you Maureen. And you're going to be doing a training in the Abundance Party. So for those who are in there, make sure you don't miss it. For those who are not yet in the Abundance Party, hop in. You also all need to go to the group practice exchange.com this is where she teaches you how to build a group practice. So if you are considering a group practice, you need to join that membership. It's affordable. You can do it. So thank you and I'm looking forward to that training.
A
Yeah.
B
Make sure your email is actually HIPAA compliant with Pow Box. Use code Abundant to get Palbox for less than $100 your first year at paubox.com if you're ready for a much easier practice, TherapyNotes is the way to go. Go to therapynotes.com and use the promo code abundant for two months free. If you're listening, you probably need some support building your practice. If you're a super newbie, grab our 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.
Abundant Practice Podcast - Episode #639: Group Practice In Today’s World, feat. Maureen Werrbach
Host: Allison Puryear
Guest: Maureen Werrbach
Release Date: April 16, 2025
In Episode #639 of the Abundant Practice Podcast, host Allison Puryear welcomes Maureen Werrbach, a seasoned expert in building and managing group practices. The episode delves into the evolving landscape of group practices, especially in the post-COVID era, and offers invaluable insights for therapists considering transitioning from solo to group practices.
Allison and Maureen begin by discussing the significant shifts that have impacted group practices over the past few years. The COVID-19 pandemic, in particular, acted as a catalyst for change, pushing many therapists toward telehealth and solo practices due to the reduced necessity for physical office spaces.
Key Points:
Notable Quote:
“There isn’t this expectation [of long-term employment]. There’s a lot of people coming and going much more quickly, which just makes business a little bit more difficult for group practice owners.”
— Maureen Werrbach [06:30]
The conversation transitions to the practicalities of starting and maintaining a group practice in the current climate. Allison emphasizes the importance of strong leadership and the challenges that come with managing a team.
Key Points:
Notable Quotes:
“If you don't want to lead and have difficult conversations, you need to think about if owning a business that employs people is something you want to do.”
— Maureen Werrbach [10:21]
“Marketing is less about trying to sell yourself. It's more about getting a relationship with someone where you both mutually are helping a certain population in your neighborhood.”
— Maureen Werrbach [24:51]
Allison and Maureen delve deeper into the complexities of marketing and recruiting within group practices. They discuss the pitfalls of scattershot marketing approaches and the importance of focusing on specific strategies.
Key Points:
Notable Quote:
“I suggest doing one thing at a time all in for around six months so you can actually see if that thing is working.”
— Allison Puryear [15:38]
The discussion shifts to the strategic decisions between specializing in a niche or adopting a multidisciplinary approach within group practices. Both approaches have their advantages and challenges in the current market.
Key Points:
Notable Quote:
“Multi specialty practices when they are intentional about treating the whole person have just more flexibility in being able to see more types of clients.”
— Maureen Werrbach [20:10]
Allison and Maureen emphasize the critical role of relationship building and networking in sustaining and growing a group practice. These strategies underpin effective referral systems and community presence.
Key Points:
Notable Quotes:
“I always feel like the way to grow your referrals is through relationship building and less through trying to get every single person to know you exist.”
— Allison Puryear [21:40]
“Networking is less about trying to sell yourself. It's more about getting a relationship with someone where you both mutually are helping a certain population in your neighborhood.”
— Maureen Werrbach [24:51]
Allison wraps up the episode by encouraging listeners to leverage the insights shared by Maureen to build and sustain successful group practices. She highlights Maureen's upcoming training sessions and resources available through the Abundance Party membership program, designed to support therapists in navigating the complexities of group practice ownership.
Final Thoughts:
Key Takeaways:
For more resources and support in building your private practice, visit abundancepracticebuilding.com and explore the Abundance Party membership program.