← Abundant Practice Podcast
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Foreign.
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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 practice building.com Links all right, onto the show. So I've talked about therapy notes 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 therapy notes 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 Alison Pereir, founder of Abundance Practice Building and I'm here with Randall Avery and we're going to talk about money. You're going to want to follow up with Randall probably after this. You can find him as Randall Avery on social media and his website will be linked in the show notes. Thank you so much for being here Randall. I'm excited about this.
- [02:20]
A
Now this is fun. Started off serving therapists, so this is kind of going back to home base. So this should be a fun conversation. Yeah.
- [02:28]
B
Yeah. So there's a lot of head in the sand action that happens with therapists around money. Before we started recording, we were talking about how once therapists are Making money. Sometimes they just don't want to look at it. They don't know when to pay themselves. They don't know what fees to set. There's just this very different relationship with money as business owners than they might have had as agency workers. Can we maybe start there with just some basics so that people can slowly pop their head out of the sand and then we'll go a little deeper?
- [03:03]
A
I think. Let's address the elephant room. There's nothing wrong with making money from your profession.
- [03:09]
B
Say it louder.
- [03:09]
A
There's nothing wrong with making money in your profession adding value to society. So if you're adding a certain level of value to society, you should be compensated, especially if you're serving clients that are also equally well compensated. So I think we need to take a step back and understand what therapists do is providing real value in society. And if that is the case, then they need to be compensated well. You should be able to take care of your family. You should be able to relax. Relax. You don't have to always be on that hamster reel. So first, I want to give everybody permission to earn money and to enjoy the life and the skill set that you've learned over the years.
- [03:46]
B
Yes. Thank you. I think it helps to have somebody say that outside our profession because it sometimes feels like a we're allowed to make money. Right. Kind of a thing that people end up saying and on social media, like, it's those of us who are more loud about it are quick to get haters. So it's nice to have that. That validation from you. Thank you. Yeah, yeah. So, like, if. If we're coming from this perspective of, like, this is a profession, it's great to make money in your profession, and you don't have to be a martyr in order to get it. Where do we go from there? Like, what are some really basic steps that therapists need to be keeping in mind?
- [04:26]
A
So I think the first thing, and I know this is a taboo, just like making money is finding a niche, finding some area of specialization. I hear a lot of people say, I want to service everybody. I don't want to limit myself. I potentially could get bored serving just this specific population. Trust me, if you love what you do, super. Serving a segment of the population will never get boring because you always find ways to go deeper, nurture things. So the number one thing, if deciding to make money is for you, is find a niche that you can specialize in and know how to speak to that audience.
- [05:01]
B
Absolutely. Yeah. And this is something I'm Preaching constantly. And as you and I were talking before, we recorded like our grad school indoctrination into how to be a good therapist doesn't usually include you don't have to work with people you don't want to work with. And it is okay for us to have populations we don't want to work with. Sometimes that comes from a lot of our own unhealed pain. Sometimes it comes from not feeling competent. Sometimes it feels comes from just like it's just not a fit personality wise. And that is okay. Yeah.
- [05:35]
A
In my world in finance they say somebody c client is somebody's a client. And the same thing operates in therapy. Some client that will be too burdensome to you, too stress for you, whether it's your background or whether you're training will be somebody's a client. Let that client or that patient go to the place where they will be best serviced. And I don't think we have to strudge and struggle with serving people who we might not be doing the best for them.
- [06:02]
B
Absolutely. I had a group of therapists once and one of them was like, well, you know, my niche is like everybody else's. I want really motivated people who want to do the work and they're blah, blah, blah, blah. And one person in the group was like, ugh, boring. I love the challenge of somebody that I've got to get to that place of wanting to do the work. So we're quick to make assumptions sometimes about, well, if I don't like this client population or this presenting concern, I don't feel competent with it. Nobody else does either. When there are people who are like, gosh, if only I could have a caseload full of those folks. So we've got this clarity around niche is important, marketing is important. And that's going to differ person to person about and population population about what's going to work best. And in the meantime, I'm assuming they're getting these clients, they're making this money. Can we talk about what might be? They're, they're the people who get really obsessive. Right. Like they're looking at their bank account multiple times a day. They're doing math that doesn't need to be done. Those are unlikely to be therapists. But then they're the people who are like, hope it works out when they're paying a bill. What's the middle ground that's reasonable. How should we be approaching our money?
- [07:19]
A
So I think, and we're talking to practice owners here, I'm assuming people aspire to be practice owners. So we have to come at peace with we are running a business. And because we're running a business, there is an expectations of looking at the numbers at a certain length and a certain amount of frequency. And you have to be comfortable with that. So this is not going to sugarcoat, but you are in business. You want to grow. And think about it this way. You want to be financially stable enough to service the clients in the best way.
- [07:48]
B
Yeah.
- [07:49]
A
Your patients can sense stress. I know you guys are professionals and you've been trained to, you know, turn it on and turn it off, but people can sense it. There's a certain level of business stress that comes along that is very weighty, that we all, all of us business owners know. So the first thing is understand that you're a business owner. Then the question is, how frequent do you need to look at these things? I recommend initially, maybe every other week, but definitely without negotiation. Monthly. Why monthly? Because most of our bills are due monthly. The zoom call could be due monthly. Calendly scheduling is due monthly. Your regular bills are due on a monthly basis. And you want to make sure you have the funds in place to cover those expenses.
- [08:29]
B
Absolutely. It's interesting the kind of guilt around money that so many therapists feel when they first start to get it and how that leads to them not looking at it. And then they end up spending because they're like, well, I'm actually making a ton of money, so maybe I'll get a new laptop and maybe I'll get this training that's like $2,000 and maybe I'll do this or that. And then all of a sudden their ehr bill bounces and it's because they're not looking at it and being planful about it, because being a steward of your money is important.
- [09:02]
A
And there's actually two sets of books. So you have your business books and your personal books. And it's so tempting to convolute the two. It's like, oh, I had an amazing month. That means I could buy a new tv. Now your business, I think something people need to understand is your business needs to be reinvested in, just like you as an individual need to be reading, invested in. We talk about self care, we talk about vacations, where your business also needs to be massaged and self care. You mentioned purchasing a new laptop. It could be purchasing a new customer CRM. It could be another video camera. Different things need different investments. So make sure you're keeping separate books because your business, which is going to Be your baby has needs, has wants, desires. And I think the key thing is experimentation. One way to keep your business fresh and fun is to have the funds in place to experiment and try different things. And I don't think that can be disconnected.
- [09:54]
B
Right. And I see that a lot with therapists and trainings. Right. They're like, I'm going to learn this new modality. And sometimes they, I think that they are trying to feel competent by taking training after training after training and trying to feel good enough for what they're billing when they were good enough to bill it to begin with or people wouldn't keep coming back. So it's interesting how the psychological side of our own self worth and money end up colliding in this way that forces personal development if you're willing to start looking at it.
- [10:27]
A
Yeah, I think like I said, the trainings are important overall. You want to be competent in what you do and super serve, but you also have to be competent in the actual service of them. Think about how your patient feels when they enter your office or enter a zoom call, how they feel when they're exiting. What does the follow up look like? I think studies need to be done on those elements because that's really is going to get the word out about your services, how that patient feels in the moment. Mm.
- [10:54]
B
And you had mentioned something about making sure, you know there are going to be unexpected things that happen and making sure your business is separate from your home finances and that there's cushion there. And I think about. So I live in Asheville, North Carolina. We had Hurricane Helene come through and destroy most of our town. We didn't have power or water for two months. It was like a thing. And what I saw amongst so many of my business owner friends, including therapists, is there wasn't enough of a cushion in that business to sustain them. And so they're traumatized and they're grieving and maybe they've got a ton of repairs they have to pay for at home that insurance didn't really pay for much of one year. So they've got this intense financial stress and their clients are spread out. You know, they're. They're not going to zoom. There's no water at the office. They don't want to pee into a bottle. You know, there's just a whole situation where the people that had savings specific to their business and savings in their life were in a much less stressed out position than the people who were going and like staying with their in laws because that's where the Internet was and they could make more consistent income because they needed to. We have to have cushions to have any sort of peace.
- [12:09]
A
I work with in practice zones in general, so that includes attorneys, accounts, things like that. And I tell them all the time, you are not a professional unless you have a cushion. Three to six months worth of living expense. And if you're a business owner, you need to have three to six months worth of business operating expense within your business. And why is that? We all think we're good people, but you'll be surprised how ethically compromised you can be because financial stressors happen. And a lot of my studies on this came. I used to work in internal audit and really it's about checks and balance and what motivate people to commit fraud. And you surprise like good people with good intentions. If there's roof is linked, is there a baby crying in the room? If you're about to get evicted, what you would do to make sure those things don't happen. So to prevent that, play a little bit of defense. Have that cushion in your personal life, have that cushion in your business life. So you won't have to compromise. You won't have to say, well, patient, you need to come back twice a week. When you probably know that may not be the best thing, but you can rationalize in your mind, well, more therapy is good therapy when they may need to take time to digest some of those conversations. So really think about if you want to be a professional, you need to have that level of cushion so you're not compromised.
- [13:22]
B
And then that leads to for therapists, your fee. Because I know a lot of therapists are listening right now and are like, how am I going to build a cushion and pay my taxes and have a cushion at home? And blah, blah, blah. And that is either because you're overspending, which could be, but it's probably because your fee isn't high enough.
- [13:44]
A
Yeah, I've noticed the biggest difference between my clients with therapists that are happy with what they're doing is really goes down to what they're able to charge. And we think, well, somebody's not going to pay, that I shouldn't charge this or I do this because I love it. I don't even want to charge that much. But being fairly compensated is important. Charging a fee is important. And making sure this is from my world, I think it's a little different from the therapist world. When people pay, they take things seriously, really shows what they truly value. So charging what you're worth means a whole lot More than just money coming to your account. It means how you feel about yourself, your practice, and how much the people you work with value what you do.
- [14:30]
B
I posted something I got some hate for over the weekend. I got a lot of haters on it, but, like, one guy, I said something like, I'm not apologizing for funding my retirement account. I'm not apologizing for having my student loans paid off. And some guy was like, what does that have to do with being a therapist? And this is somebody who's not a therapist. But that's something a lot of therapists are also thinking. They're not thinking about retirement. And y', all, I would love for our brains to work adequately enough to do this until we die. But even if our bodies could do it, our brains can't. It's just too much. We have to have retirement. And I personally didn't want to die with student loans if I didn't have to. So I made that a priority, too. And the assumption that that's just like, we're gonna die with our student loans and we'll figure out our retirement later is something that really scares me in our profession.
- [15:23]
A
I agree. And I think therapists, you know, they have to go through undergrad, they have to go to the master's, some get their PhD and they have additional studies. So what it is, they're kind of anchored into that profession. And a lot of that anchor sometimes has to do with they feel financially trapped. I have to earn so much money to justify all this schooling and student loans. I've accumulated years. But if you take your finances seriously, charge a fair rate and be compensated well, I feel like you can spread yourself out a little bit more. Maybe you want to write that book. Maybe you want to do that research. Maybe you want to specialize in a completely different area, but still leverage your learning and skills. That doesn't happen until you reach a level of financial security. So I think, I recommend take yourself out of it personally. But think about the good you can do to society, your client base, and your family when you think about pricing your services.
- [16:15]
B
Absolutely. And it's interesting. You talk about having a fair rate, and when therapists hear that, they think a fair rate doesn't include them putting into retirement every. Every month, them taking care of themselves with vacations and things like that. But a fair rate includes those things and needs to be like that calculation needs to happen, not just looking at what people around you charge, but looking at what it costs for you to live your life.
- [16:45]
A
Yeah. What I'VE seen is that therapists will anchor to what the insurance is willing to compensate them for. And I understand most therapists will start off on insurance panels until they, if they decide to go private practice or fee only and they anchor to that amount and they say, okay, well they're paying me 120 per hour, maybe I go 140, maybe I go. But there's nothing wrong with going to 200, 300, 400 if you're providing the value that necessates that fee level and serving a client base who can afford it. Sustainable.
- [17:19]
B
Absolutely. And having amazing referrals for those that are like, oh, I can't afford that on the phone. Yeah, I see that as 100%. Part of our job is knowing the great people in our state that can provide this like a great level of care for people at a reduced rate, taking insurance, et cetera. Yeah. And so like, can we talk a little bit about investment? Because I think that this is an area a lot of us aren't taught unless we came from families that were able to teach it to us. And I think people shut down. Like I'm thinking about my typical head in the sand therapist. When you start talking about the word investment or even retirement, like I don't even know what a 401k is, that kind of thing, people start to shut down. Can you give us just like the tiniest primer, like most accessible, like we're.
- [18:08]
A
Five years old, so we hear this all the time. They say pay yourself first. What does that mean? Does that mean that goes into a savings account? Does that mean that goes here? Pay yourself first really means when we talk about retirement planning is to automate your savings. So what does that mean? You can set up an automation to transfer money from your checking account or your business account directly into an investment account. So if you work for an employer, usually have a 401k. So that would be the automatic investment of paying yourself first. But when you're self employed, things can get a little bit complicated. The simple way if you, if you're just starting out is maybe open up a Roth IRA and begin transferring money into there. Okay. If you want to go a little bit more advanced, you could do a SEP IRA and if you go even more to solo 401k. But the simple thing is open up account, use one of the discount brokerage firms, so that's Charles Schwab, Fidelity and Vanguard and just transfer. It could be a startup small $50 a month and then just increase that amount as your business grows and make sure that it's automatic. You don't think about it. Times get tough. Do not be tempted to dig out of those things. And if you're not a big finance like investment guru type person, just do it with something called a target date retirement fund. And the target date retirement fund is a fund that is estimating you're supposed to retire at this year and it's going to allocate that amount for you. So that's really the simple money. Do automatic contributions into your account and just in the targeted retirement fund that matches when you would like to retire.
- [19:43]
B
I think about how we think about ages, like 65, right? That sounds like a nice solid retirement age. Start getting Medicare if it's still around. And that sounds good. I know when I was getting paid $25,000 working in an agency, working full time, I didn't put anything away because I was barely making ends meet. So some of us have some catch up to do. Like didn't put away a lot while working in agencies, not getting paid well and then starting a practice and didn't put away any during that time. So let's say somebody's like 35, they're gonna need to put away more. But the more they put away now, the better. Like they can put. If they were to do 200amonth, for instance, at 35, that's gonna appreciate thanks to compound interest so much more than if they put $200 when they're 60. Like it's just an astoundingly incredible growth rate that I wish we'd all started at 10, but we didn't. So I think people don't always understand compound interest. You say those words and people start to kind of phase out. Like they're kind of done with the conversation. Can you give some examples of either what you've seen or what's possible through compound interest?
- [21:00]
A
Yeah, my primary client is kind of like that millionaire next door. And the millionaire door manifests itself simply from somebody when they're in their mid-20s and they had a mentor come up to them and ask them, hey, are you participating in your employer's retirement plan? And the source says, no, I haven't even thought about that. And they say, why don't you just put this percent in and do an automatic increase every single year? And the client did that, didn't think nothing of it. And they look up and they say, hey, I have so and so amount of money inside the account. So it's that compounding effect that happens. So what's happening? It's really Your money, money working just as hard as you are. So when you put a hundred dollars in, that money is going to have interest or is going to grow to a certain amount and then it's going to compound that money that, that you put in. Plus that growth grows again. And it happens over and over and over again to the point where your money begins to work, like I said, just as hard as you are. I think it's around $400,000 is where you can actually earn more in your investment account than you do from your regular paycheck. And to me that's a beautiful point. That's the point where we say, okay, I'm going to be okay if I'm no longer working. So it's really the goal is to build up that amount of money so that it will begin to work for you and compound year after year after year.
- [22:20]
B
Absolutely. It's so important. And I think about like we see it going the other way with like credit cards. So anybody who's ever been in credit card debt, like you've got compounding interest there also, but it's just making you broke by the time you finally pay it off. And so this is like a way to balance the scales. Yeah.
- [22:40]
A
And I'm a big no debt guy and I'm actually going to have a discussion later on this month about, you know, business owners default to thinking they need debt. And most service based business, you should really be bootstrapping your business in the sense of as you have money set aside, invest in the business and go on and on and on. Do not take on business debt because a lot of times you don't know what you don't know in business and you can funnel 20, $50,000 down a hole to something that's worth nothing when you could have just slowly built your business over time. So do not fall into the temptation that oh, I'm just going to put it on my credit card and pay it off later. Oh, I'm just going to sign this lease I can't afford and money will come bootstrap. Especially in the days where you can do virtual therapy. You don't have to do the humongous investment to go into these type of businesses.
- [23:32]
B
Yeah, I've been in private practice since 05 and pre Covid you did just kind of have to take a leap and pay rent and it was really scary. And now there's a different way and that's amazing.
- [23:43]
A
Yeah. And I also think that you'd be surprised how many practice owners just need somebody to help with their patient load. So you can be a contractor and people don't think of it. Well, I'm still under practice. No, they pay you 10.99. You have all the benefits of a business owner. And one of the side perks is you may not have to go out and find your own clients. So there are kind of, like I say, halfway houses, or you can kind of be sitting in limbo a little while as you anticipate you making that leap. And the kicker on that is you can look around and say, okay, why is this practice successful? And what are some of the elements that I can take and what are some of the things that I dislike that I want to repel? So not only are you getting compensated, you're getting real world learning on how to grow a practice so you don't have to just go all in. There are steps that you can take.
- [24:30]
B
Absolutely. Yeah. Well, Randall, thank you so much. I really appreciate it. And I hope that folks, you've got a book too. Can we talk about that real quick?
- [24:38]
A
I wrote the book hacking the system by creating your own system. I think at times in our lives we felt like, hey, man, the financial market, the financial world is kind of against us. I have a lot of credit card debt, I have a lot of student loans. Rent and mortgage is just taking over my whole income income. My book, Hacking the system by cranial system is kind of gives you a blueprint of what you're up against, but also solutions on how to move forward, how to pay off debt, how to actually utilize your human capital even if you're not a therapist. What am I doing that's going to provide value to the market? So it's been a valuable book, it's been received well, and hopefully if this is something that interests you, you can find value in it as well.
- [25:14]
B
Yeah, we'll definitely link to that in the show notes as well. So thanks so much for your time and for kind of dumbing it down for us, because when we're intimidated by the idea of something, we don't get to benefit from it. And we all need to benefit from our financial lives.
- [25:30]
A
So thank you, enjoyed it.
- [25:32]
B
Have a great day. 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 listening, you probably need some support building your practice. If you're a super tip of 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.