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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 Parer, founder of Abundance Practice Building. I'm here with Sean Yang. You can check them out over at Practices. FYI, I'll put that in the show notes and we're going to be talking about numbers, which isn't really like the strong suit of most therapists, but it is absolutely something that you need your practice. You need to be familiar with your practice's numbers, period. Whether you're a solo practitioner just starting out, getting into the habit of knowing what your numbers are and what they can do for you, or whether you're scaling into a group practice as Sean is here to talk to us about the importance of knowing those numbers and also how to. How to do it in the smoothest possible way. So thanks for being here, Sean.
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A
Yeah, thanks for having me, Allison. Yeah.
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B
So question. Because you work with practices of all different kinds, not just therapists. Why healthcare? Why? Why this?
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A
That's a great question. So I think a couple reasons, and there are two people in my lives. The first is my girlfriend who's a dentist and she is in specialty training right now. But she's always wanted to open own practice. And through her I've met a bunch of other dentists who own their own practice. And I was just like, as I got to know them, I've always wanted to kind of do my own thing. I've always loved helping people build their dreams and so just kind of everything worked well where I got to help them. As they built their practice, I learned a little bit more about what they're doing and I saw how difficult it is, like, and ultimately I think a lot of the difficulty came from things that should be a lot more accessible. It wasn't. I don't think building a practice is rocket science, but it does take a lot of grit and it does take, I think, people who you can trust and gives good advice. And so I just wanted to be that person for them. I thought we needed more of that for all of healthcare. And as I did that for dentistry, I also started working with my aunt who is a therapist. And so that's the second reason why I kind of got into this, which is she started her own practice. She does a little bit more of helping, I think kind of middle aged women who are in corporate kind of reach their full potential is where her primary niche is. And as she did that, I saw the same problems happening in therapy that were having dentistry. And I was like, okay, let's just kind of figure out how can we solve this across all of healthcare. Because I think being an owner is one of the best things you could do for your career if that's something you wanted to achieve, right?
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B
Yeah. If it's not on your list, that's fine. Keep working for somebody else. Because it does, like you said, takes so much grit. And part of the problems we were talking about before recording was like, there are so many different hats a practice owner has to wear. And I think especially I'm going to lump therapists into a category that I think is fair generally that we're not numbers people. We don't all love that kind of data. That maybe somebody who went to dentistry school or, you know, medical school, where they do have to take A lot more math than we did. It doesn't come as easily to us and we want to. We'd rather talk about feelings all day than look at a spreadsheet. But we do need to know our numbers. One of the things that I'm constantly telling people when they're freaking out is, okay, data, not drama. Like, let's actually look at your numbers. And most of them don't have them. They're like, oh, hold on. And I get that because they feel like they're drowning, they've got so much to do, or they feel overwhelmed by even how to get the numbers together and what numbers are important and what numbers aren't. I'd love to talk about that with you to find out what's actually important, numbers wise, so that we don't have to focus on the ones that aren't. Maybe let's go there because I think if we simplify knowing what your numbers are, like, what does that even mean? It's going to make it easier for people.
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A
Yeah, I love that. There's an analogy I often think about when it comes to data, which is it's very similar to losing weight. Running a practice and losing weight, like the applicability of data and how it helps both. I think everyone knows that losing weight is a fairly simple formula. You move, you exercise and you also try to consume less calories than you expect. Right. And so if there's a calorie deficit, you're going to lose weight. You don't need data to lose weight, actually. Right. You can just follow this, you can kind of ad lib it and figure it out, eat more veggies, for example. But as you get older, it gets harder. And I think what you tend to find is if you're not tracking your calories, you might not realize that you're consuming more than you thought. And it's the same way in business. I feel like if you run a practice, there's a lot of things that you just intuitively know or you've heard through other people in the industry of what you should be doing to run a good practice. But if you're not looking at your numbers, the things that you think are going well may not be. So they start to slip. And so effectively you're playing practice owner on hard mode. It's like we already mentioned, it's already hard enough. Like, I don't think you have to do that. And, but like you said, data is scary. I completely understand that. There are also, like, it comes in spreadsheets, it's Hard to find in your ehr. Right. Nothing's easy about it.
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Right.
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But if I were to simplify it, I want to talk about two things. One is high level data and then maybe how to use data to solve your specific problems. The first is high level data. So I would look at what is your production so as it relates to your insurances, like how many, what are you filing as claims. Right. And track that number. And I would look at your collection rate or your collections because that's ultimately kind of the thing that matters. It's what goes into your bank account. And so for me, that's the top line stuff that I would keep an eye out on. And then I would follow that up with your patients that come and your new patient count. And honestly, I think that's a really fine place to start those four metrics for a solo practice.
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Yeah. And I think knowing I would add to that. Like knowing where they're coming from.
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Yes.
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Because if you're needing more clients and you are marketing and it's one doctor sending you everybody, that's great information to know. How do you nurture that relationship? How do you find other doctors? Because we don't want all our eggs in one basket. But if you've got one or two really strong referral sources and you don't need to be messing around on Instagram anymore because that never brought you anyone and that takes a bunch of time and energy, then we can drop that and reinvest in the thing that's working. I think looking at what you're collecting from insurance, for those of you who are taking insurance is really important because it might be that your hourly rate is actually a lot less than you are billing. And you think it is because a lot of times we'll be like, oh, well, you know, insurance reimburses $120 a session, say. But if every 10th session isn't getting paid or you get callbacks or just various things, it's not the same simplicity that those of us who have a private pay practice have where it's like it just gets paid every time, the full fee, no matter what. And we can kind of count on that income a little more solidly.
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A
100. I completely agree with that. I think the complexity with insurance, I mean, there's a lot of gripes about insurance and true, like very valid gripes, but it's also not something that's going to change immediately. And so if you're not keeping track of that, I think a lot of owners go into this idea of like they do all their numbers with this, like this one reimbursement figure that they have. But like you said, that number in a lot of cases, a lot less than that, it's not $100, it could be $80. And so if you're running all your numbers, if you are running numbers off of that $100, you're going to be running at a loss. And so I think just really great advice right there.
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B
Yeah. Okay. Of those four that you mentioned and then the what's working marketing wise that I added.
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A
Yeah.
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B
Where do you see people get hung up?
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Yeah. You know what, actually let me add one more metric before I answer that question. I would also look at your bank account to see how much cash you have. Like at the end of the day, that is make or break. And so keep an eye out on that. Right. And if you're seeing, hey, I, my revenue looks great, like I'm collecting a ton. But your bank account is like almost always not a number that you feel comfortable at. You should do a real hard look at your expenses. Right?
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B
Yes.
- [10:43]
A
Let me go back to your question. There's a lot I want to talk about there in terms of how you actually use data to solve your problems. But to answer your question about which numbers that practice owners typically get caught up in, you know what's funny, I think they get caught up on no shows, which is not a number I talked about, but it's related to kind of your overall patient volume. I think there's a tendency for practice owners to focus on things that do matter, but feel very acutely horrible, but relatively has a small impact to their overall business. For example, you're always going to have no shows. If you have 50% no shows, we really should address that problem. That's something you should look at. But if you have 80%, 90% show rates, it's like you can continue to spend all your energy there's which will consume you, it will bother you, it will destroy your day. Every time you get a no show, if that's your primary focus. Or you can kind of start to focus on, hey, how do we increase this other lever within the business? Maybe my collection rate isn't as high as it could be. So let me now start to focus on that because if you spend your energy getting your collection rate to from 60% to 80%, that might be an extra 30,000, $40,000. And the reality is you're not really going to be able to increase your no show rate if it's already at like 90%, 100%. That's just not going to happen.
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B
Right.
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And so I guess the short of it all is I think there are certain problems that every therapist and every owner kind of focuses on collection rate, no show rates, which matter, but only up to a certain extent. And so that's where I think people get caught up on, is not prioritizing where their attention should be because you only have limited attention.
- [12:31]
B
Right. I think that's such a good point because it's easy to. Like right now, people are listening and thinking about, okay, well these numbers aren't too hard to figure out. It's they. So maybe they're like, okay, I'm going to do everything. And doing everything all at once, we all know burns us out, right. So maybe this week you look at two of these metrics and then next week you do another two and next week the other two, and you just keep these. Once you're like rolling with them, it's easier to maintain a system where you know these things or like some of what you do where you can input things into AI and it's. You're now not having to strategize and keep up with all of this. Right.
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100%.
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B
Can you talk a little bit about how AI is helpful in these circumstances?
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A
Yeah. And Allison, I think you mentioned at the beginning, right before we started recording, that there are a lot of therapists who have this aversion to AI. So I want to speak to that really quickly, which is I completely get it. And I think more and more big therapy tech and just AI companies in general are like, let's just replace humans completely. Let's replace providers completely. One, I don't think that's going to happen for a number of reasons. And we talked a little bit about that. People need people. But what it can do and what it does a great job of doing, if you allow it to, is helping you lift your business up. It can replace or supplement a lot of these skill sets that therapy owners don't feel like they have. And so data is one of those things. If you look at Claude or ChatGPT, their ability to analyze data and recall data is really, really high. And so what I'm doing is working with a team of developers to effectively port your information, your data, your workflows, your SOPs, your policies into AI and so that you can always recall it and ask it analysis questions, things that you would typically have had to pay a consultant for. For example, like, can you get me a list of patients that didn't show up that no showed last week so that I can outreach that patient and see if they'll come back in for a visit. Right. Or collections. Same idea there. Hey, this person's overdue for a payment. Can you send them an invoice? Right. So right now where we're primarily focused on is just getting that data that reporting that information. If you ask it, hey, my revenue went down, but I didn't collect as much this week. Can you explain to me why it will theoretically be able to answer that question and answer that question accurately, which is why it's so important to port the information over correctly. But the hope is that one day we can have agents or other AI things that actually send out the invoice on your behalf that actually take that next step so that a lot of that stuff is automated and it's already happening in the corporate world. And so to be able to bring that into therapy, healthcare practices in general is what we're really excited about.
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Yeah.
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Does that answer? I got lost in the sauce.
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B
It's good, it's good. And I want to say for people who are like, oh, that's a good idea, I can be using AI to do these things. I don't want y' all to take all your EHR data and put it into Claude or ChatGPT. Not HIPAA compliant.
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A
Yes.
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We've gotta keep this HIPAA compliant. And that can be done in different ways with different portals and things like that. With cloud code, I'm assuming, or like different ways to make that safe and legal. But don't be never ever, ever, ever take anything with any client information at all. Even notes into Cloud or ChatGPT.
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A
Yeah, those are not HIPAA compliant and they don't sound baas. So 100%. Yeah, great, great piece of advice.
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B
Yeah. So I'm thinking too something that you mentioned earlier about clients is we have kind of an average number of times that clients see us. And most clients, therapists aren't doing the math for each client to see how many sessions they typically have. And that's a really important number to know. Like if you do solution focused short term therapy and you see people maybe like four or five times total, it's really different than if you're a psychoanalysis doing two to three times a week for years. Getting a new client in your practice means something very different financially from a marketing perspective. There's a lot higher ROI for that psychoanalysis than it is for the solutions focused person. Not that either way is right or wrong, but knowing your average number of sessions Per client is great data to know that can also help the freakout if people are getting. It's slower thanks to Big Therapy Tech. Right. So if you haven't gotten referrals in a while or they've slowed down, let's say like you used to get like 10amonth and now you're getting three, maybe that's okay because your people stay with you for years and you can't really have taken on all ten of them anyway. So knowing the number of sessions really helps keep you from freaking out 100%.
- [17:48]
A
I actually think that's where data is really amazing. It provides accountability and visibility.
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Yes.
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A
And the visibility is exactly what you talked about. It just makes you understand when you understand your business, you react to things appropriately, you prioritize and spend your time on things appropriately. And the accountability is honestly you could just think of as goal setting. Right. It's hard to end up somewhere if you're not actually pointing in the right direction or know which direction to go into. And so that's where I think data is really powerful. I think what you talked about is something that more owners need to think about because at the end of the day you are an owner of a business. And I love independent practices because on a whole kind of generalization, I think they care more about patients than Big Tech does. Not that the therapists at Big Tech don't care, but I think Big Tech as an organization and as a structure, they don't care as much about the patients as they do money. How do I know? Because I worked at mental health care startups that are venture funded. I hear how they. Yeah, it's very numbers based, you know, it's all how many patients can we get in? We know the capacity. They don't think about the clinicians, they don't think about their burnout or the fact that it takes X amount of time to do notes after. And they don't really think about the care other than hey, can we keep them coming in as many times as possible? Right. And I think that's why we need more independent practice more generally or practices that care. But not enough owners think about their therapist practice as a business. And the most important thing in a business, one of the most important things is really understanding revenue. And revenue to your point is like there's so many components here that people don't think about. It's price and volume and price is a little bit more clear. It's the rate you charge. We just talked about with insurance companies, there's might be a Little bit. It might be a little bit more confusing to calculate that number, but volume is something that you have a lot more control over outside of your. If you're a private, pay in volume. If you understand how often patients are coming, you can really start to understand, hey, is this the right number? Should patients actually be coming more and something's happening in the cycle where they're dropping off? Maybe it has something to do with my follow up. Maybe it has something to do with kind of how I'm structuring the business and not necessarily the therapy itself. Right. It could be that, hey, you need more new patients. It just opens a whole new door when you start to evaluate data at an operational level.
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B
Yes.
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A
And I'm. It's like, I'm trying to like, not get too in the weeds of it all, but I, I love that you brought it up because you have to. The more in the weeds you get, the more answers you get to building a successful business.
- [20:41]
B
And systems are so important because we are carrying plenty. I think about my. One of my daughters goes to therapy for a specific phobia. She's doing a specific protocol with this therapist that she's one of the few therapists trained in it and it's been great when she goes, but trying to get like, I can't schedule online. She doesn't prompt first to schedule. When I pick her up, I'll text and like, it's just kind of hit or miss if she responds because she's busy. And so we can't get her farther along with this phobia because we're not going often enough because it's hit or miss. And she might be looking at her revenue and being like, I just don't understand why people aren't coming consistently. But it's, it's honestly because I'm kind of dogged. Her follow through is not great because she doesn't have a system for it. She's great. She just doesn't have a system for follow through and she's a busy woman. So seeing your data and being able to realize, okay, there are some holes in my systems and the data is telling me this then allows you to build a system that works.
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A
I'm. I'm like, just waving my arms in like full support, because that's when I mentioned earlier, I was like, how do you use data to solve actual problems? This is it. Like systems and data, they go together. Data shows you what's working and what's not, and it doesn't show you why something's not Working, you have to actually understand your business. You have to go talk to the people. Boots on the ground. As an owner, you know, you probably see a lot of this stuff. You just don't recognize the impact that it's having to your bottom line or your top line. And so exactly like what you said, when you look at numbers and you're like, there's something wrong here. And then you dive deeper into the actual business, you're going to figure out what you need to improve. And, and there's. You could break data down to get very specific. For example, like, let's just think about new patients coming in. I love your example, but I'll switch to another one for more variety. It's like, new patients. You're like, my new patient volume isn't as high as it could be. And you're like, why is that the case? I'm paying for SEO, I'm doing Instagram, I'm doing TikTok, all these things. I'm going out. Boots on the ground, which I love. You mentioned this on a previous podcast. I triple plus agree. It's like boots, like, getting to know your community, I think is so important. That's where the advantage is against big tech. But it's also the only thing where you get to really, oh, if you build a brand, that's something different, but you get to actually own your audience. Because ads will always get more and more expensive. It just will. And so to depend on that is it's a recipe for lower margins. Yeah, but you know, with new patients, you could be looking at all these things. You're saying, I'm doing all these things. Why is it not working? And then there's data you can look at to figure out whether your SEO works. There's data you can look at to see whether your Instagram works. I love asking your patients from where they came from. That's a huge source of data, first party data that you can use to validate that. But let's say all of that, those numbers look good. Then you can look at your phone system and see how many calls are you getting and how many are you answering. Maybe you're just not answering enough calls. Maybe people are on your website, but there's a drop off on your scheduling after they click on the scheduling link because it's so hard to navigate. That's how you use data to figure out what's working, what's not. But I will say as a step back, because I think sometimes that could get intimidating, like, I don't know how to pull that data, that takes a lot of time. One, I do think I will make that easier. But two, you know, just through your own experience, what works and what doesn't, through your DARs experience, you're like, this is so difficult to book an appointment. And if we just had things that everyone knows they should do. Have a good scheduling link. A scheduling that works. It shows your available times. Pick up the phone when people call, or at least text back or answer when you have availability. It's not rocket science. It's just like, it's a lot to do at one time. I don't want to minimize it. But yeah, yeah, yeah.
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B
And I mean, if she had an online scheduling link handled, it's handled and it's automated. And it's no time on her part except putting that widget on there or that link on there. But she's busy, so I get it. But it is hurting her bottom line because that's $800 a month she's not making for me, you know?
- [25:08]
A
Yeah.
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B
So, yeah. Amazing. Well, thank you so much, Sean. And you are helping practices get this, like, get this all handled so that they are not messing around with something that's not HIPAA compliant or not putting it off until later, later, later when they'll look at it. So we have the link in the show notes so folks can get in touch with you. And thanks for talking about numbers in a way that's a lot less intimidating and easier to wrap our heads around.
- [25:37]
A
Yeah, I appreciate it. And once again, thanks for having me on.
- [25:40]
B
Absolutely.
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A
It's a lot of fun.
- [25:42]
B
Yeah. Take care. 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 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.