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Private Practice Startup Podcast
Episode 140: Counseling with the Cows- Six Tips for Growing a Rural Private Practice
00:27:36
Dr. Julie Merriman
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- [00:03]
A
Welcome to the Private Practice Startup, where we inspire you from startup to mastery. We chat with entrepreneurs, experts in the mental health and business arenas, and successful private practitioners to give you the tools needed to make your dream practice a reality. Visit theprivatepracticestartup.com for awesome resources, free trainings, and so much more. Here are your hosts, Dr. Kate Campbell and Katie Lemieux.
- [00:28]
B
Hey, everybody. Welcome back to another episode of the Private Practice Startup podcast. We are really excited because our fingers are crossed that technology is going to work. We have been. Microphones not working today. Internet not working. This is like three times the charm. We are going to nail it this time. So before we dive into today's topic, I hope that you guys joined us last week for Dr. Andre Caruso on creating a transgender experience, inclusive and affirming practice. I know that was really super helpful for me and I'm sure a lot of you struggle with, well, how do I create a transgender affirming practice? What's important to know, what's not. So this podcast will definitely help you out with that. Today's guest is Dr. Julie Merriam and it's really cool because we. Well, she's sitting on the opposite side because she interviewed us on her online summit several months ago. I can't even remember what month it was now, but it was several months ago. So we have her here today and we're going to be talking about counseling with the cows. Six tips for growing a rural private practice, which I'm excited about this topic because Startup Nation, you have been actually asking this question, how do I create a thriving practice or a full fee private practice in a rural or country area? So she's going to have some really great tips for you there. But before we dive into all of that, if you are new here, we want to say welcome, you are our VIP and we have a special gift for you and that is our A to Z cheat sheet, the essentials for building and growing your dream practice. And you can grab that along with several emails of practice building tips, tricks and hacks by going over to privatepracticestartup.com heading over to the resources tab and looking for the A Z cheat sheet. So just go ahead and opt in and you'll get that for free and all of those practice building emails and goodies. So without further ado, Julie, welcome.
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C
Thank you. I am so excited to be here with y'. All.
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A
We are so excited to have you here and I love your topic, the counseling for the cows. It's just so creative and makes you go, hmm, what is this episode about? It's so funny because someone really did ask us that question yesterday in our Marketing Myths webinar that we were hosting. So I'm excited to dive into the topic.
- [02:45]
B
And before we do that, I just want to share with you a little bit about Julie. So Julie is an avid camp gladiator, which she's going to tell you a little bit about that shortly. Mom's a farmer and fireman in boomby to court and bow. She and her state trooper hubby farm and ranch in the middle of nowhere Texas. Clearly not on the map if it's nowhere. She's been in private practice since 1999 and has started practices in both the big city and in a tiny country town, both insurance based and cash. So that means she's a wealth of knowledge for you guys questioning or having lots of questions about how to build practices in both areas. But today we're going to be talking about rural and she's also a published author, national speaker, associate dean, professor of counseling, and lover of supervision. So without further ado, Julie.
- [03:30]
C
Hey, let me just jump back to the Camp Gladiator. Absolutely. That is where we meet in the mornings with our weights and our mats and blood, sweat and tears, if you will, and pump out some massive exercise before the sun comes up. So it is amazing and I am very proud that at 55, I most of the time lead that pack. And whew, I love that.
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A
There you go, girl.
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C
Not all the time, but most of.
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A
The time before the dawn. That's impressive commitment there.
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C
Yes. My biorhythm is early. I'm in bed by eight, so. Wow.
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B
I'm just finishing up my last client at 9.
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C
Oh, I admire you.
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B
It's funny when you talked about blood, sweat and tears with Camp Gladiator, I feel like creating an E course is like a camp gladiator.
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A
Yes, it is.
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C
Yeah. Oh, I'm sure. I'm sure. Yeah. Y' all have your sore muscles.
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A
Yes, we do.
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B
It's a huge mental game and a very like your neck and your shoulders get tight because you're constantly on the. So that's the tough and tough part, really. Just keeping that commitment and persistence. It's kind of almost like building a business. So share with us. You know, let's just dive into your topic and talk about this counseling.
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A
Sure.
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B
And share with us what tips you have for us.
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C
I will. And you know, a cow may poke his head in the window anytime over here because they're known to do that. But I love that what I've got for y'. All. It's beautiful out here. But I've got six tips to help you. If you're thinking about or trying to grow a rural private practice, it can be done. I've done it. I've done a very successful private practice with insurance out here, and I now have a cash pay insurance out here. But first and foremost, as with any practice, you've got to work on relationships. But out in the country, it's more about you've got to be willing to bring those baked beans to the picnic, you've got to be seen, you've got to be known, and you've got to be authentic, really involved with your community, not just, you know, talking about it. And that means you go to as many local functions as humanly possible. Getting a subscription to that local paper is really going to help you with that. But you go to the fish fry and you support the local volunteer firefighters and all those things that can leave you exhausted. But also because I'm an introvert, so all that kind of wears me out. But you also get a lot of really good relationships built. So it's worth the effort you've got. And I think joining Camp Gladiator falls into that because I'm not just talking about being in the community. I am in the community. I've joined all the chain.
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B
I was really worried a few weeks ago. We had just got our bathroom renovated. Finally it's done, almost the shower door and the guys had needed something else from Home Depot. So here I'm at home on a Saturday, coconut oil in my hair, doing a little hair treatment in my gym clothes, and I go into Home Depot and I turn the corner and boom. A brand new couple that I've been starting work with is like, right there. There was no chance to avoid them.
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C
And I was just like, hi there.
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B
What are you working on? I can only imagine that is so much more in a rural area. And how do you navigate the dual relationships?
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C
Yeah, that's a huge piece. And you know, anyone that's going to practice out here has to know what our professional orgs say, but also our state orgs, because those can vary. But, you know, I discuss it in my disclosure paperwork and we sit and really have a conversation about confidentiality and that we are going to see each other at the grocery store or in church or at these functions because I want my client to know I'm going to respect their confidentiality and I may not speak to them until they speak to me. Just. And letting Them know I'm not being stuck up because they'll think that. So just, it's important that we take the time to go through that with them.
- [07:42]
B
It's interesting, Julia, as you talk about that. So interestingly enough, in a rural area, you just kind of gave me this idea, like in a rural area where everyone knows everyone, if you actually chose not to talk to someone, that actually might demonstrate that you're. They're your client.
- [07:58]
C
That's true. That's true. And, and I mean, you don't. It depends on the event and what's going on, but it's never been an issue. It's because we talk about it in the get go and they give me right there in the office, they'll go, oh, my God, yes, come up to me. Don't worry about that. But, you know, we, we talk about it because our codes say, I mean, an adult relationship. It's. The client has to have full information so they can make their decision, and then I honor that decision. But it's, it's. I've never seen it to be an issue. I mean, but boundaries are really important because they want to. You know, I've had people come up and want to squeeze lemons with me and talk about, you know, how the husband was an ass or whatever that week, and I'm like, can't do this right here. So having really good boundaries is important as well.
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A
I love how with your first tip, Julie, you talked about the importance of being seen, because that's really what marketing is. It's positioning yourself in a way to be seen. Because if your ideal clients or potential referral sources don't know that you exist and don't know that you help with a specific population, then you're not going to be able to help people. You're not going to be able to do what you do best. And there's so many people out there waiting and being able to look at it from that perspective. And you create this strategic marketing plan from what you shared and getting to the newspaper, looking at the city events and the events in your area. And what would be most useful for you to position yourself and just be there, be present, be authentic, be friendly, and nurture those relationships that you build over time. And that's been your number one referral marketing strategy, which is so cool. I'm curious, what's your tip number two?
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C
Tip number two? Telemadicine. We've got to be willing to do online counseling if you're out here in the boondocks, because for my Niche client. There's only so many folks out here, so I really had to dive into that. And I think it's really important I had my counselor do some online stuff with me because I felt like I needed to receive it as part of the training ground, if you will. And that was very helpful. And you've also got to be willing to travel like Waco is close. And if y' all have ever seen Fixer Upper, you know that Waco and then stephenville is close. And being willing to see some folks in those areas as I'm building reputation helps tremendously as well. Plus, I've seen clients, I had a practice in Fort Worth for years, and that helps with people who don't want to drive but are willing to do virtual counseling. Julie. So I think that's very important.
- [10:28]
B
You said one important thing that I just want to highlight. I don't want to pass over because it was really important. So Kate and I, when we talk about really marketing a successful practice, is you have to have an ideal client and niche. And you did say niche. So for my folks who are really scared about, well, there's not going to be enough people. Julie just gave a great way to kind of circumvent that issue, is you just have to be willing to telemedicine and travel. And remember, when you guys work with your niche and your ideal client, that's the client that you're most meant to serve, that you're most passionate about serving. And so, you know, why let an area be a boundary, like allow yourself to break those limits and you to work with the people that you desire. So I just, I wanted to highlight that I thought that was so important.
- [11:11]
C
Well, and I'm glad you did because I thought that for a while I was like, I'm in the country. I can't niche. But no, I can, and it works.
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B
And you said that very country I'm in the country I can't name.
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C
It comes out once in a while. And you know, one thing that regardless, but I think it's uber important in the country, you've got to know your local community and appeal to the values and needs of that local community, which goes back to knowing. But the next point would be networking. Number three is networking. And you know, I'll say it again and again, you've got to be a part of this community, and they've got to know you, like you and trust you. Y' all say that all the time, and it's so true. And then you've got to spin it and think a little bit outside the box in the country. So when I think about participating in local events, not only attending as a participant, but I like we have a big local cook off here and doing a booth at the Cook. And my niche is couples. I work with couples relationship counseling. So I've had a booth at the Cook off where we do. It's a silly survey about how healthy is your marriage. I mean, you don't want to get really deep and into the weeds, but just something kind of light and humorous. What's the health of your marriage? And then I have a kissing booth where the couple can kiss and I take a picture of them.
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B
Yeah.
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C
Just to get out there and let people know you know I'm here and you're not crazy if you want to come see me. I'm probably more crazy than you.
- [12:48]
B
I was going to make a joke about a kissing booth and you actually do that. I love it. It's a great social media marketing. So fun. So Julie, before we hop on to the next tip, let's just take a quick break for our sponsor. Knowing you need legal, ethical and competent paperwork is overwhelming, time consuming and let's face it, expensive. We're clinicians, not lawyers. We put in 100 plus hours of work scouring through the laws and ethics and paid thousands of dollars and expensive, expensive attorney's fees so you don't have to save yourself time, money and headaches.
- [13:19]
A
We're Kate and Katie from the Private Practice Startup and we invite you to experience the quality of our paperwork with our HIPAA form as our gift to you. Go to privatepracticestartup.com head over to our Resources tab and download the free HIPAA form today. You can also shop our a la carte and paperwork options under the Paperwork tab. Enjoy. Are you feeling stuck, overwhelmed and frustrated not knowing where to start or how to grow and scale your private practice? You've spent years in school and a.
- [13:49]
B
Ton of money getting your degree, but.
- [13:50]
A
You weren't taught the necessary branding, marketing and entrepreneurial skills needed to be successful in private practice.
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B
We get it. We've been there. We're Kate and Katie from the Private Practice Startup. We've spent a crazy amount of money and over a decade learning and perfecting a proven marketing strategy that works. Let us teach you the step by step proven system to help you fill your practice with the clients you love and live the life you've always dreamed of. Visit private practicestartup.com look for the e Course tab to learn more and see the amazing Results our coaches have been achieving. All right, let's jump into tip four.
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C
Okay, tip number four. And just, oh, there's something in tip number three I'd like to hit if I can.
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B
Tell us, tell us.
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C
I don't know if people are familiar with the community resource communication groups, but in the country, the CRCGs are really important and every county has one in Texas. I think that's important for people to look into. And also I do a really personal networking experience where I create a basket that has like coke and peanuts for my plumber guys. I mean, I market to every, every business in town. I'm marketing to the employees. We actually have a phone book still that I go through. That's another. But like for my plumbers, I might put cokes and peanuts in the basket and a brochure that is specialized to that population. And I, and I drop that off a couple of times a year and I follow up with a handwritten thank you note for letting me in. But in the country, I think that handwritten, very important because, you know, this is what manners still matter out here in rural Texas. Not that they don't everywhere, but I think that's very helpful. And then going into number four, speaking. I mean, y' all talk about this all the time, but speaking is really important. And you've got to have value that you're offering your potential referral sources. So like I will, once I drop off these baskets, I'll follow up by offering say a church, a two hour workshop on premarital counseling that I do for free. Or I'll offer the sheriff's office mental health first aid for law enforcement. And my husband's a state trooper locally, which can be a two double edged sword because he gives tickets to everyone. But.
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B
That'S gotta be hard in a rural area. And then the wake up campus, they'd.
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A
Be like, oh, I know your husband.
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B
Officer, wait, I have a great marketing strategy. So your husband gets the ticket and then the husband or wife or whoever goes home to their spouse and they're mad now because they are having financial issues in their marriage and then boom, they can call you.
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C
Right? I keep trying to get him to hand out my cards, but yeah, that would be great.
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B
On the back of the ticket.
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C
Yeah. But I also go into school districts. In fact, in the early 90s I was a schoolteacher out here, so I have some relationship. But offering in services to teachers about self care and such, hospices, nursing homes, just for even the 4H club, which is huge in rural America, I'LL go in and speak to them about mental health or self care or whatever. But it gets. I mean, you're just out there serving and also being. You know, the chamber does a lot of stuff, so I try to offer speaking engagements or being available for them. Really. The potential is just endless. And recently, y', all, I just out of. Just on the whim, I posted a Facebook video on self care just out of a whim. I got almost 800 hits on that. And I got three bookings on that. A new intern, two new clients. Nice. It was a good whim. Yeah, it was a whim. And point five would be writing. You just have to write your arse off. If you gotta write, write, write. I have volunteered to do a column in the local newspaper about mental health. They don't pick it up every week, but it's out there. Some gets my name out. I have an ad that I have at the local theater. You know how the movies wrote the advertisement before the movies. While I don't know if I'm getting clients off that, it keeps me out in the community all the time. And then I write. You can do like a little. Yeah. And it's 200 bucks a year. It's not much. But I also will do a column for the little insets that people do in the church bulletins, you know, and then I just got a $300,000 grant for providing mental health care for people 55 and over with depressive symptomology out in rural America. So there's all kinds of grant writing opportunities to help fund what we're doing out here as well.
- [18:48]
A
I can hear you're so intentional about the different strategies that you're using. And there can be so many different options to build your practice. Out of all of the strategies that you've used, if you had to pick your top 20% that you were getting the greatest return on your investment, what do you think that is?
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C
Showing up, going to events, passing out my cards, going to visit the businesses, putting together my basket, which is an ass. Oh my God, that takes so much time. But it's worth it. Just showing up and being authentic, I think is very important.
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B
That's awesome. And I thought you were going to say that because especially in a rural area, I mean, overall, people love authenticity, right? That's really important. And especially in a rural area, you know, everyone kind of knows people. And when they really know, like, and trust you, that sells itself. And there's no selling that then has to be done there. I know sometimes, like when I'm with friends or whatever. You know, people find out you're a therapist, and I could talk about couples and relationships forever, and I can get on my soapbox and things like that. But it's happy. I'm passionate about it. Right. Not like I'm gonna sell anything. I'm just talking about what I've learned in relationships and what I know and what doesn't work and what works.
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C
Yeah.
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B
You know, and it's almost like giving, you know, giving away information for free. And, of course, then you stick out in people's mind. But I don't have a secret family baked bean recipe, though.
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C
I do have that, and I will send that to y'. All.
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B
Oh, okay.
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C
You know this. I'm doing a cash practice out here. I mean, my sessions are 175 for individuals and 225 for couples. And, you know, if it's not the right person, you have to have that abundant mindset that you just. You get them hooked up with their right person, and that leads to number six would be that fearless mindset. And we've talked about money mindset before, but it goes beyond that. You know, it's. If you believe you can, you can. If you believe you can't, you can't. I mean, that narrative is so powerful, and I believe I can. I think it's really important, especially out here, when you're the only private practice person within an hour's drive to or a mental health person, you've got to have a great support group. You need to be doing masterminds. You need to have a coach. You need to be listening to y' all stuff like the webinar y' all did yesterday. You know, having things that feed your soul are very important. Podcasts, I mean, I feel like I know y' all because I listen to your podcast regular. My students, you probably have a big Tarleton following, because I'm always go, you know, I'll plug in in class and go, listen, y' all got to know about this stuff. It's coming, you know, that's awesome.
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B
You should video us in one day.
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A
So we can say hi.
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C
I will do that. Oh, they would just squeal with glee. I'll do that.
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B
That would be so much fun.
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C
And I think it's important. Wouldn't that be fun?
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B
That would be fun.
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C
And I think it's important. I think that stuff like that is really important. And it's important to. Because that becomes part of that support team that nourishes your body, mind, and soul, and you Know, regardless of where you're practicing, that's important. But I, of course my dissertation is in that, so I kind of preach that. But I think that that helps me sustain me out here in Podunk.
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B
Julie, I really love that you shared your fees. That was really important. I think a lot of. For Stark Nation and those listening, because I think there is a curiosity of, well, if I work in a rural area, then I can't charge how I value myself. And I think that's really important. So thank you for sharing that. And you know, I love all of your tips and things like that. So just kind of going through them again. We talked about relationships, really building the relationships in the country, showing up. I love your creativity. You talked about doing telemedicine and telehealth and that's really important to expand your reach. Talked about networking, thinking outside the box with your kissing booth. So, so fun. Making sure you're speaking, showing up, being present, writing and having that fearless mindset. So that's awesome. So what do you want our. What do you want our Startup Nation superheroes to take away from your message.
- [23:00]
A
Today.
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C
That it can be done? I mean, take your date, your desire on a date and then romance it and make it into a permanent relationship, which is what I've done with this private practice. It can be done.
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B
I think that's like the perfect place to end. Right? Like it can be done. Like. Yeah, well, that it's possible.
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C
Yeah. And you know, I have a little girl who, she felt like she. This was so important to her. She's a barista at Starbucks and works as a. Works at a movie theater. But she found my prices were affordable. I mean, if people really see the value, they will show up.
- [23:47]
B
Yeah. And especially being out there in the community and just, you know, authentically getting to know people and connecting with people. Like that's, you know, the know, like. And trust factor is important and I mean, school teaches us that. It's called common factors. Right. And that's the number one one of the two predictors of clients achieving their goals. So, you know, Kate and I like always talk about this. We said it yesterday, we'll say it a gazillion times. As therapists, we our prime to make the best marketers. And now we have a little cat friend walking across the desk.
- [24:14]
C
That was awesome.
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B
That wasn't a. Was that, was that a cow covered and looking like a cat now?
- [24:20]
C
No, it was the cat. He and the cow are friends.
- [24:25]
A
It was a mini cow. That's so fun. On the farm. Julie's podcasting on the farm. I think this is our first official farm podcast. I used to live on our farm, so I love that.
- [24:34]
C
All right. I want them to know again that rule. Any practitioner can build a practice in rural America. You've just got to think outside the box. Awesome.
- [24:46]
B
Awesome. And I know that you have a giveaway from a giveaway for our audience.
- [24:52]
A
What is that?
- [24:54]
C
I do. It's called. It's a book. I put. Oh, it's a little ebook I put together called Ninja Guide to burnout Proofing your life. And I've got five life changing prescriptions in there and it's. It's got attacks. Do a yoga pose and some mantras and a smoothie recipe. It's got. It is a turnkey. You go to one of those, you're going to be okay.
- [25:19]
A
That's awesome. It sounds like our hashtag Ninja tips. You got the Ninja Guide. I love it.
- [25:24]
C
Cool. Yes, yes.
- [25:27]
B
And so people are interested in that. They could just email you and we'll go ahead and put that on our show notes page. So thank you so much for being with us today. Today and Startup Nation. We hope that you join us next time. We're going to be talking to Faith Charis Carlson and she shares her story about going from homeless to private practitioner. So this is really a story about motivation and inspiration. So wherever you are in your private practice journey, we hope that she will inspire you. But before we sign off for the day, we want to make sure that we give ourselves Startup Nation superhero shout out of the week.
- [26:05]
A
Our shout out for this week is from Scaber 200. They say Dr. Kate and Katie have done a great job providing an exceptional resource for seasoned and inspiring private practice professionals. Motivating and fun. It's great information. Thank you, Skeeper200 and you know, we do this because we want to provide content for you guys. We want to help inspire, we want to motivate you. We want to support you in reaching your private practice dreams. And so we love when we hear your feedback that the content that we're providing is something that's really useful for you. And if you haven't already, we'd love for you to subscribe, rate and review our show, share with your friends, your fellow colleagues, help us get the word out about what we do and how we can help. And thanks for all that you do.
- [26:51]
B
We'll see you later, Startup Nation. Thanks for always allowing us to inspire you from startup to mastery.
- [26:56]
A
Take care. Thanks for joining us on the private practice startup visit theprivatepracticestartup.com for awesome resources, free trainings, attorney approved private practice paperwork, and so much more.
- [27:22]
C
Sam.