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Private Practice Startup Podcast
Episode 143: 5 Private Pitfalls and How to Fix Them
00:27:37
Sherry Shockey-Pope, LMFT
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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.
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B
Startup Nation. Welcome back to another episode. We hope you guys joined us last week for Trina Little, who talked to us and you, of course, about three things you need to do to start a YouTube channel from scratch. If you have listened to anything Kate and I have said, we actually really love video and we would love for you to love video too, because it's a really great way to market your practice. And today's guest is Sherry Shaki Pope. She's a licensed marriage and family therapist and joining us from the other side of the world, AKA the US In California. And we actually got to meet Sheri face to face for the not so typical psychotherapist summit. That is always like a tongue twister. I have to make sure I enunciate every little thing. And she was the bomb what she presented. And luckily for all of you who didn't make it, which you probably have fomo if you've been seeing anything on social media, totally, you have the opportunity to make it again. But here in South Florida, May 2020. So Ernesto is going to bring that all over here and you guys will get to see Sher present as well as us. But today, Sherry is going to be talking to us about a topic that you guys had requested, which is the five private practice pitfalls and how to fix them. And then of course, before we do dive into today's topic, we want to make sure that we say welcome back. If you are one of our loyal listener starformation family members and if you are brand new to us, we want to say welcome and we're rolling out the red carpet for you. And we want to give you a gift. We want to give you our A to Z cheat sheet, the essentials for building and growing your dream practice. And you can grab that by heading over to our Website, Private Practices startup.com head over to the resources tab and there you will see that it's chock full of resources, ninja tips and five days of private practice building email. So we really want to help you grow your dream practice. So before we jump into Sheri's topic, just a little bit about Sheri. You know, it's funny, I'm going to actually start off with her fun fact, because she writes here. Once the fire department had to come rescue her and three friends from the top of a very tall tree. I think we will start off with that.
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A
Yeah.
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B
I want to know how in the world were they on the top of the tall tree? But Sheri is the author of a book called Therapist Practice in a the Ultimate Guide to Building a Private Practice. And she is co owner of an extremely busy therapy practice, which she actually talked about at the summit. She's been selected twice for social worker of the year by her county. And when Sherry's not coaching or seeing clients, she's enjoying sailing, hiking, kayaking, and getting rescued from a tree. Welcome, Sheri.
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C
Thank you. Thank you very much. It's so great to be here. Thanks for inviting me.
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B
So how did you end up at the top of a tree?
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A
Yes. And how old were you when this happened?
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C
I was about nine years old and had a gigantic elm tree in our backyard. And we decided, the three of us, to climb this big elm tree, and I was the first. So everyone comes up behind me. We get to the very top, and the trees sway back and forth. And my friends decided they were stuck. And I'm like, no, just walk down. So here I am providing counseling, stress stress management at 9 or 8 and saying, it's okay, just put your hand here and then put your foot here. And we climbed down a little bit, but the tree was still swaying. In California, we have what they call Santa Ana winds, and so they're very strong. And so the winds are starting to pick up. And so then my friends got even more scared, and they're holding onto the tree, and so I'm trying to say, it's okay, just move this foot. And then we'll go down one step and then move this foot. And they didn't. So my mom comes running out because she hears the winds, and she says, you guys have to get out for the tree. And they're like, we're stuck. We can't. So she called the fire department. They came with their hook and ladder truck and swooped us all out.
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A
Wow. That's a crazy story. And how interesting that you're coaching them and counseling them in that moment of, like, you know, facing potential death from falling from the top of the tree.
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C
It wasn't that far, but it felt like it. Yeah. Yeah.
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B
Well, and I was thinking, like, how interesting because, like, you're the leader of business. Right. And you were leading them up the tree. Right. But couldn't get them Down.
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C
Right. They just weren't listening.
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B
That's a great story. To start off, our topic about pitfalls. No pun intended, right?
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A
Yes. And being stuck. Right.
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B
Oh, the stuck feeling.
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C
Yeah. Well, and the funny thing is, is the fire department just said, okay, put your foot here, then. Put your foot here, put your hand here. So they did everything that I was telling them to do, but they were behind them. So that was. That was kind of like business. You have to be behind people.
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B
Gotcha. Gotcha. And then I was thinking, like, I was thinking from the authority factor, like, you didn't have the authority yet. Right. To be know, liked, and trust.
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A
Right.
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B
Because it was your first time up the tree, too, with them. So that's. That's how I was thinking about it in business.
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C
All right.
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B
But now you do have the authority factor. And so share with us a little bit about your group practice so people can really understand what it is that you've done and what you've created.
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C
Sure. I have two locations, one in Marietta and one in Riverside. That's Riverside is our main location. And currently we just hired a couple new people. We have 25 therapists and four support staff. And we treat everything pretty much but eating disorders. We don't do anger management or any counseling to do with perpetrating. We do a lot of victims work because that's where the business partners and I came from was from a county. We both were doing CPS work. And when we left the county to do full time private practice, we wanted to focus on foster kids and foster families and adoptive families and people who we felt weren't maybe getting enough good quality care.
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B
Awesome. So with having two practices, two different locations, one practice, two different locations, 25 therapists, you might know a little bit of something, huh? So share with us. So why don't we just kind of dive into the topic and start talking about these pitfalls?
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C
Sure. Well, the first pitfall is fear. We will talk ourselves out of things. We'll think about, oh, yeah, the freedom of private practice and all this fun stuff. And then we start to, like, figure out how to actually do it. And then we become fearful and we become paralyzed, and we don't bet on us. And so part of the real need is for us to bet on us as people and go, I can do this. I can make this happen, and I'm going to figure out how to do it. And I think that people start the process and then sometimes they don't know that they need to just hang on a little bit longer because right behind this big, hard stuff, then it becomes easier a lot of times. And so they give up. I have two people right now that work for me who have had difficult times in their private practice and came to work for me because they just felt like they weren't getting enough referrals, they weren't getting enough sustaining income, and they struggled for four and a half, five months and they just gave up. And so part of the reason I wrote this book was that I didn't want people to give up. There's a need in our communities, there's a need in the nation for mental health care and good mental health care. And so if we can just support these people, they can be their own business people. And we need that. We need that quality of care.
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B
I love the notion of betting on yourself. I love that idea. Do you have your own kind of story of where maybe you gave up on yourself, but then you bet on yourself and you re emerged, or have you always kind of been the one to just move forward?
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C
I think for the most part, I have moved forward and just struggled through. Because when I first started my private practice, failure. I never even thought about failure. That was just like. It just wasn't something I thought about. But I tell you, about four years in, we were a little bit too singled on one particular income source. And for whatever reason, this particular insurance company chose not to pay us. And it was about $300,000, so it wasn't a little chunk. And we had enough reserves to pay our payroll and everything for about six weeks. And after that, I went to my business partners, I said, if we can't get this squared away, we're going to have to. We're not getting enough income to make this work. And it was Christmas time, and my business partners are looking at me astonished, saying, we can't lay people off on Christmas. You know, that's just like Scrooge. And I'm like, I'm not trying to lay people off. I just. The income. You know, we've used all the income reserves that we've had. We have a payroll of about 60,000, well, about $120,000 a month. And so we had run out of reserves in our income. You know, we needed that money to come in. And we called the company and we explained to them what was going to happen. And we happen to be one of their larger providers. And they're like, oh, we didn't mean to do that. We're just behind them processing. And they made all these excuses. But that same day, they rolled over with a check for about $40,000. And we were able to make it until our next checks came in and everything else. But what that taught me was not necessarily not to give up, but it taught me about diversified income and trying to space that out some and so that we weren't so reliant on one source.
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B
And then how did you guys diversify your income from there?
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C
Well, we expanded to a few more insurance companies. We also do some cash work, so we do some adoption work where we're advising birth parents. So that's cash work. We also have added classes, so we have a co parenting class and a parenting class. We have done divorce boot camp. And then we had then added on a few other insurance companies. And then we really put a focus on also bringing some more cash clients in because that gave us a better cash flow. Awesome.
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B
So really just taking that fear and it's that moment, right. It's like we could either do this or we could figure out a way. Right. And that's really where we often get pushed. Yeah. And it's interesting, like, I'm thinking about that, like, for myself, and I know we're chatting a little bit about, you know, for me, I'm in this journey of like, what's next for my life. And I've even thought about him listening to the book you're a badass at making money by Jen Centuro. And you know, she talks about really doing the things that are really uncomfortable. And I was like, what if I threw myself into something that freaks me out? And then I'm like, I don't want.
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A
To do that again.
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B
Right. Like, because when I went in a private practice full time, I left in November 30th. Right. During the holidays, no plan, six weeks, couldn't breathe. I was freaked out. I'm like, I don't want to do that to myself. But it's most often there that we are faced with, you know, our best self and being able to figure stuff out. So that's really like betting on yourself.
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C
Yeah, yeah.
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B
What's another pitfall that you see therapists go through in our experience?
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C
Well, like you were just mentioning, they don't start out with a business plan. They don't start out with, you know, what kinds of services are we going to provide? And so writing a business plan is sort of putting their vision out of their head on the paper. But what it allows us to do is it allows us to see pitfalls that we may not think about. It allows us to make projections of income. It allows us to Target our ideal client. I know you guys do a lot with branding, so it really helps to try to figure out, is my brand unified? Is it really what I want people to see? And I think that laying it out on paper, it's different than just thinking about it in your head. And you know it's right. Because, you know, branding is not just business cards and a logo. So you have to plan some of that. And that's, you know, because we didn't give this information in graduate school, we don't know. And it's like you don't know what you don't know until you start figuring things out. And, you know, I never knew about a SWOT analysis or how to know if I had competition or even what that meant or how could I, you know, investigate and network with other people? I had no idea.
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B
So for people who are probably wondering, what's a SWOT analysis?
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C
That is a strategic plan, basically. So we're looking at a connection of strengths, weaknesses, opportunities. Opportunities and threats. Threats and. Sorry, I just blanked for a second. And so basically you can go online and you can see a detail of it, but it usually is part of a good business plan and it talks about the internal things that we do to create our business and the external things that will have an influence on us. For example, my insurance is an external thing because I can, yes, provide the service, but if they don't pay me, it doesn't help my business. So those are things that I think are problematic.
- [13:04]
B
One of the things I know that Kate and I see, and sometimes we struggle with this too, right? Because there's always so much to do is that people spend way too much, much time working in the business. Right. And not stepping back. And like you said, planning, projecting, really getting a clear idea, working on their branding, working on their ideal client and that, you know, we just kind of hit the ground running and without a business plan is then we just kind of start just doing whatever works, right? And we, we know this because we did this early on, right? Just throwing spaghetti at the wall, just hoping something sticks, trying to figure it out, not following any type of specific step by step process or plan. So that can get very exhausting and overwhelming.
- [13:40]
A
Yeah. I can remember when I first started out in private practice, I definitely did not have a business plan. I had no brand, I had no idea. I just thought I needed a business card and name and beautiful office and the clients would just come. It doesn't work that way. And if I let that failure define me and I gave up at that time, I never would have built what I did with Bayview Therapy and what we have. And so to be able to learn from those, to fail fast and feel forward, is so helpful. I was going to say I love your idea about the business plan as well because it's so helpful to be able to put all of those ideas onto paper. And it really helps you to have a strategic step by step plan to know where you're going and to understand the financial aspect of things. Your SWOT analysis, your ideal clients and how to reach them, your marketing strategy. It's so, so helpful. We actually had Amanda Patterson on at episode 68 talking about how to create a business plan. So we'll put that link for you guys as a resource as well.
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C
Awesome.
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A
So before we jump on a topic.
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B
Or tip number three, let's just take a quick break for our sponsor.
- [14:42]
A
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- [16:14]
B
So Sheri share with us. Sheri share with us. Tip number three.
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C
Tip number four I should say unreal expectations. And you know part of that is we we don't stay in one item long enough. So, for example, we'll invest in AdWords, but we'll only do it for six weeks because we don't see an immediate return. Or we'll blog, and then we blog three or four times. And then we don't get people calling us and saying they heard about us through our blog. And so we don't follow through with it. And so we have to stick with a couple of things, which is why business plans are so good. You take one or two things and you stick with it for, say, six months, eight months, a year, and then you make tweaks. But what we do is we get impatient, and so we start an ad word campaign, we'll do a print ad campaign, we'll do something else. And then we have no idea where these people are even coming from. And so part of that is we need to hone that down. The other expectation is we think insurance. If we provide the service, they'll pay even though we provide the services. Sometimes they disallow it. And even so, sometimes they'll call us to see a client. We have to call them back and fight with them for our money, even though we provided the service because maybe it was coded wrong or maybe their insurance changed in the middle of it and then we weren't notified. And so sometimes we don't get payment even though we provided service. So that's another reason why we have to stay on top of things and bill on a regular basis. But I think that we just assume these things are going to happen. I'm going to do my job and they're going to do their job, and that's not the case. We also do drive by marketing where we, like, we talk to an attorney or we talk to a doctor, and we say, here, here's my information. I'm in town and I just started this practice. And then we never contact them again.
- [17:59]
B
So here's the truth. Like Kate and I always say, we did everything wrong, right? And I remember my colleague and I, Susan Block, and we, our office is in Coral Springs. We literally hit the streets one day, walk around with our pamphlets and our flyers providing no value, going to every door, everybody, no ideal client, handing out our stuff, hoping that something. And like, you talk about, like, doing those. And I remember when Facebook ads, like, came out, I was like, oh, Facebook ads, 20 bucks. That doesn't work, right? And for me, it's having unrealistic expectations, but also really not either investing in coaching, mentoring, or even hiring someone to help you with the step. By step system. So I think that is just so essential and critical.
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C
I would agree.
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B
So, Sherry, share with us what is. So we talked about unrealistic expectations. What's another pitfall that you see therapists.
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C
Come across not knowing the legal and ethical responsibilities. Clients will stop paying. And therapists sometimes feel they still have to see the client because they don't want to abandon a client. And then you get into a dual relationship and you're compounding problem after problem. So it's really important that you know not only the ethics of your particular profession, but also the ethics of the professional organization because sometimes they'll streamline it, be a little tighter and be available when you need to have a consultation, make sure you get a consultation. And so the number one ethical issue that therapists get themselves into is that they don't do their CEUs on time. And they do their CEUs, but they either miscounted or they are going to take it. And then they sign that little document under perjury and now they're. It's sort of. Now it's a compounded error again. And so you have to stay with the knowledge of what's the ethics of your system, what are the laws and regulations in your state? Because they vary. And then you have to make sure that you're tracking those things. So that's part of the numbers that we need to track on a regular basis. So I put it into a spreadsheet. Every time I take some ceus, I write it down. There's track your hours that now track CEUs. So there's other things that will help you do that. But I think that we don't mean to do things that are incorrect or wrong, but we just. It's our responsibility to know the laws.
- [20:20]
A
Yes, for sure. And the laws vary from state to state. So if you're practicing in multiple states and you're licensed in multiple states, it's so important to be aware of what those are. We talk a lot about the laws and the rules and the legality of things when it comes to paperwork, because we have our attorney approved private practice paperwork. And that's one of the pitfalls that we see a lot of clinicians falling into. Just to kind of add to what you're saying, Sherry, is that they get into practice and they either piecemeal their paperwork together from past agencies they worked at or stuff that they find online, they're copying and pasting things, but it's not even necessarily from their state and it's not even necessarily approved by an attorney. So there's definitely a lot of pitfalls out there. And that's why it's so important to have a coach or a mentor or both, to be able to have that support and that community of other successful private practitioners. Because it is really hard. And it doesn't have to be super difficult and take forever to build your practice. If you know what works and you have that support and you have that guidance from somebody else who made all the mistakes and they learned everything the hard way. They got a lot of wins along the way as well. And they're able to help you be more strategic in your process so that you don't have to waste all that time, energy and money too. Right. Because when you're just throwing spaghetti at the wall and trying to figure out what sticks, you're chasing all the shiny objects. We like to call it the SOS syndrome. It just doesn't really work well.
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C
And I think that people who start private practices are visionaries. And so that's part of one of our dilemmas is that we see a lot of different things, but we then get distracted by, oh, let's try this, let's try that, let's try that. And I know at the beginning a lot of people are chasing money, so they're looking at what services will provide money. Where you can't do that. You have to provide services that you're passionate about and the money then follows.
- [22:15]
A
Yes, absolutely. Did we hit on all five of your tips?
- [22:19]
C
I have one more and that's just diversify income streams. So like I was mentioning in my insurance, make sure that you have three or four different income streams. It could be a class, it could be a group, it could be a book that you're writing, it could be, you know, other things, multiple insurance companies. It just needs to be more than just one insurance company and one form of income.
- [22:43]
A
That's really good advice. And then when you. Yeah, when you think about the diversified income, when you're in a service based industry and you're providing, you're only getting paid when you're seeing clients. Right. So it's that fee for service type of business, you're not getting paid when you're not seeing clients, when you're able to diversify your income and you're actually having, whether it's another product or a service or a course or a book, like you're talking about, you can make additional income when you're not necessarily seeing clients during that time. So it's really nice to have that diversification for sure. Right.
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C
It could be as simple as renting your room when you're not there. It doesn't have to be a lot of, you know, managing people or things like that either.
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A
Good point. Yes, very good point. Now, what do you want to make sure our listeners take away from your episode today, Sheri?
- [23:32]
C
I think that they just need to know that they can do it. That the skills that you talk about or I talk about are just skills. They're just that they're nothing more. There's nothing so miracle about them. They just are things. We all made it through graduate school. We can learn these things.
- [23:50]
A
Yes. And these are skills. Business is a skill. It absolutely is. So thank you for that reminding us, because so often people can be really intimidated by business and marketing and all of that stuff, and it's just a learned skill.
- [24:03]
C
Right, Right.
- [24:04]
A
Awesome. Well, it's been so great to see you again today. And somehow Katie dropped off the call. I think she's having an issue with her computer having narcolepsy. So we just kept running with the show because luckily we have three people on here and not just the two. So it's been great seeing you again. And are you going to be coming to round two next year of the not so typical Psychotherapist conference?
- [24:27]
C
I am, because I need to come and see Florida a little bit more.
- [24:31]
A
Yes. Well, we are excited to have you in our neck of the woods, and it would be fun to have you come into the actual podcast studio and we can do that together. Maybe we'll create something fun.
- [24:42]
C
Well, that'd be nice.
- [24:43]
A
Yeah, for sure.
- [24:44]
C
I do have an offer to give your listeners.
- [24:47]
A
Yes. Okay, perfect.
- [24:50]
C
I have on my website, I have my book and I'm giving 35% off of it. And all they have to do is put in the code startup and they are. They will be getting that discount.
- [25:05]
A
Perfect. Thank you so much for that. We'll put the link for that in our Show Notes so everybody can go there. They can go to the Show Notes page, click on the link and visit your website. Enter the code startup to get your book at a discounted rate. Fantastic. Well, thank you so much, Sherry. And for those of you listening, you definitely want to tune in to next week's episode as well, where we have Kim and Justin Slagle. I think I'm butchering their last name. What is branding and why do I need it? We met Kim and Justin at the not so Typical Psychotherapist conference as well, and I think I'm butchering their last name. But I'll find out exactly how to pronounce it before we have them on next week, so make sure to tune in for that episode. And then I wanted to take a quick moment to give our Startup Nation superhero shout out. This is from Bridget. She says as a social work major in the process of opening up my own private practice, these resources have been incredibly helpful. I'm grateful for a podcast that caters to my field unlike anything I've ever seen. Bridget, good luck to you along your journey in private practice and let us know how we can continue to support you. And we just appreciate you guys so much. Again, we're so excited because we just hit our 200k downloads and we've been podcasting officially for three years. Happy anniversary to us now that you guys have been listening to this. It was, I guess a little while ago that we hit that anniversary. I forget that there's a little time lapse between when we record the episodes and when you hear them live. For those of you who have taken the time to send us a review, to subscribe to, rate and review our show, or even just a friendly email and say what's standing out to you, what topics you like, what topics you want to hear. We so value getting that feedback from you guys because this show is really about supporting you along your journey and we want to make sure that we're doing that in the best way possible. We hope you enjoy today's episode and we look forward to seeing you on the next one. Thanks again for allowing us to inspire you from Startup to mastery. 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.
- [27:28]
C
Sam.