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What We Didn’t Learn in School …
Building a Successful Private Practice
Trina Young Greer, Psy.D., LCP, LMFT, LPC
Steve Greer, BS
• Practice Management Survey
• Setting the Stage
• Entrepreneurial Mindset
• Business Basics
• Building Blocks for Success
• Keys to Growth
• Next Steps
Agenda
Setting the Stage
Potential Conflict of Interest
We are the owners of Genesis Assist
(Booth 445)
Medical Billing * Insurance Credentialing * Consulting
www.GenesisAssist.com
Practice Management Live
Look for the following logo on topics we
have a Podcast on for more information
Available on iTunes & GenesisAssist.com
“Everyone should eat and
drink and take pleasure
in all his toil – this is
God's gift to man”
Ecclesiastes 3:13 ESV
What Attracts You to
Private Practice?
PROS
• Being your own boss
• Flexibility
• Earning potential
• Control
Nationwide Poll Results
CONS
• Economic uncertainty – Managed Care
• Responsibility for all costs
• Isolation
• Management work
Walfish and O’Donnell, 2008
Barnett and Henshaw, 2003
What Concerns and
Challenges do You
have with Private
Practice?
• Marketing
• Finances
• Clients
• Insurance
• Business Aspects
2013 AACC World Conference Poll
Greer, 2013 – Building a Thriving Practice in the 21st Century
Is Private Practice
Right for YOU?
• Can you handle uncertainty?
• Are you energetic?
• Can you handle change and failures well?
• Are you passionate about your vision and goals?
• Do you look at life from a standpoint of what can be improved?
• Are you willing to take risks or leaps of faith?
• Are you committed to developing an Entrepreneurial mindset?
Checklist
Adapted from Baron and Shane (2008)
Entrepreneurial
Mindset
Why is this
Important?
“…what is risky and what is
safe has changed
permanently. … The new
reality is that working at a job
may be a far riskier choice.”
Chris Guillebeau, The $100 Startup
Genesis Counseling Story
“Accidental Entrepreneur”
“If you don’t start
thinking like a
business owner, your
Vision will die.”
Randy Case – C12 Business Consultant
• Therapists don't go to school to be business
people
• Most graduate programs don't provide
training in business
• Therapists can have an elitist attitude
toward people helping versus making
money (Walfish and Barnett)
Overcoming the Mindset Bias
How Can You
Create Value for
Your Clients?
• Focusing First and Foremost on the Client – Genesis: “Win With Every Client Every Time”
– Winning at the First and Second Moments of Truth
• Giving People What They Really Want or Taking Away What They Don't Want
• Business Focus: Adding value that people will pay for
Value Creation
A key to practice
success is changing
your relationship to
your practice
The Three Essential Roles
Adapted from E-Myth Revisited, Michael Gerber
• Dreamer
• Creator
• Inventor
• Developer and Gatekeeper of Vision
• Sees the Outcome – the ideal
Entrepreneur
Adapted from E-Myth Revisited, Michael Gerber
• Turns Vision into Systems
• Enabler
• Organizer
• Bridge between Entrepreneur and
Therapist
Manager
Adapted from E-Myth Revisited, Michael Gerber
• Producer
• Doer
• Provider of Therapy
• Why We Went to Grad School
• What We Love to Do
Therapist
Adapted from E-Myth Revisited, Michael Gerber
• Most Therapists who start their own
private practice are not Entrepreneurs –
they are Therapists suffering from an
Entrepreneurial seizure
• The Rules of the Game have changed
• We have to change our mindset to
succeed
The E-Myth
Adapted from E-Myth Revisited, Michael Gerber
Working On the
Business versus In it
www.genesisassist.
com
27
Business Basics
• The Challenge: 30% Less People received
Psychological interventions (2008 compared to 1997)
– shift toward medicine alone
(Dr. Katherine C. Nordal, “Where has all the psychotherapy gone?” APA, Nov 2010)
• Niche: specific, targeted group of people who
“gather” and have common needs and wants
Find, Attract, Keep Clients
• Examine Your Passions, Gifts, Experience and Calling
• Who Do You Want to Serve & How?
• Focus – Smaller is Bigger
• Clarify Your “Who’s” Wants & Needs
• Evaluate, Test, Launch
• Examples:
– birth trauma and other pregnancy issues
– military wives
– kids with Asperger’s syndrome
Finding Your Niche
• The idea can feel very uncomfortable
• There is no “one size fits all” plan
• Know your message
• Identify who needs to hear it
• Pick what works best for you
Redefine Marketing
Adapted from Be a Wealthy Therapist, Casey Truffo
“Most therapists feel more
comfortable taking a full
sexual history from a new
client than they do talking
about their fees.”
Be a Wealthy Therapist, Casey Truffo
• Develop & Work Your Personal Marketing Plan
– Passive
– Active
• Identify the marketing steps that fit your personality
– Take steps to build relationships
– Regularly communicate
– Speak for community groups, churches, etc.
– Etc.
Your Marketing Plan
• Be an excellent Therapist
• Be flexible to the needs of your clients
• Find new ways to serve your “Who”
• Consider joining a busy group practice
Proven Steps
• Website
– Keep it Simple
– “Who” Focused
– Provide Value
– Search Engine Optimization (SEO)
• Organic Search Ranking
• Pay-Per-Click Advertising
21st Century Marketing
• Leverage Therapy Directories
• Blog – Your Own and Guest
21st Century Marketing
• Key Considerations
– Be Strategic
– Draw Boundaries
– Define you Goals
– Finish Your Profiles
– Be Relevant
– Be Careful
– Give More than You Take
Social Media
Adapted from: TOM’s Tips to Fill Your Practice, Create a Following or Promote Your Book Through Social Media, Blogging and S.E.O.
The Most Important 2 Days
State of the Business Owner 2014
• Business owners who spent at least
40% of their time on sales &
marketing
– 60% more growth in revenue
– 200% more growth in profit
Customer Service Reality
shankmanhonig.com
• Cash & Check
• Credit Cards (Fees)
– Traditional Merchant Services
– Mobile Payment Providers
• PayPal
• Scholarships
• Insurance
Establish Ways to Get Paid
• Benefits: Able to Serve More Clients & Increased Referrals
• Challenges – lower reimbursement rates
– more administrative demands
– stress
– short-term treatment models only
– insurance company may affect quality of care
Managed Care?
Building Blocks For
Success
• Spend Time on the Foundation
– Clarify Your Values
– Define Your:
• Dream
• Vision
• Purpose
• Mission
First Things, First
• Vision – What are you building?
• Mission – Why does this practice exist?
• Objectives – What results & goals?
• Strategies – How will you build?
• Action Plans – What is the work?
One Page Business Plan
Adapted from: One Page Business Plan by Jim Horan
• The Bus (Jim Collins)
– The Right People On the Bus
– The Wrong People Off the Bus
– Everyone in the Right Seat
• Establish a Hiring System
– Based on core values
– Clear role description & what counts factors
Solo or Group?
The Criticality of Alignment
State of the Business Owner, 2013
• Role Descriptions – link to mission &
expectations
• Work Plans
• Policies and Procedures
– A battle worth fighting for
– Standardize – same great service regardless of
who
People Systems
• Why Measure?
• The Critical Choice of What to Measure
• Regular Review & Plan Adjustment
You Get What You Measure
2011 2012 Jan-13 Feb-13 Mar-13 Apr-13 May-13 Jun-13 Jul-13 2013 IYA
Sessions 1351 1492 1734 1595 1476 1898 1927 1791 1875 1757 1.18
New Clients 148 187 242 202 191 250 225 229 194 219 1.17
% No Shows 8.3% 8.5% 9.9% 8.1% 9.7% 9.4% 8.9% 9.5% 9.4% 9.0% 1.06
GENESIS DASHBOARD
• Focus on Net Income
• Monthly Review of Profit & Loss Reports
• Manage Overhead Costs
• Loss Analysis & Elimination
• Challenge: Total People Cost as a % of Sales
– Standard for Business: < 50%
Financial Management
• Coaching
• Neurofeedback
• On-line Therapy
• Speaking
• Passive Income (workbooks,
instructional DVDs, eBooks, etc.)
• Learn from others
Multiple Streams of Income
Keys to Growth
• Choose the Learner Path
• Develop Your Leadership
• Focus on the 20%
• Win with Clients & Referral Sources
• Constant Forward Motion
• Framework that Connects
• Build a Winning Team
Growth Ingredients
• Internal & External
– Clinical and Operations
– Lawyer
– Accountant & Bookkeeper
– Technology Support
– Insurance Credentialing
– Medical Billing
– Private Practice Coach/Consultant
Team Sport
Next Steps
• Private Practice is a business
• There are 3 key roles you must play – Therapist,
Manager & Entrepreneur
• Marketing, marketing, marketing
• Win with your clients & referral sources
• Framework of systems focused on your vision
• It takes a team ... choose carefully
Key Points
• Personal Action Plan
– What is 1 step you will take in the next
week?
– Who can help hold you accountable?
Follow-up
• Booth 445
• GenesisAssist.com
• 855-282-1777
Want Help?
GenesisAssist.com/2014APA
Presentation Download
What We Didn’t Learn in School …
Building a Successful Private Practice
Trina Young Greer, Psy.D., LCP, LMFT, LPC
Steve Greer, BS