Private Practice Planning for the Future of Mental Healthcare: An Interview with Maureen Werrbach, LCPC
Curt and Katie interview Maureen Werrbach of the Group Practice Exchange on upcoming trends for mental healthcare. We talk about what is predicted, how to prepare your private practice for success in 2023, and how to plan for unexpected changes to our profession.
Click here to scroll to the podcast transcript.Transcript
An Interview with Maureen Werrbach, LCPC, The Group Practice Exchange
Maureen Werrbach established The Group Practice Exchange after starting her private practice, Urban Wellness, and growing it into successful group practices in various locations.
Spending countless hours researching how to start a private practice (the legal and procedural steps) and then so many more hours learning how to grow it into a group (again trying to figure out the appropriate steps), she remembers wishing there was a place that she could go, or a book that she could read, that would explain not only the steps it would take to launch a group practice, but also discuss topics that relate to group practice ownership.
A degree in the social service field doesn’t offer any training on the business side of running a group practice! Maureen learned through trial and error what works and what doesn’t in running a counseling group practice. She enjoys helping others reach their full potential and feel confident in running their business.
In this podcast episode, we talk about upcoming trends in Mental Health and what it means for your therapy practice
We reached out to our friend Maureen Werrbach of the Group Practice Exchange about where our field is moving and how we can plan for success.
The way therapy is provided and paid for will be changing
“I feel like are going to be (or have already started) affecting our industry – outpatient private practice – is the shift, slow shift to values based reimbursement… which essentially is shifting away from a fee-for-service model that insurance companies now pay a certain dollar amount for sessions, to values-based reimbursement based off of values-based care (which insurance companies are going to be dictating what values based care is)… they’re going to shift from this fee for service model of paying a flat amount per CPT code to a drastically reduced amount and then based off of the values-based care that you give, there can be additional reimbursements per session.” – Maureen Werrbach, LCPC
- Insurance: Fee for service versus value-based pricing
- Large tech companies and one-stop shops
- Ease of access and diminished costs via telehealth
What therapists can do to future-proof their practice
“There’s going to be an unfortunate consequence. You already have a therapist shortage. I believe that there’s going to be a lot of people who close their doors because the business side of it becomes too difficult. And where my feedback is: start now – by any practice owner, solo or group – start now by dedicating even one hour a week to researching the future.” – Maureen Werrbach, The Group Practice Exchange
- Strong niche and branding
- Doing what we do best
- Addressing fees, profit margins, hiring
- Dedicate time to researching upcoming trends
- Diversifying offerings
- Determining the best fit for your business, your career, your employment
Special considerations for Group Practice Owners in 2023
- The concerns related to large group therapist mills taking employees
- Focus on people, culture, and innovation
- Intentionality related to values, mission, vision
- Avoiding divisiveness and conflict between employers and employees
- The importance of transparency and clarity on how you’ve set up your practice
- Pathways for employees to grow and creative employment opportunities
Resources for Modern Therapists mentioned in this Podcast Episode:
We’ve pulled together resources mentioned in this episode and put together some handy-dandy links. Please note that some of the links below may be affiliate links, so if you purchase after clicking below, we may get a little bit of cash in our pockets. We thank you in advance!
The Group Practice Exchange Membership
The Group Practice Exchange Facebook Group
Relevant Episodes of MTSG Podcast:
Maureen’s previous interview: Becoming a Group Practice Owner
Fixing Mental Healthcare in America
Beyond Reimagination: What is right (and wrong) with mental health apps
All Things Group Therapy: An interview with Katie K. May, LPC
Who we are:
Curt Widhalm, LMFT
Curt Widhalm is in private practice in the Los Angeles area. He is the cofounder of the Therapy Reimagined conference, an Adjunct Professor at Pepperdine University and CSUN, a former Subject Matter Expert for the California Board of Behavioral Sciences, former CFO of the California Association of Marriage and Family Therapists, and a loving husband and father. He is 1/2 great person, 1/2 provocateur, and 1/2 geek, in that order. He dabbles in the dark art of making “dad jokes” and usually has a half-empty cup of coffee somewhere nearby. Learn more at: http://www.curtwidhalm.com
Katie Vernoy, LMFT
Katie Vernoy is a Licensed Marriage and Family Therapist, coach, and consultant supporting leaders, visionaries, executives, and helping professionals to create sustainable careers. Katie, with Curt, has developed workshops and a conference, Therapy Reimagined, to support therapists navigating through the modern challenges of this profession. Katie is also a former President of the California Association of Marriage and Family Therapists. In her spare time, Katie is secretly siphoning off Curt’s youthful energy, so that she can take over the world. Learn more at: http://www.katievernoy.com
A Quick Note:
Our opinions are our own. We are only speaking for ourselves – except when we speak for each other, or over each other. We’re working on it.
Our guests are also only speaking for themselves and have their own opinions. We aren’t trying to take their voice, and no one speaks for us either. Mostly because they don’t want to, but hey.
Stay in Touch with Curt, Katie, and the whole Therapy Reimagined #TherapyMovement:
Consultation services with Curt Widhalm or Katie Vernoy:
Connect with the Modern Therapist Community:
Our Facebook Group – The Modern Therapists Group
Modern Therapist’s Survival Guide Creative Credits:
Voice Over by DW McCann https://www.facebook.com/McCannDW/
Music by Crystal Grooms Mangano https://groomsymusic.com/
Transcript for this episode of the Modern Therapist’s Survival Guide podcast (Autogenerated):
Announcer 0:00
You’re listening to the Modern Therapist’s Survival Guide, where therapists live, breathe, and practice as human beings. To support you as a whole person and a therapist, here are your hosts, Curt Widhalm, and Katie Vernoy.
Curt Widhalm 0:14
Welcome back modern therapists, this is the modern therapists Survival Guide. I’m Curt Widhalm, with Katie Vernoy. And this is a podcast for therapists about things going on in our practices and in the world and all of the fun stuff of being a therapist. And we are joined by one of our very first guests, somebody who, when we were very first launching our show, very graciously stepped out and said, hey, I’ll lend my voice out to things, so we are joined, once again, by Maureen Werrbach over from Group Practice Exchange and all of the wonderful things that she does all of the time. One of those therapists that I think never sleeps, just with everything that’s going on. But thank you very much for returning back to the show.
Maureen Werrbach 0:59
Thank you for having me again. Before we started recording, I think, Katie, you said it’s been almost four years or even over four years since I’ve been on.
Katie Vernoy 1:07
Isn’t that wild?
Maureen Werrbach 1:08
Yeah. It just feels like it’s been so long. And I forgotten about how quickly time has passed.
Katie Vernoy 1:16
Yeah, yeah, no, I think it’s something where we purposely reached out to you at the beginning, because we’re like, we love what Maureen’s doing. We want to have her on the podcast, and you’ve stayed in the community with us. And we’ve been able to support each other over the years. So I am just really glad to have you back on the show. And always love to talk with you. You’ve got such great wisdom in the group practice space, as well as just kind of our profession as a whole. But before we dive in, the question we asked everyone is who are you? And what are you putting out to the world?
Maureen Werrbach 1:47
I am a therapist, mom, business owner, friend, family member. And what I’ve been really thinking about this past year of what I’m putting out there is intentionality in everything that I’m doing. Curt mentioned, thinking that I just don’t sleep, and I’m just doing a lot. I’ve gotten to a place of feeling burned out a little over a year ago, July of last year, and decided that I really want to be intentional about everything that I do in my life, whether it’s in business, in my personal life. And so that is what I’m putting out there is everything I do I’m doing with intentionality.
Curt Widhalm 2:23
One of the discussions that we’re hearing a lot in therapist land is around just kind of the future of practice, and especially where economy seems to be facing inflation. There seems to be a lot of chatter within both the therapists as well as clients as far as what that means as far as prices and affording therapy and that kind of stuff. Save everybody all of the trouble. What’s the answers to this? Like? What are…
Katie Vernoy 2:52
Just tell us what to do. Tell us what to do Maureen. Just tell us all what to do.
Maureen Werrbach 2:56
You just pulled the rug out from under my feet. This is not what I was thinking. I can tell you what I feel like is the future of our industry of outpatient private practice. And I can give some suggestions on what I think can help us practice owners kind of live through that. I don’t know if I have a one size fits all answer, though. But I’m, I’m excited to chat with you guys about it. See what your opinions are, too. I feel like there’s so many things that we can look at. And I don’t know that we can fit it all in one podcast episode. But some of the things that I feel like are going to be or have already started affecting our industry, outpatient private practice, is the shift, slow shift to values based reimbursement. I don’t know if you guys have talked about this before. We have one insurance here in Illinois that is has already headed in that direction. And it will definitely kind of shift into all insurances at some point, which essentially is shifting away from a fee for service model that insurance companies you know pay a certain dollar amount for session, to values based reimbursement based off of values based care. Which insurance companies are going to be dictating what values based care is. And we are going to be having to do assessments with clients and sending those assessments to insurance companies so that they can dictate whether or not we are doing what we’re supposed to be doing. And so what’s happening and what I’m 99% positive is gonna happen across the board with insurance companies is that they’re going to shift from this fee for service model of paying a flat amount per CPT code to a drastically reduced amount and then based off of the values based care that you give, there can be additional reimbursements per session. And I think that’s going to cause some stress. I think it will lead to practices going out of pocket. I anticipate that there’s going to be some kind of supply demand issues with too many therapists who are not accepting insurance with not enough clients who want to not use their insurance. And so that’s one thing that I see coming. I, I already see it here in Chicago just with one though. But that’s the first one. I don’t know if you guys have any thoughts on this?
Katie Vernoy 5:18
Well, I just wanted to clarify values based care. My understanding, and we actually talked a little bit about it in some of the fixing mental health care in America episodes. And so I want to make sure we’re on the same page, because what I understand values based care to me is that it will be being paid for the diagnosis not being paid for or the assessment, the kind of overall treatment plan versus each session. And so the way they’re pitching it is this is going to help folks who have higher acuity needs, more intense needs, because they will be being paid for at a higher rate, because they’re the expectation is that more care will be needed. Whereas folks with a garden variety, quote, unquote, life transitions will be given some, you know, kind of lower rate, that’s, you know, we’re not expecting them to be in therapy forever. These insurance companies haven’t met Curt and me, because we keep our clients forever.
Maureen Werrbach 6:16
Yeah.
Katie Vernoy 6:17
And so values based insurance reimbursement, I think it’s very difficult because unless they actually reimburse at a rate that provides for the care that each client needs, I think, you’re right, I think that people go out of pocket. And I want to ask you to go into more depth on this supply demand issue, because I think we have it in California, there’s not a lot of therapists in California who are taking insurance. And so at some point, folks just have to get therapy out of pocket. But it means that people aren’t able to use their insurance benefits unless they have some sort of out of network benefits. And then if those are also supposed to be this value based stuff, it just gets so strange.
Maureen Werrbach 6:58
It does. And I feel like I don’t anticipate insurance companies dictating what values based care, I’m air quoting this, means in a way that aligns with how therapists view it. And I think that’s what is going to be the unfortunate piece of it, and where practice owners can start being proactive, and kind of communicating with each other about this ahead of time, so that we can work with our, you know, NASW, or whatever board you’re a part of, so that they can work to, you know, put our voice in there with that. But yeah, I anticipate that it’s it, we’re definitely not going to be being reimbursed in the same way. Obviously, we’re not gonna be reimbursed in the same way. But I don’t think we’re going to be actually at the end of the day being paid what we were being paid pre flat fee by insurance, I think it will be lower overall. And so that kind of affects practice owners who have their operating expenses and things lined up based off of what their income is now. And so I think there’s going to be a lot of practices that are going to have to shift how solo or group, if they continue to accept insurance, to shift how much they’re spending in their operating expenses to account for the fact that their income is probably going to go down. And group practice owners are gonna probably struggle with, you know, what their current pay model is for employees. As you guys may have heard, a lot of group practice owners overpay, not realizing the additional, you know, benefits, compensation and all that. And so I think it’ll be a really interesting place to be in as a group practice owner too when those reimbursements go down. And you are still, if you’re doing like a flat rate or salary, you may have to change that as well. So I think there’s a lot to think about when it comes to this aspect of kind of the future of private practice.
Curt Widhalm 8:55
And this is already with insurance rates that for many people have not gone up very much at all in 10 years. And what other industry are we just okay with, like not getting raises for like 10 years. I mean, we talked about fees, and this kind of stuff, all the time. But, you know, one of the things that I’m hearing some group practices talk about and by hearing and doing in my practice, and assigning this to everybody else as well. Those of us who are operating outside of kind of the insurance system in looking maybe a step ahead, where some of these practices are outside of insurance stuff is maybe a different print use of the term values here, but really being able to have that group identity and being able to really specialize and hone in on what we do well, rather than trying to broaden out and manage to try and reach every single client.
Maureen Werrbach 9:54
Yeah, I kind of lines up with another thing that practice owners should be paying attention to and just thinking about is and Curt, you mentioned this before we started recording but corporation, these big tech corporations kind of coming in and buying out, you know group practices and kind of turning into this like conglomerate. And we also have insurance companies who are purchasing other companies like Aetna having CVS as an example. And now CVS has therapists in their stores. And essentially, Aetna is paying itself, you know, and not having to rely on outpatient practices. And I think that’s, you know, another conversation we can have too about how that might affect outpatient private practice. But what you said Curt is going to be really valuable, whether it’s niching, and creating an identity for your group practice that sets itself apart in some way. I also think that for group practices, specifically, is COVID has sort of done this, I don’t know if we would have gotten here anyways. But people want to get their care or get their things easily, right? We have Amazon, you can order things and get it next day. Now we’re really impatient, right? We can go to Target and order our food ahead of time and go to the drive up. So we don’t have to even walk through and get the food. And because people got used to telehealth when pre COVID, that was, you know, it was really hard to get clients to do, it felt like a scary thing. They just wanted to be in person. And now people are used to and are like, now I don’t have to drive. There’s a big percentage of people who are now okay with this, me being one. I’ve never met my therapist in the past two years and I have no desire to. I can meet her consistently on Zoom. But I think group practices specifically can weather through being sort of watching other practices around them being kind of gobbled up by these corporations, is by ensuring that their practice is caring for the whole person. And that can look different. One example would be that they have not only therapists but psychiatrists, maybe a dietitian, depending on the work that they’re doing. Other fields that are related in support the mental health of a client in one space, because then clients can get their whole mental health needs serviced in one space versus like having to go to, you know, a bunch of different places. And I think that’s another way that medium to larger group practices can stand out, marketing wise, and visually, they might feel flushed out by these big companies.
Katie Vernoy 12:31
Yeah, I like that idea. Because I think it lines up with I think Curt and I, that you and I talked about this on the app based therapy, one of the app based therapy ones where he talked about kind of learning from what they’re doing. Being able to do what they’re doing well, but doing it better, because we have that personal touch. Because we’re not beholden to investors. I think there’s opportunities there to really provide high quality care, or to use it differently values based care for our clients. But I’m, I’m curious, because I think that we’re asking folks to be really strong business people, and really think about where is the blue ocean? Where can I go that these other places can’t go? How do I really address my expenses? How do I make sure that I’m keeping my profit margins as big as they can be so I can be sustainable? How do I make sure I do all these things? And I don’t know that that’s for everyone.
Maureen Werrbach 13:27
Right. I think I was gonna say, I think to your point I there’s going to be an unfortunate consequence, you already have a therapist shortage. I believe that there’s going to be a lot of people who close their doors because of it, because the business side of it becomes too difficult. And where my I guess my feedback is, that is, start now, by any practice, owner, solo or group start now by dedicating even one hour a week to researching the future of… you can Google things and see like, and I would start with just Googling things like values based reimbursement, see what’s happening around that, because that’s coming down the pipeline. Google things related to these online companies and you know, there’s going to be articles that are coming out, that come out all the time on things that are that they’re doing that seem to be working on the client end, right? And things that are problematic, but that’s all going to pave the way for they’re going to be shifting how they do what they do to continue to be sustainable. Then looking at like these big companies like the Apples and the Googles and the Walmarts of the world who are also trying to step into the mental health space, and just Googling what does that what does that mean for outpatient care? So if we can dedicate even an hour per week to just researching what’s happening, it makes it much easier to be proactive and not reactive. Obviously, all of us were in a very reactive space when COVID hit, right? We could not plan for that and this is one of those areas where you’re either going to be in that same space where all of a sudden insurance switches over and you realize your reimbursements are half that, or, you know, you notice that all the practices around you have been gobbled up by these, you know, tech companies coming in and sort of absorbing them. And then it makes it twice as hard because you have to, you’re coming from a reactive space when you think about how you’re going to sustain your practice. So I do every Friday, from 10 to 12, is my research time. I just Google things, I have no goal I haven’t, there’s no, nothing I have to do or get done or check off by the end of it. It’s just reading and researching. And that helps me keep a pulse on on our industry from a, I guess, a business lens. And in a, what can I anticipate based off of what’s happening now?
Curt Widhalm 15:48
The other piece of inflation and all of this kind of stuff is employee salaries. And we spend a lot of time on here talking about how expensive it is to become a therapist. And with some of these things coming down the road, with a cost of living going up, how are you seeing group practices manage that piece of it? While painting this bleak picture of insurance reimbursements going forward.
Maureen Werrbach 16:19
So I think, you know, there isn’t an answer, that’s not going to be for everyone, or it should be for everyone, but not everyone’s gonna want to do it is diversifying services. And that doesn’t mean that you have to throw 100 things against the wall that don’t line up with your values or your vision for your business. But if you want to ensure that your staff can continue to be paid fairly, even if insurance decides to reimburse even less, or make it more work to be reimbursed at the same, you know, rate by, you know, adding assessments and all of these things and submitting them and all of that. Diversifying your services that don’t require insurance or one on one work not only helps with reducing burnout, for therapists who, you know, private practices might be full time, usually around 25 clinical hours a week. One, it can reduce some of that face to face time with clients and, you know, allow them to do something creative, outside of that work, but also allows for practices to be able to continue to pay therapists, the rates that they were, if those reimbursements go down. So as an example, for me, my practice being proactive, because it takes a long time to start a new type of service, right, it’s like almost like starting a whole nother business, you can’t just say, Tomorrow, we’re going to now start groups. It’s very unlikely that you’re going to get a group filled right away. And it takes a lot of work to, you know, to set that up. So two years ago, we started the process for becoming a CE certified group practice. So we can offer CEs. And therapists who are really interested in public speaking and training now have the ability for the past couple of years to provide these trainings. They go up on demand, because we have that full certification so people can do home study, and it’s up on our site and can get income continuously without having to do more work. Another and the second thing that we do is we now do corporate wellness programs for like big companies. And that’s taken, we’re on our second year of that. And it’s just now becoming profitable. It took a whole year to build the infrastructure to do things with these big companies for a lower amount so that we could get testimonials. So working with Lurie hospital Epilepsy Foundation Alta, you know, things like that, now have paved the way for us to have these larger companies that we go in and work with leadership on how to prioritize mental health and their employees, which is proactive, stops them from coming into therapy potentially, also is an out of pocket thing that our staff is now involved in just examples.
Katie Vernoy 18:51
I love those ideas. And I think about the ingenuity and the forward thinking nature of having those things ready to go. I think for your staff, it sounds like they are also getting income and filled up and excited about some of these things. And to me, I guess I’m kind of leaning towards this question around folks who are wanting to have their own practice or expand into a group practice versus folks who may better serve as employees right now. And I think there would be folks who would be shocked that they have been, quote, unquote, overpaid. And then now they’re gonna get paid even less. And so I guess I’m trying to figure out kind of, for our audience members who are like, this business stuff is not for me. I feel like there’s also a responsibility we have around where do we guide them because they could go into these big corporations that are gobbling up group practices, they could do these things. But I mean, what does that actually look Have you seen because I know there’s group practice owners that are like people are trying to coach my clinicians. Yeah. have, you know all this stuff? Like on the employee side? I mean, what do they need to know? Because there’s opportunities with practice owners like you and Curt, but there’s also folks that are creating mills, I think.
Maureen Werrbach 20:11
Yeah, at the end of the day, large companies that have purchased group practices, and now are just one, you know, these larger companies, they can offer a lot of benefit to employees. And that is what is right now luring a lot of people over there. And that’s why you see here, group practice owners say they’re, you know, losing clinicians to, you know, x y company that is now purchased a group practice, you know, down the block. I have friends and people I know who have sold their group practices to companies like this, what the future holds, even in that space. And these companies have investors, and so they’re able to pay more, because they have people who have invested millions upon millions and like hundreds of millions into these companies to be able to grow and expand really quickly and purchase these group practices, and also pay staff well, but it comes at the price of once they are established, they reduce those rates with clinicians, and you see clinicians leaving. So it feels scary initially when a new company is starting to purchase, because their benefits packages are enticing. But the one thing I’ve learned because I’ve talked to a lot of these companies, because I have a group practice. And I kind of always want to know where I’m at, if I, you know, is that they don’t like practices that have diversified services. Their model is to stick with simple seeing clients, they don’t care about groups, they don’t care about, you know, corporate wellness, they don’t care about CE programs, they care about one on one work. And so that I feel like is also an enticing thing for employees who, as you guys know, get burnt out quickly. Because to make decent money, you have to see a lot of clients, and practices like mine or other you know, group practices that have the time to invest, because there’s a real person behind it to diversify those services are also then providing that space for clinicians to do work outside of just kind of the rotation of one client after another after another. And that is worth something.
Katie Vernoy 22:16
It is I think it’s worth it for the culture of the group practice. I think it’s something where the larger the corporation, the more the investors, regardless of the pay, at some point, it becomes really just all about numbers.
Maureen Werrbach 22:28
Yeah.
Katie Vernoy 22:29
And I think smaller group practices need to pay attention to the numbers as well. But my experience anyway has been that they pay attention to the people too.
Maureen Werrbach 22:38
Yes, exactly. And those larger companies don’t create a space for employees to talk about things that they’re passionate about. Whereas practice like mine, we encourage every employee, if you have a cool idea, bring it to the table. We are always looking for ways to support employees passion, if they align with my you know, business values, and there’s something that we can do. And that has created a lot of opportunities for people in my practice, who might not otherwise have had those opportunities in an outpatient setting. And you don’t get that kind of thing, that ability to step into leadership or spearhead a program. You’re not going to get that in these big companies because what they’re looking for is increasing those numbers.
Katie Vernoy 23:23
Yeah units.
Maureen Werrbach 23:23
Having more clients sessions.
Curt Widhalm 23:26
Since you were last on the podcast, and keeping kind of this spirit alive and kind of employee management and I have a part of the group practice exchange Facebook group, internal advertising for Maureen’s stuff. Yay.
Katie Vernoy 23:39
Yay. Woo hoo.
Curt Widhalm 23:39
But I see a lot of the group practice questions end up being around employee management sort of stuff speaking to these kinds of values and this kind of stuff. And then I go over to some of the other Facebook groups for therapists and I see people complaining about their group practice owners. It sounds like you take kind of this management approach of you know, really fostering community wellbeing, investing emotionally in your employees as well. How have you seen that advice either being followed in the last four years by effective group practice since you were last on our podcast? Or have you seen that just kind of continuing to be the same old thing in a industry that is slow to adopt change?
Maureen Werrbach 24:29
Well, that is the most true statement I’ve ever heard. We are slow to want to accept change, which is why I tell people you should be dedicating time to researching what is going on in our field and what projections are because change always happens. So let’s let’s all get on board or you’re gonna be you know, kicking and screaming your way through it anyways. It’s so interesting what you said Curt because this is like a tale as old as time. Employees complaining about group practice owners and group practice owners complaining about their employees.
Katie Vernoy 25:02
Yeah.
Maureen Werrbach 25:03
I think there are a lot of bad group practice owners out there. And I also think that there is a lack of transparency by group practice owners to help employees understand why things are the way they are. As an employee, you’re not a business owner, you might not be business minded. And most issues or problems, whether it’s feeling like you should be paid more whatever, will often go and be directed at the group practice, when sometimes it might be that the group practice actually pays their employees really low and has a, you know, insanely high profit margin, but most don’t. And they don’t realize this as just an example, that the profit margin for that group practice is, like under 20%. Right is very low. And that the problem is actually reimbursements. Right? That’s just one example. And I think where I’ve been trying to do my work with the group practice owners that I work with, and who listen to me is that the more transparent you can get with your team, the more understanding and trust that the they’re going to have in why procedures or policies or things are the way they are in the practice. And I think that is one of the ways that you can stop this kind of issue that you were mentioning Curt.
Katie Vernoy 26:22
And when you were talking at the very beginning of the podcast, I think there was this element of intentionality. And that I think should be something that all of us take away, right? I think there’s that element of, if you’re starting a group practice, because during the pandemic, you couldn’t get enough therapists to see all of the folks that needed therapy. And I think there’s still some of that. And as we’re hearing, you know, from your research, and from what we’ve seen, as well, like this is going to change, like things are going to slow down, people are going to start tightening their belt, so to speak, closing their wallets. And so if there wasn’t an intentionality around how you built your practice, there wasn’t all of the pieces in place, the systems, the processes, the policies, the mission, and the vision, and kind of the values that align for what practice you’re trying to build. When things start hitting the fan it’s going to get chaotic, and we’re not at our best when we’re chaotic. I think as leaders, as managers, as all of those things, you can get to a place where you’re doing things in a way that you that you hadn’t intended. And so then all of a sudden, it becomes us versus them because they need to get paid, you know, these employees need to get paid and the group practice owners need to be able to sustain. I mean, I don’t know how many of your practice owners I’ve talked to that haven’t paid themselves in like six months or a year, and then our employees are paying about how little they’re getting paid. And it’s like, this is an issue that is not between those two people, potentially it is but it’s really more about how the group practice was set up, how things are being communicated. And if you haven’t done it intentionally, whether it’s because of time or excitement, or the environment drastically changed, and you didn’t know what’s going to happen, I think it can be very easy for that divisiveness. And that us versus them thing to come up with this. And so to me, and what I always recommend is seeking support, and I often send them to you, Maureen. Because I think the Group Practice Exchange has a lot of guidance in there. But how do you address that when it starts getting to be like group practice owners going like, ah, please, quiet rah rah, like, how do you address that in the culture of the group practice exchange?
Maureen Werrbach 28:31
I don’t come from a space naturally of complaining, or negativity with my staff, because I feel like my business is what it is.
Katie Vernoy 28:41
Yeah.
Maureen Werrbach 28:42
Because they’re there. And it’s, you know, I started it, but they keep it going.
Katie Vernoy 28:46
Yeah.
Maureen Werrbach 28:47
And so that feeling, when I see other group practice owners complaining, it reminds me a little bit of parents who bring their kid into therapy and are like, fix them and it’s like, we need to have you mom or dad coming in here too. It’s similar. I feel like it’s similar. If there are, you know, outliers, obviously, to the statement, but for the most part, the issues that employees are having, whether they’re realistic or not, doesn’t really matter. The group practice owner is playing a role in that and not leading the way they need to, if that is continuously happening, and obviously there are outliers, you might have a bad fit therapist to even the best of the leaders in the world wouldn’t be able to support. But for the most part, I think a lot of times I look at the group practice owners and I think the issue really lies in your hands, not in theirs.
Katie Vernoy 29:38
Yeah.
Maureen Werrbach 29:39
I know it’s not a the most supportive statement, you know, outright, but I you know, as a group practice owner myself if I ever get, you know, a complaint, I’m looking at it and saying, Is there anything that I can do differently or is it something that we just have to accept, like is not something we can change, you know, and that I think points to last thing I want to say, which is if you as a business owner, this is kind of with any business, if you are being intentional about the pay, the benefits, the procedures in your practice, the policies, whatever how you’re building your business, you’re going to feel confident when someone is upset by them, because you have been purposeful and intentional about it. So as an example, with my pay, I feel really good about it. My compensation package for my team, I feel based off of what we are paid it by insurance companies and clients or out of pocket rates, I feel really good that I am at the top of the top. I know there’s nothing else I can do. I feel good about it. And so when I get that person here or there, you know, I have 60-something people in my practice. So it is bound to happen every once in a while. I feel, I don’t feel bad, I don’t feel like I’ve you know, or angry, this person is complaining. I can say, I understand that you want more. And I wish you could have more from my practice, I think every therapists should be paid probably a shit ton more than what they’re being paid. Even in my own practice, it is what it is. And I understand that people lives, their personal lives are all different. And they might actually need to make more money. And so I will say like, I feel really good about the compensation package that we have. And I can’t make any movements in that. But I totally understand if you need to look around and see if there’s something better out there. Because you deserve to be paid what you feel like you need to be paid. And oftentimes, when that has happened, they look around and they see that they can’t really find anything else. And maybe they start their own practice. You know, there’s options out there. But I think confidence in the decisions you’re making in your business will go a long way in having those conversations with employees and having them understand. Because when you’re competent, they’re like, oh, okay, even if they don’t like it, they’re like I get it, you know.
Curt Widhalm 31:59
You’ve been around for a while. I’ve been around for a while. We’ve got our group practices. One of the things that we’ve come across in one of our episodes, as far as kind of the workforce issues that come up is there doesn’t seem to be a whole lot of pathways for employees to grow, and to have promotion kind of opportunities to field where it’s alright, you’re either a therapist or you’re an owner. How do you keep employees with, you know, not that being a therapist is a dead end job. It’s a great fulfilling job. How do you foster in an industry that doesn’t really have kind of that traditional pathways towards leadership that a lot of other industries have?
Maureen Werrbach 32:45
Diversifying services, and creating a culture where people can come to our leadership team with any ideas that they have, and we try to make it work if it’s within, you know, value systems and all of that. So we have, you know, 10 people in different leadership roles, one of our staff, he’s an LMFT, and he also got a degree in I’m gonna say it wrong, like photography, or digital media, maybe and he had one said a few years ago, my dream job would be that I could do both things, that I could have a job that allows me to see clients and also do my creative side. And we created a creative director position and he does 15 clients, he’s full time salaried in a leadership position. 15 hours of client facing and the other 15 hours you can use creatively to do things like he does our staff bio videos, all of our staff have bio videos and he gets to make them fun and creative. He does our bloopers every end of the year we have like a whole 20 minutes blooper reel it’s culture building and of all of our staff. He does our social media, like…
Katie Vernoy 33:58
He’s hilarious.
Maureen Werrbach 33:59
He is hilarious. Yeah.
Katie Vernoy 33:59
He’s so funny.
Maureen Werrbach 34:03
He does so many things. We have a newsletter that goes out to all of our staff every first of the month that talks about our anti racism work it talks about any you know, new staff that come in and they have to do like a welcome video that’s really funny. He talks about like any happenings within the practice: people pregnant or you know, whatever, it is a way that our huge practice can connect and everyone looks forward to it. But that’s how he gets to literally have what he said my dream job would be. And that is what I would say is the answer to your question Curt is how can you not be so, not you Curt, but any practice owner…
Curt Widhalm 34:38
I will represent all.
Maureen Werrbach 34:41
How can you how do you not be so narrow minded but then was like oh, that’s a rude way of saying it but you got to like open, practice owner you, has to open your lens a little bit more and allow that creativity to come in because you’re right, Curt, people for the most part, don’t want to just see clients for 50 years day in and day out. They like a little bit of other things, a lot will write books, people will start doing speaking engagements, they have to get that other creative part of their selves out in some way. And so my practice really worked hard at trying to foster that. So we have a lot of different opportunities within that, you know, support that for people. And then we have those rock star employees who are very consistent, they don’t you know, they like their their life balance, I want to be able to go home and not worry about anything else and see their clients and and those rock stars are great as well.
Curt Widhalm 35:37
Where can people find out more about you and everything that you’re doing?
Maureen Werrbach 35:43
So they can find me at thegrouppracticeexchange.com. They can go to, if you’re on Facebook, we have a Facebook group. As long as you’re a practice owner, so lower group, but you can’t be an employee of a practice, unfortunately, to be in there. But if you’re an employee still or a contractor at a practice, but you’re wanting to learn about how to break out and start your own group practice, you can go to the website and there’s a ton of free resources in there as well.
Curt Widhalm 36:09
And we will include links to those in our show notes over at mtsgpodcast.com. And follow us on our social media, join our Facebook group, The Modern Therapist group, consider becoming a patron or supporting us through Buy Me a Coffee and until next time, I’m Curt Widhalm with Katie Vernoy, and Maureen Werrbach.
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