Should I start a group private practice or stay solo? (with Marie Vakakis)

[00:00:00] Hey mental workers, you're listening to the Mental Work Podcast, your companion to early career psychology. I'm your host, Dr. Bronwyn Milkins, and today we are talking about whether you should make the move from solo private practice to group private practice.

[00:00:18] Bronwyn: This topic is inspired by listener Brittany, thanks Brittany, who enjoys her solo practice but feels pressured to expand. And many early career psychologists face similar dilemmas, wondering if growing their practice is the right move or if staying solo might be more workable or fulfilling for them. Today we're going to explore the pros and cons of both options, provide practical advice, and share real life experiences from our guest.

[00:00:43] By the end of the episode, you'll have a clearer idea, hopefully, of what path might be best for you, or just more ideas that might help you along the way.

[00:00:52] Our guest today is Marie Vakakis. Hi, Marie.

[00:00:56] Marie: Hello, thanks for having me back.

[00:00:57] Bronwyn: Thanks so much for coming back. And could you please just remind listeners who you are?

[00:01:03] Marie: Yeah, absolutely. So I'm an accredited mental health social worker and family therapist, and I have a small private practice called the Therapy Hub, and then I also have my personal branch in Marie Vakakis, and I do some training, consulting, supervision, uh, mental health sort of well being workshops, and the podcast This Complex Life.

[00:01:24] Bronwyn: Yes. And I love your podcast. I was just saying to Marie off air that I really enjoyed listening to her and she had a great episode on supervision recently, which probably by the time this is released, we'll be like in the distant past, but anyway, great episode if you want to go back through the, This Complex Life catalog.

[00:01:40] And Marie, I thought I would ask you because you've been on the podcast a few times and usually I ask, guests what their non psychology passion is, but I've asked you five or six times. So I'm just wondering if you could let us know what's been good for you lately.

[00:01:54] Marie: Absolutely. So, lately I've been trying to reduce my distractibility. I've noticed that I dart between lots of different things, and so, the last few weeks I've actually taken all social media off my phone, and even deleted the news app, and that's been interesting.

[00:02:12] So, that's working well for me. I, um, found that I was, I'd lose so much time as many of us watching Reels, and I think, the tipping point was a 45 minute Reel just rabbit hole of highlights of America's Got Talent. And I was like, well, it was kind of wholesome and some of those kids can dance. And then it went into Britain's Got Talent. I was like, I was literally sitting on the floor with like one sock on midway through getting ready... and 45 minutes went by, so I was like, okay, this is a problem. So, I got rid of that, and I also signed up for a local art group at my community centre. So-

[00:02:53] Bronwyn: Wow, what kind of art?

[00:02:55] Marie: it's like a beginner's foundation art. I haven't done any formal art learning since high school. Um, I've tried live drawing and a few other things, but this is like a kind of six, seven week program, and so I'm looking forward to that. So, doing... yeah, trying to reduce some of my overstimulation of things that aren't really helpful and try and add some restorative, um, relaxation. So I was inspired by a couple of different things. One podcast episode I listened to about trying to find what your inner child used to like do. I'm like, I used to love making a mess.

[00:03:29] And then an episode of, I think it was All in the Mind, an ABC podcast, or This Working Life. It was one of those two and they were talking about our rest between work and the weekend and all of that is better when we're actually doing something restorative, not just binge watching TV. So, I thought I'd give the art to go.

[00:03:50] Bronwyn: Wow, that's so awesome. I look forward to hearing how it goes. It sounds really cool. And I'm with you on taking the social media off the phone. I did that a while ago, because like you, it was for me, it was cute dog videos. And my mind would justify it by being like, look, this is so wholesome. Like I'm watching this dog and it's been rescued and it's so good. Um, but it, yeah, just a time sink. Um, and yeah, like interrupting. Um, but my brain, I wonder if this will happen to you. My brain, my brain did try and get around it by being like, um, so I took off the apps and then I would open the browser on my phone and then go to it that way.

[00:04:26] And so then I had to get one step ahead of myself and install an app blocker, um, to block the websites. I, I, I'm so crafty. I don't know if you've gone down that.

[00:04:36] Marie: I've done it occasionally for Facebook Marketplace when I've got a couple of things that I'm selling on there. But I've actually been pretty, pretty good because it's not as user friendly. So, I've just, just taking the app off my home screen, like deleting it has made enough of a thing. And then I've put books in different rooms of my house. So, when I sit on the couch, I've got one book next to the downstairs couch, a different book upstairs. So, just flipping through a book or a magazine. Um, I put a couple of fidget. I'm just trying different things say, um, and same with podcasts. Like, I love podcasts. I'm a podcaster. You're a podcaster.

[00:05:12] But sometimes I find, uh, and this will link really well into what we're going to talk about. I'm trying to learn so many different things, but I can't action everything as quickly as I'm consuming the knowledge. And so a 40 minute podcast on branding, a 40 minute podcast on marketing, a half hour interview about the, like, the, all these things. And I'd go for a walk, listen to two, three podcasts and then have like 40 things to action. And I found that... just, it was too overwhelming. It felt like an over, oversharing of information. Um, so now I've started listening to music, having silent walks and, um, maybe e books, using a few sort of audio books to just have longer pieces of things that I'm engaging with. So, I'm really trying to get that attention back.

[00:05:56] Bronwyn: I love this for you. Awesome. What a great era to go into.

[00:06:00] Marie: Thank you. So, if anyone wants some amateur art, um, get in, get in touch. I'll see what I can post out.

[00:06:06] Bronwyn: I love amateur art. I love seeing people's arts because usually they think that they can't do art and then they come back and you're like, wow, that's so beautiful. Not putting pressure on you that you have to produce

[00:06:15] Marie: I will... give me your address. I'll send one in post.

[00:06:19] Bronwyn: I'd love it. Okay. Let's, let's move on to the topic then. Okay. So could you just tell us a bit more about your private practice side of things? So you've got a group private practice. Could you tell us, did you start out in solo? Did you go to group and how big is your group now?

[00:06:36] Marie: Yeah, so I started off doing private practice a couple of evenings a week while having a part time job and I would have ideally liked just a 0.8 position, um, somewhere and just have a day off to kind of do my other stuff. But the job I got that I really loved was only 0.6. I thought a private practice might be a nice way to do something different.

[00:06:57] And then in lockdown, uh, we went to kind of working from home and I just tried to kind of do my own thing. I moved away from that group practice and then kind of like probably what some people experience, I had extra referrals. I had one that was a particular conflict of interest for me. So I brought on a friend who I studied with. Um, she was my first contractor. So I went through and got, um, contracts written by a lawyer. And pieced all that together and then it slowly grew. So we're sitting at about six or seven practitioners now and an admin or business manager and then some virtual assistants on the side with some of the other things that aren't client facing and it's ebbed and flowed but at the moment that's sort of where it's sitting.

[00:07:40] Bronwyn: Yeah, and I'm interested in this part of your journey, which is that you had extra referrals, there was a conflict of interest, and so there was perhaps a need or an opportunity to bring other people on. But what was your decision making process around that? Like, because to me, that seems like a big undertaking. It's like, it seems simple on the surface, but then underneath that, it's like, "How do I potentially employ a contractor? How do I go through these work laws"? I feel like there's a lot to consider. Could you just take us through your decision making around that?

[00:08:15] Marie: Yeah, so I had started engaging with content around private practice, um, probably about two years prior to making that decision. So, I was listening to early episodes of, um, "Selling the Couch", which is an American podcast. Um, and there was a couple of others that I had a, a kind of idea of the language. I sort of knew what to expect. I knew what to do. And this was just a, I'm going to kind of jump in the deep end and sink or swim kind of person.

[00:08:44] So I gave that a go. I don't know if I would actually do it again in hindsight. Um, but we can maybe get into that later. So I, and I'm very, um, litigious as well. So I've seen in some Facebook groups and I am not very, um, I don't think it's a good idea. People are like, can I, can someone just share with me their contract?

[00:09:05] Bronwyn: Yeah, I've seen that.

[00:09:06] Marie: And, um, that is, that's not okay. That's someone's intellectual property. It does, it's not fit for purpose. Um, there's so many things wrong with that. Um, but so I went down, I got business coaching. I got a lawyer to write up all of that and, and that's never stopped that involvement and investment in understanding all of those policies, procedures, frameworks is, is crucial.

[00:09:30] Bronwyn: Yeah, could you just speak to that a little bit more? Because I think, judging by how often I see those sorts of posts in the group, people being like, I want to take on a contractor, could just people share their contract with me? Is, is taking on another person, like, it's not just a quick and easy thing? Could you just tell us a bit about that?

[00:09:51] Marie: Yeah, so the best way I can describe it is, um, there's a book called The E Myth, um, by Michael Gerber. And he talks about this idea that you have to be the technician, the manager and the entrepreneur. So if you're building a team and a business, you can't be... you have to be all of those things. And so, if you're making, um, lamingtons, and you want to open up a lamington shop, you can't be the person who makes the lamingtons, who serves the customers, who does the, like, you can't be all of those things, and none of those things.

[00:10:25] So there's this balance of, you need to, if you're opening up a private practice, you might have a caseload, but you can't be 90 percent technician and forget the other stuff. You need to find a, almost, equal thirds split. And part of that is accepting you are in leadership, you are a manager, and there's the entrepreneurial bit, business, marketing, sales, advertising, networking, um, new ideas, moving with the market. And then maybe you have a technical skill there as well.

[00:10:56] And so you might love being a therapist, but if you step into private practice, especially as a group. You're a small business owner and you've got to put your big girl pants on, or big boy pants, pants, skirts, whatever, and accept that that is now a different identity, a different role and a new skill set that you might never have been taught. And that's okay, but you have to learn it.

[00:11:20] Bronwyn: What do you think are the consequences if you don't learn it? Like, I guess I'm trying to take us into the worst case or just bad case scenario.

[00:11:27] Marie: Yeah well, around 80 percent of businesses failed in the first five years, so there's that. I've seen people pay their staff more than they've paid themselves. There's not understanding the financial viability of your business, not understanding, um, legislation, frameworks, maybe having to pay money back to, if you get audited through Medicare or NDIS or even tax, getting lumped with huge tax bills, people going into Um, liquidation and receivership. There's someone I know recently who's had to do that and have everything completely liquidated.

[00:12:01] Um, yeah, so it can be really, really soul destroying and money finances, there's money stories and issues there, and then there's the hurt and the bruise to the ego. And if you're consumed with all that stuff, it's really hard to do the bit you love most, which is therapy. To sit there In a room present with someone if in the back of your mind you're thinking I have a bill due and I don't know how I'm going to pay it. I just got a, you know, a $10, 000 payment for the ATO and it's due in this BAS and I don't know what I'm going to do.

[00:12:36] Bronwyn: Mmm, okay, so when I hear all of that... a part of me wants to crawl into a corner and not look out and just ignore that all and just stick with my private practice. And because I have had the thought of going, of growing a group practice because I have been in the position of having heaps of referrals and I still do keep a regularly updated list of people in my area, practitioners in my area who I can refer referrals onto, um, because I get so many but when I hear these things, like that you've just described, I'm like, no, no, no, I'll just stay in my little comfort zone, please.

[00:13:15] Um, so I'm wondering for you, like, do you feel like there's personal, personal characteristics that, or was there a vision for your career that made you want to go and grow?

[00:13:26] Marie: Probably the best characteristic for me is one of my top strengths is learning. And that can be to my detriment, because sometimes I can get overwhelmed with knowledge and not know what to action or implement. And sometimes I don't trust my instincts, but I like learning. I value that and I'm prepared to invest time and money into it.

[00:13:47] And I remember this, um, it was, it was in a really, probably like some sort of, um, funny TV show, but there was one scene where they're hiring a carpenter and the carpenters drew a triangle and at the top of the triangle was, um, was the words, was cheap on one corner of the triangle was, um, fast and the other was quality and she was saying at any one point, you can only have two of these parts of the triangle and I, I saw businesses a bit like that. I'm like, it can be fast and cheap, but the quality might not be good. It can be cheap and good. it might not come fast. It can be fast and have good quality, but it won't come cheap.

[00:14:26] And I got to choose which one of those. So I invested in online courses. There were some free courses. There was business coaching. I probably spent over maybe $40, 000 to $50, 000 in a combination of business coaching and consulting. Um, reading books, going to retreats, connecting with business owners. So my, that was one of my strengths is in the learning and having that humility to be like, I, I don't know what I don't know, so I'm prepared to figure it out.

[00:14:55] Bronwyn: Yeah. And why this career direction as opposed to another career direction? Like you could be, let's just say a tech entrepreneur or I don't know, any other career like, you know, pathway.

[00:15:07] Marie: Yeah, I'm still thinking about that. Um, I'm reading a book called The Million Dollar Weekend and it's getting you to think about ideas of what you can generate. Uh, you know, the idea is that you can sit down over a weekend and come up with your potential million dollar idea and now through business and through developing, The podcast, I do all the editing and uploading for that. The quality has gotten better over time. There's my YouTube channel now, my ConnectorTeams course. I'm looking at turning that into a book. I do have the option of saying, do I want to use those business skills into a business that's got nothing to do with therapy? Maybe I want to bake homemade peanut butter dog treats. I don't know.

[00:15:45] Bronwyn: Yeah.

[00:15:46] Marie: I could use, I know how to build a website, I know how to advertise them, I can network and sell the peanut butter dog treats, that might be really fun. Um, or I might reduce some of that and dig deeper into therapy because I also love that I'm doing marathon couple sessions. I'm doing EMDR intensives. So I guess I can sit with both options and I have the choice at the moment where as long as I'm keeping an eye financially on how I'm positioned. I can go into a bit more of one in the future. and float in and out and and then see what comes up in a few more years.

[00:16:24] Bronwyn: Okay, well let's talk about mindset then, because I reckon you've probably got a good one, and I reckon that this might be difficult for a lot of therapists, mental health professionals. One would be around money. I reckon people have got some money mindsets, such as, it's greedy for me to make money. I should be more... I should offer low cost.... low cost sessions. Um, it's bad if I'm making money.

[00:16:51] Could you just tell us around your mindset? Was these some of the beliefs that you had or have you always had a a different mindset that helped you to grow your business?

[00:17:01] Marie: They definitely were some of them, especially being my background being in social work. I've pointed this out a few times with colleagues and with friends and coaches who are social workers as well is we were often taught this idea of like a welfare kind of model and universal health care and access.

[00:17:21] And I actually think that that did a disservice because it's almost like it's saying anyone who needs help can't afford it. There wasn't actually allowing the dignity of those who can afford it might want to access it or those who might be wealthy don't suffer from poor mental health or don't suffer from, you know, they might, they might need a palliative care social worker. They might need an aged care social worker. So there was this real... um, just forgetting about vulnerable people. Like, we can all be vulnerable regardless of our financial capacity,

[00:17:53] Bronwyn: Totally.

[00:17:54] Marie: and so that's fine. And then there's a part of me that realized people who do good will do good when they have more money. So, the more, anytime I've gone up a little bit in a pay bracket, which isn't much, I donate, I increase the, some of the donations that I make.

[00:18:12] Um, as I get to, there might be a next level, where I then think, I don't want to work more hours. I might give that back to volunteering. I get to volunteer for the Mental Health Professionals Network, I coordinate events, I get to run group supervision. There are other things I get to do that, are only because other parts of my business can earn me money.

[00:18:34] So, nowhere, doesn't pay you. And like, and this is such a hard job and so many after hours work to put into this and such an investment. Why shouldn't that get paid adequately?

[00:18:50] Bronwyn: Yeah, I completely agree. Is it something that you had to get business coaching on though? Like did you find that these sorts of views and and I do recognize with social work I do feel like there is an entrenched kind of expectation of selflessness like over selflessness And so yeah, did you did you have to get coaching or around this?

[00:19:09] Marie: Coaches are pretty good around this. I had some good conversations with them. My anger came out, oh anger is probably a strong word, with other people. Social workers, actually, is when I say when you know, I just want to see what people charge. It's like you should charge what you need to cover your expenses and what the market's telling you and for your skills and experience. Like, it was again this like half hazard ad hoc tentative stuff. It's, it's business. job. That's even, even charities have to run at some profit or they collapse.

[00:19:44] Bronwyn: Totally

[00:19:45] Marie: So, but there's a whole thing with maybe gender as well of women not talking about finances. And that's, and that's, you know, there is, um, like a ignorance tax. You will pay, you will pay for that lack of knowledge, either in your super, in your investment, in your stability, security, your business. Like, you've really got to do the work. It's not something that can be done lightheartedly. You can be a beginner and that's totally fine. We all started there. But don't expect that it's not going to take work.

[00:20:18] Bronwyn: Mm, 100%. I want to bring up another mindset aspect with you, which is, I think you were mentioning, tell me if you agree with this statement, like when you go to a group private practice, you're working more on the business rather than being in the business. Is that generally correct or not quite?

[00:20:36] Marie: Yes, and the bigger the practice, then the more you remove yourself from actually doing the technical work. So some of the larger private practices, their directors don't have a single person on their caseload. And it's almost like in a school, if you're an assistant principal or a principal, an assistant principal might teach one subject if they really want, but as soon as you go up into leadership, it's hands off the tools. And so you're then in leadership.

[00:21:03] Bronwyn: So with that, I reckon some people would have this, sunk cost fallacy. It would be like, I have spent six plus years becoming my qualified mental health profession. Psychologist, social worker, clinical counsellor. Why, like, what a waste, what a waste of my life to have spent that much time into that to now be working on my business. What's your response?

[00:21:29] Marie: Yeah.

[00:21:30] Bronwyn: Okay.

[00:21:31] Marie: That might be the reality. The bigger my team gets, the more I reduce my hours because that involves then me having to do more branding, more marketing, more meetings with the accountant, more bookkeeping, more frequent meetings with my lawyer, staying up to date with HR, supervision, organizing everything from who's going to come and wash the windows and cleaning and every part of the practice needs to be run.

[00:21:57] And when the team is smaller, I pick up more clients, because I can and I like that. So I'm not saying you can't do both. It might not be at the capacity that you want, the amount of clients and those other things that manage your role and that entrepreneur... that has to get done by someone.

[00:22:16] Even if you hire a business manager or practice manager, it's not their business, so they might still do some, but you, the buck stops with you. You need to know enough to have oversight of those things and to keep your finger on the pulse and to understand where the money's going, what are your overheads, your operating expenses, your profit, your loss, where that's all going, and keep up to date with any technical skills.

[00:22:43] So, it's actually really hard. I was, I was probably doing 50, 60 hour weeks, um, and it's only just started to, I think my, my business is more of an adolescent now. It was a, an infant before, and a toddler who cracked, kept cracking tantrums, and now, and now it's a teenager who wants some space. So I'm getting a bit more of my time back. That's why I can do my art class.

[00:23:04] Bronwyn: Yeah, cool.

[00:23:05] Marie: Um, but that, that took a lot of time, a lot of sleepless nights, a lot of, crying under the desk, seeing a meeting in my diary with the accountant thinking they're going to just talk to me about gobbledygook that I don't understand.

[00:23:19] Bronwyn: And so maybe this brings us back to something you teased us with earlier, which is the choice. So you made the choice to go into this group private practice and grow this and invest in this and do all this learning. And you mentioned that maybe it's not the decision you would make again. Could you tell us a bit about that?

[00:23:38] Marie: Yeah, I think when I first started, I mean, it wasn't that long ago, but even just the digital platforms we use weren't as, uh, available then. So if I was to do it again, especially now in 2024, I might stay Um, seeing clients three or four days a week and then just focus on digital course creation. So, if the idea was to create more revenue or not be reliant on hour for hour trading time for money, I might look at investing more of that time in a digital program, um, some sort of collaboration or something like that.

[00:24:18] But I don't know because the other thing with being in a private practice is a lot of people want the collegiality in the company, but you're the boss and whether it's contractors, subcontractors, room rental might be different. There's still an element of you having to be a step above in order to things to run, and that's really lonely. Those peers are no longer, you're no longer their peer in the same way. You might be with a tricky case or something. But the dynamic shifts because they're very much aware if they bring a case to you to supervision that is not so, um, that you might question their effectiveness, they could lose their job. might choose not to, to work with them. If, if they do something that is not okay by you, you could terminate their contract. Like, it actually does change things. So, you know, you can't be friends in the same way.

[00:25:14] Bronwyn: And so with that isolation, have you found some comfort or, uh, what's the opposite of isolation? What's the, what's the antonym of... connection! Oh God. Yeah. I was like, what's that word? Um, have you found connection with other people in, in your life to be able to manage that loneliness?

[00:25:35] Marie: Yeah, it ebbs and flows. I wish there was more. A lot of my connection comes from other small business owners, so it wasn't through, they weren't all necessarily counselling in psychology practices. My local council's actually, shout out to Maribyrnong Council, has run lots of small business events. So through that I've met other small business owners...

[00:25:56] Bronwyn: Wow. That's really cool.

[00:25:56] Marie: ...happen to live locally. Yeah, part of the sort of local traders association. And so that's, that's a lot of fun. That's really fun. Um, we can, and cross refer as well. So I've met branding people, designers, financial advisors, accountant, like, so it's that. I've been to like networking events, really like formal ones. So now I've got a few people I connect with.

[00:26:22] And now post COVID and post lockdown, especially for those in Victoria who struggle through it quite a lot, a lot of people are working from home. So then it's re shifting that as I'm trying to get more of that. Connection from my local community, through the gym, through yoga, through parkrun, through other activities with people who otherwise might get up and go straight to the office and now actually hanging out locally in a different way.

[00:26:49] Bronwyn: That's really cool. Shout out to Parkrun. Shout out to your council. That's also really cool.

[00:26:53] Marie: It's really cool. Yes, I've got a breakfast coming up soon. I guess depends when this is released, but yeah, they have a lot of small business events. So there's a few different clubs and organizations. There's women's only. There's, there's, uh, Corporate like there's so many different ones and you can network in a way that feels authentic to you. So it doesn't have to be really aggressive sales networking that can be really small groups, intimate groups.

[00:27:19] It is an important component of that for longevity and for sustaining the business viability because you might get a lot of referrals now, but things can change really quick. Um, the market can change really quick. And when you have other people on your team, you have a fiscal responsibility for their livelihood in a way as well. And you have to be able to manage the finances in a way that is appropriate, or you can actually get into some significant trouble.

[00:27:51] Bronwyn: I did have a list of common misconceptions people might have about group private practices. We've pretty much covered them all except for this one, which is... some people might think that there's immediate- immediate financial gain. You go to a group practice, you're bringing in more clients, you're earning more money, right?

[00:28:08] Um, and yeah, I guess like you mentioned a lot of investment in business coaching in that kind of knowledge acquisition. Maybe would you be comfortable sharing with us like, what is the, are you aware of a standard trajectory for group practices? Is it like, you know, most group practices don't earn a dollar in surplus in the first two years?

[00:28:33] Marie: I don't know stats for other people, but I think when you're listening to the success stories of others, there's a very big, very big difference between revenue and profit. You could make a million dollars revenue, but if it costs you $980, 000 to get your product to market, that means you've only made $20,000 profit.

[00:28:56] So you've really got to understand those numbers. And when you become that sort of manager, you're also... your time is an hourly rate. So if it takes you 5 hours or 10 hours on a Sunday to do something and you think if I was working somewhere else at Sunday rates I would get paid $120 an hour, you've got to factor that into what it's costing you to run the business. It will take, if it's your time, that's costing you time that if you were working somewhere else you would get paid. Um, there's no easy way for this.

[00:29:29] Bronwyn: Yeah, so I guess what, what keeps you going in this line of work? Like, what are the good things for our anxious listeners at home who are like, I was thinking about this, but now it sounds a bit shit, to be honest.

[00:29:43] Marie: I think it's, I do like working with other therapists and I like being able to bring people into my team who have similar values in the kinds of presentations that they work with and can do some really good work. So we work a lot with adolescents, for example, that's something that some people don't want to work with. So being able to scaffold some people's learning. It's not very involved because uh, Their contract is not employee, so there's a different relationship. It is a business to business arrangement, but there is some of that ability to, to share knowledge, which I love.

[00:30:19] And then it's, I want to see if I can get through that adolescent phase and I'll keep revisiting that. So, I think I will stay myself in private practice. Probably forever, whether I then pick up other things. I'd love to do some teaching or some other short term, uh, work like that to be involved as part of something bigger. But education is a really big thing, which makes sense because I love learning. So I also like teaching, but we'll, we'll see.

[00:30:48] I think it's, you know, It's possible, I mean, if you got to where you are as a therapist, you've got some skills in being able to learn. It's now applying that to something else and just recognising you might be starting from scratch. You might be really having to understand really basic things about finances, risk management, employment law, human resources.

[00:31:12] It's possible. Again, it's cheap, quality and fast. You can do it the cheap way, which is just hours and hours and hours of consuming free content, or books, or I mean, you could, you could do it really, you could try and become a lawyer and write your own contract. That's a nice, cheaper way to do it, but it's going to take a long time.

[00:31:34] Bronwyn: Yeah.

[00:31:36] Marie: Right, so anything is learnable, right? It's all learnable.

[00:31:42] Bronwyn: No, I agree with that. Even starting my solo private practice, I think I took a cheap way because I love learning and one of, and I haven't been, I haven't had much money growing up at all. So one of the ways that I have saved on money is by learning things myself because I'm really good at it.

[00:31:58] Um, and so when I started my solo private practice, I read about eight books, um, on business, private practice, and actually there's a small business corporation in WA and I attended one of their, um, courses on small business just to make sure I was on the right track. Spoke to an accountant. I think I spoke to a lawyer.

[00:32:18] So I did, I did invest in a few things, but I was like, okay, like that's enough to, to get me off to a start. And I'm not going to make any of these like liquidation type consequence type things and screw myself over. Um, learnt Medicare back to front as much as I could.

[00:32:33] Um, but I will say that, um, like, I didn't have a business background at all. I didn't know any of these things. I literally picked up like Business for Dummies and was going through it and it was learnable. It was learnable. So just to reiterate what you're saying, it's not, it's not like these things that you, if you've gotten to this point, you can, you can learn. You've demonstrated you can learn.

[00:32:54] Marie: Absolutely, and being okay with that, just being aware that that's what you're in for and... the ego can take a bit of a hit because you could be an expert in your field and then feel really, really out of your depth learning. It could be even just, um, the technology setting up. I mean, I see so many frazzled people in groups being like, I don't know how to set up a Halaxy template. And I'm like, there's literally videos that step by step guide you, like, if you're at that level of overwhelm, starting a business in a bigger scale is going to be, it's going to be that on a huger scale. So it's really thinking about what you're prepared to

[00:33:38] do, how much, what's your tolerance for discomfort, for growth, for learning, for not knowing, for getting it wrong, and what investment you can make.

[00:33:50] And that's time, financial...

[00:33:51] Bronwyn: Yeah, and I mean, like, that might even be some of your own therapy. Like, um, I think I, cause I've, I like, I love learning. You love learning. It's like, I think I have a pretty high tolerance for discomfort when it comes to learning.

[00:34:05] Um, one thing that's come into my mind is I love sewing clothes and sometimes literally. Like, there's a machine in sewing called an overlocker. It, it makes all the nice seams that you see in your clothes. It is a pain in the arse to set up an overlocker and if a thread comes undone, I have literally spent days and posted in several Facebook groups, try and get my overlocker working again. And I've been like, okay, I'm going to try this for 20 minutes and then it won't work and then I'll be like, okay, I'm taking a break for the day, um, and then I'll try again.

[00:34:33] So, I feel like it was actually the same when I was setting up my private practice. I would literally be reading the Halaxy instructions and I'd be like, today I'm going to set up a template. That's my goal. And we're going to do that. We're going to watch these videos. And I got it. Um, but yeah, it did take a lot of being kind with myself and being like, look, you are a beginner. There's no shame in this. It's okay not to know.

[00:34:54] Marie: And think of it on a, for a different industry, for example, like if you were baking muffins, you could sell those at a market and you could slowly save a bit of money to get a bigger oven to sell more, to make more muffins, or you can spend all night using your little oven and bake. Or if you got a business loan from a bank of, I don't know, let's make up $50, 000, you're like, cool, that might mean I can buy that bigger oven now. I can set up a little shop front and I can employ someone on the register. And so I might make that money quicker than otherwise.

[00:35:28] So it's a bit like that. Like someone might say, look, I'm, I'm not good with tech. So I'm going to hire a virtual assistant, a personal assistant, an admin person. I'm going to sit with them, tell them what I want. They're going to go and do it. And now I'm going to use that. It means you have to have that money, that investment, whether you've pulled it out of your offset mortgage, you've got a grant, it's got to have come from somewhere. So, a lot of tech companies will use grants, they'll use venture capital funding.

[00:35:55] Restaurants might get a silent investor, like the money, the startup money that needs to go in there, or it's time.

[00:36:02] Bronwyn: Exactly. Yeah. So, A question that I have is, what do you wish you had known when you were starting your group private practice?

[00:36:14] Marie: Probably of how lonely it is. I had this lovely dream of having a beautiful clinic that was sort of like a private practice, headspace or community center where I could run groups and have parent sessions and group supervision and have guest speakers. And I had this beautiful idea and it's really hard to do all that.

[00:36:36] Groups flop. People get busy. Supervision doesn't work for some people because they don't want to miss billable hours. So we do it at night. At night doesn't work for people with kids. Um, and so that can be... it can be sort of disheartening and then there's the loneliness of being up on a, you know, Sunday night trolling through spreadsheets being like, why did I do this to myself see another spreadsheet?

[00:37:03] Bronwyn: Yeah, it's, it sounds very difficult in that way. I remember groups was one of my early disappointments, actually, because I love groups. Group therapy is one of my passions. And when I, my first placement, um, when I was training as a psych, was group therapy and I was like, I want to be a group therapist forever. And then bringing that over to private practice and it's like cursory, like, Oh, I wonder if I could do groups. It was like, no, not really financially viable. And I was like, it's quite difficult.

[00:37:32] Marie: Yeah, and so that's hard because sometimes there's what we might know works, um, in a good treatment plan that the private pay market isn't ready for.

[00:37:42] Bronwyn: Yeah.

[00:37:43] Marie: And so you have these extra things with people trying to get their work done in 10 sessions and it's like nowhere in nothing I've learned apart from single session therapy says 10 sessions is enough to treat anything.

[00:37:58] So there's just all these extra challenges of being able to do good work and keep a client engaged and afford it to be able to have the outcomes that they're coming to you for.

[00:38:11] Bronwyn: Conversely, what do you think would be a good reason to start a group private practice? Is it like, I want to make a bigger impact, or I want to learn the business? What is a good reason to start a group private practice?

[00:38:27] Marie: Definitely, I don't think it's the impact because you could do that probably in other ways. Um, I think there has to be probably a part of you that's just entrepreneurial. That actually, um, If, if anything you picked up, you would be like, I can see how we can grow this, scale this. There's a desire to, to know, to expand, to tweak, to understand how things work. So it's putting on a, it's having like a business hat and, and being in leadership. So I think there's a few different things there.

[00:39:02] Bronwyn: So do you reckon a situation which is what I've heard described and I think originally Brittany wrote in with, which was receiving a lot of referrals, people are saying, hey, you could have a group practice. Is that a reason to have to start a group practice that just that you have too many referrals?

[00:39:20] Marie: No, because that doesn't mean they want to see someone else.

[00:39:23] Bronwyn: Ah, that's true.

[00:39:24] Marie: That doesn't mean they trust the people you're going to work with, that doesn't mean you'll be able to find people who will work for you at the fee that makes your, that job viable, and that's worth the, you know, to write a contract's a couple of thousand dollars. So how many referrals will they need to see to do that? And then who's going to process the referrals? What system are you going to use? So you could think about it, but if people are referring to you specifically, it doesn't mean they want someone else.

[00:39:53] Bronwyn: Okay. No, that's a really good point. I didn't even consider that, but I have heard that as well. It's that group practice owners, they may name the practice after themselves and then they struggle with new clients coming in to be like, Oh, you can see one of my colleagues, we've assigned them to you. And they're like, no, I wanted to see the group practice owner.

[00:40:11] Marie: Yep, so if you're wanting... if it's more how do I make more money from this, then you can look at other ways of increasing your fee or offering groups or some other product or service. So if you're getting, you know, if you've got 10 referrals because you're a neonatal specialist and you work with parents who have kids struggling to sleep, then say look I've actually got a wait list of six months but we're actually running a three week parenting workshop on getting your baby to sleep. So you might have a different way of using that abundance of referrals to increase your profitability or to scale something. So it requires still one or two hours of your time, but can reach two, three, four, six people. That might be a group, that might be a webinar, that might be a product, a book, or increase your fees.

[00:41:01] Bronwyn: Okay, cool. Let's say then that there is a listener who is like, Marie, I have that entrepreneurial spirit. I want to dig deeper. I want to grow. I want to look at the spreadsheets. I want it all. Um, what advice are we giving them for starting out and growing a group practice?

[00:41:18] Marie: Definitely get support. So still don't do it on your own. Find some sort of group, whether it's peer or paid or something. But also the other, I would caution someone, if you don't have any actually runs on the board with your therapy, like If you're not that technician, like, I, I think I've seen some people come out of, I've had some social work students on placement who graduated, like, I want to go, I want to open a private practice. Like, you've done no, you've got no industry experience yet, but your placement. You need to have that technical manager, entrepreneur, you need to have all three.

[00:41:52] Bronwyn: Yes. Yeah, that makes sense because I guess even one example that comes to mind is client retention. And I feel like you need to know as a practitioner, like tell me if I'm wrong, but you need to know how to retain clients as a practitioner before you can advise other people on how to do that. I guess, understand, I don't know. Maybe it is a skill set you can come to outside, but I do feel like having worked on it myself that I am in a position to be able to tell people, am I wrong about this?

[00:42:20] Marie: I don't know because I think a lot of people aren't good at retention. so I don't know if it's a, just because I did it, I could teach it necessarily

[00:42:27] but I, I think it's, if, I don't know if you've got the... it's starting too many things from infancy, right? So if you haven't yet got any business skills and you don't have any runs on the board as a therapist.

[00:42:42] Bronwyn: It's just too much then.

[00:42:43] Marie: Yeah, how can you do both? How can you, like, your brain, you really can't. There's not enough hours in the day to learn to consolidate your skills as a therapist and learn how to be in the room and, you know, get a good handle on the two, three, four therapeutic modalities that you're working from, understand the areas of concern and presentation within what funding arrangements and models, and run a practice and a business. I think, I don't know how you can do both at the same time.

[00:43:11] Bronwyn: Okay. Follow up questions. How do I find a business coach? And does the business coach need to be of the same profession as me to help me?

[00:43:19] Marie: I googled it. Um, I, I found one locally. I actually wanted someone local and I wanted a female, um, who was brilliant. Her name's Kaye Frankom and she had, um, a book. And so I kind of looked on her website. I ordered her book. I read the...

[00:43:36] Bronwyn: I've read the book.

[00:43:38] Marie: Yeah, Fit to Practice.

[00:43:39] Bronwyn: Yeah, great book.

[00:43:40] Marie: Yeah, really, really good book. And then I hired her and I recommend, had some recommendations from her about some other people. So then I worked with, um, some of the other people she recommended and then I picked and chose.

[00:43:53] So I started off very, very small with a very small group that was like, it was like a $50 membership a month and it was one group coaching call with one online module. of your choice from this person's catalogue. And that's where I dipped my toe. And then I worked with Kay, I worked with others. Most were psychologists or social workers.

[00:44:14] And then I went into... outside of that. So the skills that I needed to run the business, for branding, for marketing, for ideas, even to interact more with my ideal audience. I work with teenagers, even though they're my ideal audience, I target the parents in my comms.

[00:44:31] And so I got to hang out with other, With women, with dads, with who are parents, I could learn about copywriting, about newsletter, email sequencing, web design, like, so all of those skills came from outside of that. So I started with whatever content they had that was low cost or free to see if I liked what they had to offer before I invested in their bigger products.

[00:44:57] The last business coach I worked with, I heard her on the podcast. I really liked her podcast. I looked on her website, she had a free clarity call. I booked in the clarity call as part of that. She sent me a, uh, an email. Like a webinar link from a previous webinar that she talked about sort of cash flow. I really like that. Then I signed up to a small course of hers and then that was really good. So, I got her for a bigger package.

[00:45:22] So, you can kind of test it a little bit and see. Who's got knowledge that is good, but also who, who's going to make you feel good about yourself. Who talks in a way, like you want a real straight shooter, there's going to be that. If you want someone who's sort of that person at the gym is like, give me 10 more. Come on, you can do fine.

[00:45:42] If you, if you struggle with accountability, you might need someone who's really good at holding you accountable. And that comes at a price point too. If you want their availability to be, to have that many touch points throughout the week. So, yeah, it's, it's. I picked and chose depending on what mood I'm in.

[00:46:01] Bronwyn: Awesome. Okay. Is there anything that we've missed today that you feel it's important for listeners to know when thinking about starting a group private practice?

[00:46:11] Marie: I think knowing your why, um, there's that YouTube video, Start with Why, if you seen that, just YouTube it, um, but it does expose you to a different world. And just like with Instagram and glossy pictures, people are just showing one side.

[00:46:28] So you might see someone being like, you know, we've got 10 people on our team and that's amazing. That doesn't mean it's profitable. That doesn't mean that they have all the things in play. Like, so we, we have to be very, um, careful of the content we consume and not let that dissuade us because where you work, what rent you're paying, whether you own the building, whether you have to do a fit out, all of these things factor into the cost of your bum on the seat with a client.

[00:47:01] So. I don't know how anybody bulk bills, but I don't think I don't even know how there's a way to make a profit off that because literally just to keep the lights on and the room and admin. It's almost like I'm paying the client. Like it's, it's actually losing money. Like you might charge $200 an hour, but you don't get paid $200 an hour. And you're not, you're not seeing 38 clients a week.

[00:47:28] Um, if you're budgeting off 20 clients a week, you've got to think, okay, that's 20 clients. But if only 18 get booked in, I've missed two. Now, if only, um, 16 show up, I've missed four. Next week I'm not necessarily going to see 24 to make up for that. I might then also have the same issue and then there's a few public holidays and then there's sick leave and so you've really got to know your numbers and you've got to understand your hourly rate, what you want to get paid, what your expenses are. When you take sick leave it means you're not getting any clients in the door so you have to budget for sick leave. So you can't just say it's $200 an hour times 20 clients a week over 52 weeks. It's more like maybe 40 weeks.

[00:48:08] Bronwyn: Yeah. Cancellation rate as well.

[00:48:11] Marie: Cancellation rates, you know, could be anywhere between 20 to 40%.

[00:48:16] No-show rates, you've got to spend time chasing them up. You might need to pay for admin. Um, then there's PD that you go to. You have to pay for the PD and you don't get paid while you're attending the PD. So then you've got to balance all this stuff out. Is... do I want to do this stuff after hours and not get paid? Do I do it in the day and lose billable hours?

[00:48:39] Am I... the biggest mistake is doing this for flexibility. Individual solo, yes. The start stepping into the group, doing it for flexibility, especially in the beginning. Um, it's not possible.

[00:48:56] Bronwyn: Yeah, absolutely. Yeah. Thank you for taking us through the finances. It's so, um, at the start when I was starting up solo private practice, I had such a bad money mindset. It's something that I've had to work on. But I was like, I want to bulk bill everyone. And then my partner, very good with money. We sat down and made a spreadsheet. He's very good at spreadsheets. And we worked out that you would be earning about $20 bucks an hour, um, from bulk billing, which would translate to an annual salary of about $17, 000. Um, and I was like, Oh, okay. Well, that's not possible. Is it?

[00:49:30] Marie: No. I love them. I love the money mindset stuff. And maybe, um, when you asked me earlier about, um, where the career could go with the entrepreneurial stuff. I've actually loved the money mindset stuff so much that I've, I talk a lot about it in couples therapy... finances and the conflict that arises and I'm doing, um, or will have done by the time this episode comes out a series of co hosting episodes with the Australian finance podcast.

[00:49:56] Bronwyn: That's so cool.

[00:49:57] Marie: Yeah, on money mindset and how we can talk about money from that relational side. So, random things pop up. I, my, that, the big thing is still for me that the well being and the psychology behind and relational work, but that can be in all sorts of ways. So...

[00:50:15] Bronwyn: No, absolutely. And like, because I have, I've had done an episode on money before. I should do another. We should do another episode on money mindset. Well, anyway, but there is research which shows that mental health professionals have higher financial insecurity relative to say, like, um, blue collar workers, like white collar workers. Just if you compare us to a number of other professions, because, and they've linked it to money mindset, we have. More vulnerability to financial insecurity. It sucks. So yeah, great area to align yourself with.

[00:50:47] Marie: It is, and being a very female dominant profession, you've got to, this is where you really have to put your big girl pants on.

[00:50:55] Bronwyn: Totally.

[00:50:56] Marie: The rise of women who are homeless in their 50s is extraordinary. The lack of financial freedom, doing kind of good work or seeing the business as like the hobby on the side. It's bullshit. It's not going to cut it.

[00:51:11] Bronwyn: So, true. Like that's how I overcome it.

[00:51:14] Marie: ...setting yourself, you're setting yourself up. No one's going to turn around and say, oh, you bulk builder, you did good work, so pat on the

[00:51:22] Bronwyn: Yeah, yeah, it's so true. It's literally the thing that stops me because sometimes I see online people saying like, you're so selfish for charging and we should be charging less and, and I feel that I, I take on that, that shame quite easily. And the only thing that stops me from feeling that is I'm like, I'm already like $60, 000 behind in my super than my partner. I've got to get that super up. So like, I think of my super, like every time I feel like changing my money practices due to shame.

[00:51:51] Marie: But it's terrible that other practitioners are putting on that shame.

[00:51:54] Bronwyn: I know!

[00:51:55] Marie: Um, it just shows they don't value the work they do enough to pay for it. So they're probably also the same people who are trying to find a supervisor who will do it for like 90 bucks or do for free. Um, and. I'm not that, but I, I would recommend it was the old podcast. It was called more money for shoes, but now it's just Melissa Brown and the, She's on the Money.

[00:52:18] Bronwyn: I love She's on the Money.

[00:52:18] Marie: Um, yeah, the podcast is great, but her books are really digestible and you know, money win. If you rent it from the library, you don't even have to pay for it. And if you're like me and you like audiobooks, if you get a library membership, you can sign up for BorrowBox or Libby, which are apps that are free with your library membership, and you can rent it for free and listen to it on your phone.

[00:52:42] Bronwyn: That's so funny because, so Money Wins is something that She's on The Money does pretty regularly. She reads them out on the podcast, but I don't ever think I've heard that particular Money Win read out on the podcast,

[00:52:51] Marie: That's my money win.

[00:52:53] Bronwyn: Which, which, you know, I don't expect her to do, which I would expect her to keep that one close to her chest as well. Um, but...

[00:52:58] Marie: But no, they have talked about it.

[00:53:01] Bronwyn: They have really?

[00:53:02] Marie: The author makes more money. They make money every time the rented.

[00:53:06] Bronwyn: Whoa, I had no idea. That's so cool. Good on her. Yeah, she's so cool. She actually came to Perth and I couldn't go to her breakfast because I had something else on and I was like, but yeah, awesome.

[00:53:16] Okay. Marie, I reckon we'll wrap it up. is there anything that you want listeners to take away from our conversation today? Just like a one liner, a thing to stand out.

[00:53:27] Marie: Every, I think every expert was once a beginner, so just be ready to start some things from scratch again.

[00:53:35] Bronwyn: Hmm. Love it. I love beginner mindset. I used to do a lot yoga and my yoga teacher would say that and I'd be like beginner mindset.

[00:53:41] Marie: Yeah, I think there's a saying of like, the best way to get good at something is to first suck at it.

[00:53:46] Bronwyn: Yes, agreed. Thank you so much Marie for coming on and sharing your experiences, your insights, your expertise. I really appreciate it. And if listeners want to learn more about you or get in touch, where can they find you? And I believe you're offering supervision a bit more now, is that right?

[00:54:01] Marie: Yeah, so I don't do business coaching because that's, I don't know how to do that. That's not me. Um, but I do supervision. So mostly around adolescence and family work, um, couples work. If you're interested, I use the Gottman method. And, uh, for referrals, it's through the Therapy Hub for actually client work.

[00:54:18] Bronwyn: Excellent. I'll pop those links in the show notes. Thank you again, Marie. It's been a pleasure.

[00:54:23] Marie: No worries. Thanks.

[00:54:25] Bronwyn: And listener, thank you so much for listening. I hope you take care and do share the podcast with someone else. If they are considering growing a group private practice, put this in their ears and share it with everybody you know.

[00:54:36] Okay. Take care. Have a good one. Catch you next time. Bye.