Group Practice Success ft. Danielle Kepler

Uriah
Danielle, welcome to the podcast!

Danielle
Thank you.

Uriah
I'm so excited to chat with you. Yeah. This is the first time that I've ever interviewed one of our now former members. I know, so sad. But it's also exciting. Just over four years.

Danielle
Yes. Basically when it was starting from the ground up, I think I went as.

Uriah
Your first client pretty early on. Yes. So we started in 2018 and you joined and started working with us in May of 2018. So, yeah, I was curious if you could just like, we could go back to 2018. Tell me what was going on then.

Danielle
Oh, my gosh. So May of 2018, I was trying to expand my practice at that time, and I had hired somebody and had to let them go. My first person, they weren't up to my standards, I guess you could say. And then I hired my second person in June of 2018. So I just started working with you guys in that space between hiring somebody and letting them go and then hiring somebody else who's actually still with me, I was just expanding then. Wow. It was like the perfect timing.

Uriah
That's so cool. And I'm curious if you think back, what motivated you to consider working with a virtual assistant all the way back then?

Danielle
Well, I was thinking about it for a while, actually. I probably should have done it sooner, but I remember I was just starting my practice, expanding it, and at that point, I was still seeing a ton of clients, like 35 clients a week. And when you're seeing that many clients in sessions for that long, a lot of the admin stuff as far as, like, scheduling and answering emails, responding to clients inquiries, follows to the cracks. So that's really the push that I needed to hire a virtual assistant, virtual assistant company, especially because I knew I was expanding and I was like, I'm just going to even get more referrals and I need somebody on the back end handling the scheduling stuff for me.

Uriah
Oh, my goodness - 35 clients a week!

Danielle
You do not right. Maybe I'm being a little bit hyperbolic. At most it was 35, but it was a lot of clients and so much where I was using my office so much back then that I wanted to hire somebody, but I needed my office for all of my clients. So that was the thing that a lot of people, they just hire somebody to work with them when they're not using their office. But I'm like, oh, I need my office all the time.

Uriah
Yeah.

Danielle
Finally an office opened up across the hall, so I rented that, and that's how I was able to hire somebody and then slowly decrease my case load.

Uriah
I don't know the answer to this question, but were you always thinking about group practice, or was that just something that came to you and you're like, I'm too busy, I need to get help with this?

Danielle
No. When I first started my solo practice way back in 2015, I had come from a group practice, and I was like, no, not for me. It's funny, but I was just like, more people, more problems. I just want to do my own thing. I don't want to have a group. And three years into having a solo practice, I was like, I'm kind of flonely, I want coworkers. And I was having to refer so many clients out because I just couldn't see any clients. Well, it's great to refer out and everything. It's also great to refer in, I guess, to your own practice. In your own practice. But I also wanted to hire some people that did different things than me, too. You just hire people that do similar things to you, but also a little different. So I wanted some people that had different kind of specialties as well, a group practice. But now I really enjoy it, now that I'm however many years into it.

Uriah
I was talking to someone the other day about the idea of if you knew back then what you know now, would you do the same thing again? Obviously, we would all make changes. My answer to would I start a VA company, like five years ago if I know what I knew now? Maybe not, because it's really hard. And group access is really hard, right?

Danielle
It is really hard. It's hard being a grown up. I always tell people, too, it's a lot of responsibility. I have eleven employees now. None of them are full time, and two are part time. The full time people rely on the practice for their income and their family and their rent and everything. It's kind of scary in a way, when think of it that way.

Uriah
It's also a huge privilege, though, and it's like an honor to be able.

Danielle
To yeah, very much so. I think that every time I run payroll, actually, I'm just like, wow, look at this. It's so cool that I'm able to provide for these people. So I guess there's always a flip side, a dialectic.

Uriah
It's both. Yeah. I'm so proud of you. It's so cool. I'm curious. One of the unique things that people wouldn't know, of course, listening to this, is that you and I have been able to work with the same two people in our respective practices for the last four years, which doesn't always happen. And you and I would say have two of the best VAS that.

Danielle
I had. Well, I told both of them I was like, if I were to use TPT again, I'm getting both of them, and I don't care what you're saying.

Uriah
Right. No negotiations.

Danielle
Yeah. I was kind of a unique client in a way, where I had two VAS, so I was very lucky to have two, where most people, I guess, get one, possibly. I had started with Jamie, and she couldn't do phone stuff because she had a kiddo at home. And so you were saying, okay, wait a few months, and you'll get Tiffany, who will do the phone stuff. But Jamie really helped me a lot. Like I said before, I just started expanding, so I was like, how should I do payroll? How should I do this? I don't know if you know this, but she was like, oh, well, uriah does it this way. And I'm like, well, shoot, if it's good enough for Uriah. Oh, yeah, good enough for me. So it was really helpful having a virtual assistant that already had worked for group practices already, so they were able to sort of help me develop some systems that I had never had used before. I never had to do payroll and stuff like that because I was so low. So that was really helpful. And then Jamie did a lot of the back end stuff for me, and then Tiffany handled more of the front end and the phone calls and things like that when she started. It was kind of nice to have two people. There was lots of coats to the kitchen, but that's okay.

Uriah
Got to sort out the workflows. Yes. Jamie is a master of operations, for sure. And then Tiffany is one of the best virtual intake coordinators that definitely we've ever had. Yeah, they're amazing. And our model has always been whatever we can figure out and optimize and test on my practice, we're going to give away the secrets that's always been the model, for sure. Share the wisdom, right. How did Tiffany taking over your phones, how did that make a difference for you and your practice?

Danielle
It made a huge difference. I hate making phone calls myself, but when you're expanding to one of the toughest things, I think starting a group practice is everybody wants to see you. And while it's very flattering, you want to potentially reduce your caseload and not take on new clients and send the new clients to your clinicians that you're hiring. So it was really helpful to have Tiffany kind of as like a gatekeeper in a way, or like a barrier for people calling in because they would say, oh, I want to see Danielle, and Tiffany would be like, well, Danielle is not accepting new clients, but we have Catherine here, who's great and has a similar style and stuff. So that really helped. They were like, oh, okay, we'll see Catherine. But if it was me talking to people, they'd be like, well, why can't I see you? You're clearly able to answer the phone.

Uriah
You're so nice and you're right here.

Danielle
You're right here. You mean I can't see you? What the heck, why not? But that was really helpful and just as far as, like I said, I was seeing lots of clients myself and you obviously can't see clients and answer the phone at the same time. So the quick turnaround and being able to get back to people, I feel like that was just super helpful. With growing the practice definitely makes a big difference.

Uriah
I think you and I are alike and that neither of us really want to be doing handling phones and new inquiries. Like, it was nice in the beginning just because you're really close to the potential clients coming in, but then at some point it just becomes too much and having somebody competent that you can trust, that's going to run traffic control for you, it's so nice. Funny enough, that's what we built Productive Therapist on. And I didn't know when I started it that's what everybody would want is that virtual intake coordinator. But then we kind of designed it around that because that was the most requested service for sure.

Danielle
Yeah, I can definitely see that. That's what I really wanted, for someone to answer the phone, someone to direct traffic, someone to just be the first point of contact with people calling in and email too.

Uriah
And that role is so important because the incoming referrals, that's like the lifeblood of your business, bringing in new clients and then obviously bringing in cash flow to the practice as well. So if you have an intake coordinator that's not good at converting those callers to clients, or is not trustworthy, or doesn't have good follow through, then your practice will suffer. But you and I both thrived with Jamie and Tiffany for sure.

Danielle
Yeah, definitely. Yeah.

Uriah
Let me take just a quick pause and tell you a bit about our sponsor. This episode has been sponsored by Simple Practice, the leading practice management platform for private practitioners everywhere. More than 75,000 professionals use Simple Practice to power telehealth sessions, schedule appointments, file insurance claims, communicate with clients, and so much more. It truly is an all in one HIPAA compliant platform. Get your first two months of Simple Practice for the price of one when you sign up for an account today. This exclusive offer is valid for new customers only and you can go to SimplePractice Productive Therapist. Learn More so you realize at some point that you were just so busy and you couldn't do all the things and you didn't want to do all the things. So I guess this might be a layup question, but I'm curious. When you think about or talk to group practice owners who are just overwhelmed and still doing all the admin work, what is your recommendation?

Danielle
So when you gave me this question, I thought about it. I didn't realize how much time the admin stuff was taking up in my life because I knew how much it's easy to measure clients 1 hour, 2 hours, 3 hours. But all of the admin stuff, I never really, like, set a time off, like a start and stop. And I'm like, oh, well, it's just part of the business. That's what I do, return phone calls and everything. But I never realized how much time it was actually taking up in addition to seeing clients and whatnot. So I would probably say, really think about how much time it does take you and if your time could be better spent doing something else. Yeah, for sure. And my time was definitely better spent elsewhere, growing the practice, seeing clients, even.

Uriah
That's a really good point because most people don't know how much time they're spending on all those other things. It just sort of eats up the rest of your time in order to choose the ideal solution for you. Whether it's like a part time virtual assistant or an in house person, you kind of got to know what the hours look like and what you really need, right? Yeah.

Danielle
Yes, for sure.

Uriah
Makes sense. So you're supposed to say that your advice was to work with productive therapist. That's what I paid you to say.

Danielle
Well, you clearly did not pay me enough, so darn it.

Uriah
No, but seriously, you've been so kind over the years in the Facebook groups, like, talking about talking us up and saying, like, I haven't had to respond to a phone call in three years. It's amazing. Productive therapist is the best.

Danielle
Like I haven't and I still don't. It was really hard to end services with productive therapist, but when you get too big to bring it in house. But working with you guys has really even set me up to even train my new in house person, because she probably got sick of me saying, like, well, Jamie does it this way, tiffany does it this way. But they really helped me build my trust and confidence in having somebody else do all the admin stuff. Like, not all of it, but do a lot of the admin stuff. For me, I was very skeptical, in a way, because nobody can do it better than you. But actually, that's not necessarily true. I mean, knowing you and knowing that you were giving me the VA's that you worked with at your practice really helped me and like, okay, this was someone that you trained, and we use the same EHR. I'm like, okay, well, if your eyes using them and they're just going to basically transition very smoothly to my practice, that really helped. It's hard to give that up. Like you had said, it's the first point of contact. It's very important. And I was like, yes, it is, and I should do it. All right. I would be very stressed out right now if I had to do all...

Uriah
All that, and you wouldn't be where you are with eleven clinicians, plus yourself.

Danielle
Absolutely not. No way. Because towards the end of my time and everything, they weren't just doing phones and stuff for me. Jamie was doing initial interviews, like phone screenings for my clinicians. For me, yes, for hiring. And that's something that was hard for me to hand off because, of course you want to know the people that you're hiring and stuff, but that was also great to hand off because she could do that when I was seeing clients, and her schedule was a bit freer versus me being like, okay, I can fit them in my, what, hour lunch break? It's like, no, I should have a lunch break. And it was also really nice to have someone that you trusted. I mean, I had worked with Jamie for four years at this point, and she knew my current clinicians, and she knows my personality. So I was like, I trust you with being able to screen out these people for me. So that was really helpful, too. It's something that you wouldn't think a virtual assistant would be able to do.

Uriah
But no, it's true. I highly recommend that because that falls into the category of those tasks that somebody else can do just as good as you. At least the first step of it.

Danielle
Right.

Uriah
So I think that's a good call. So I'm curious, how did you know and when did you know that it was time or almost time to hire in house and kind of transition from what we are providing?

Danielle
I joke with lots of people that it took kind of health care for me to be able to transition, that. I had to have eye surgery back in March, and it left me basically not able to see for two weeks. I don't know if we would talk about this, but this is when we were sort of transitioning off of I do, actually. Jamie, can you please stay on for a little bit longer? Because I'm having kind of a situation. So I actually trained. My mom had to do my billing for a little bit just because she was available and is pretty tech savvy herself, so I did that. Tiffany and Jamie were helping as well and stuff, but it was really tough for me not to be able to be incapacitated for two weeks.

Uriah
I can't imagine.

Danielle
Yeah, it was very difficult and pulled it together and everything, but it took my mom and my sister to basically be like Danielle. And this was also with billing, too. They were like, when do you go on vacation? Do you work on vacation? I was like, Right, Judge Melted, yes, of course I work on vacation. The billing needs to get done. We need to get paid. And my sister was like, that's awful. So I was like, okay. And I knew you guys don't really do insurance stuff, so I had been working with another administrative assistant. Assistant to help me do verification of benefits earlier in the year and she had been wanting to quit her full time job and do admin work full time. So that was sort of the right time.

Uriah
Oh nice. So you found the right person.

Danielle
Yeah, found the right person. And it's actually a friend of mine's friend who was also doing like admin stuff for her practice and so she was doing phone stuff for her. So I'm like, well if I train her how to do basically be a mini me insurance wise and she does phones and I'm like she can take over the world and it was just the right time. As far as having somebody, it is nice having one person do all that for me. But the bigger reason why I took it in house was because more so the insurance stuff and it would be tough to have like three administrative assistance. That would be a lot. My practice isn't that big.

Uriah
Right, that makes a lot of sense. I know that some people who use the term graduated from productive therapist services. It does kind of happen serendipitously where they find an amazing person and they're thinking, well maybe this will cost less money and I can be closer to them. And there's lots of pros and cons to having virtual versus in office or like what Jamie is to me local remote is what I call that.

Danielle
Right, yeah.

Uriah
Can your person come to the office?

Danielle
Yeah, she's about like 2 hours away. Yeah, she's in Illinois. She's local remote. Yeah, but she works that's a good I like that term. She could come to the office potentially if needed, like occasionally. Yeah, maybe she was going to come to a group outing and stuff like that.

Uriah
Yeah, that's nice.

Danielle
And being in the time zone that I'm in is also helpful too.

Uriah
It is. Time zone matters at this point. We try to match people within 1 hour on either side and that seems to work pretty well. But yeah, having somebody in your time zone is really helpful. Well, that's so cool. Danielle I mean would it be okay can I give you a moment to pitch Be Your Own Biller and talk about that for a moment?

Danielle
Sure. Yeah. I also have an administrative assistant that helps with that, but that's a completely different person. So in addition to running my group practice, I guess I never fully introduced myself. No, you didn't talk. So let me just do that a little bit too. So my group practice I have eleven clinicians, one just started today. So I have to add her at eleven clinicians.

Uriah
Excellent.

Danielle
Nine full time, two part time. And we're in downtown Chicago and Illinois as well as telehealth of course. That's the world we live in. We see only adults, so individual and couples therapy as well. And I also do consulting with my consulting company called Be Your Own Biller or by OB for short, because sometimes you need to have an adult beverage. I remember mom being like, Danielle, you know the acronym is by O B, right?

Uriah
I'm like, Right?

Danielle
Yeah. I don't really think that's true, but it works.

Uriah
Bring your own biller.

Danielle
Yeah, be your own biller, bring your own beverage, something like that! What I do is insurance credentialing and billing consulting for clinicians. And I also, ironically, help a lot of people hire in house admin staff to be their bills, and I train them to be billers and stuff like that. That's what I don't have courses and all that stuff. Webinars. So yeah, it's kind of my side hustle right now.

Uriah
I like it. Yeah. We've used your materials for our team as well, so it's been nice.

Danielle
Oh, yeah, that's great.

Uriah
Occasionally a few things well, that's so great. And people can find [email protected]. And then if they want to check out your group practice to spy on you, it's therapy NOTES.COM, right?

Danielle
Yes, people get spy on me. That's perfectly fine.

Uriah
Be inspired is what I meant. Be inspired by you. So I'm curious, one last question for you. What do you think all ridiculously successful therapists have in common besides type A personalities?

Danielle
I was thinking about this. Probably really good systems in place and just a knack for organization. You wouldn't be able to tell this by looking at my drawers and stuff. Just ask some of my clinicians. What about my director of business? Actually, business office. He actually reorganized my closet for me in my office. He was like, Danielle, but organization for sure. I have my practice. Everything is kind of all set up and organized and just like, really good systems in place. So that really I can say that I have good system in place. Probably due to productive therapist is actually because you guys helped me with a lot of my system. It's just thinking about your client flow as far as first contact and, like, after their intake session and being able to really lay that out for your clinicians and really break it down as far as how you want to keep that organized, I think that helps people be successful and also knowing when to delegate too. We've said this lots of times. I don't think my practice would be as successful as it is now if I didn't delegate some of the administrative productive therapist to an admin person.

Uriah
Those are great answers. Be organized, have good systems, and delegate.

Danielle
And delegate and trust somebody. Because like I said, it took me a long time to trust and to be able to hand off stuff. But if you train the person or if it's a virtual assistant company like you have here, put some of the stuff in their hands and be able to take things off your plate, for sure. Frees your mind up.

Uriah
That's so key because you can delegate and you can have people on your team, but if you don't trust them, it won't work.

Danielle
Right.

Uriah
Also, if you have the right person or the right people doing the right roles, but you have disorganized systems, then that becomes a bottleneck. So you're absolutely right. That's like the trifecta right there.

Danielle
Yes, for sure. Right. If you have the staff to help you, but you're kind of a hot mess and you don't really know what you're doing or how to delegate this, which, I mean, we're all out there, right? How to delegate things. I really had to be like, okay, how do I respond to an email? Okay, here's the script for the admin. Writing scripts for Tiffany was ideal, and that really helped with trust too. It's like, okay, here's how I want her. Here's the feel, here's the pitch. Like, here's how I want her to answer emails. And at first, I had to be like, oh, wow, this is really micromanager. But no, that's actually a good thing to have scripts. It helps with trust and helps them know what to say and do in certain situations.

Uriah
It does. Right. Well, I'm so happy for your success, us, and I'm glad that we got to be a part of it, and obviously we'll be friends forever, so that's great.

Danielle
Yes, definitely.

Uriah
Yeah. And thanks for coming on the podcast. I'm happy to have you tell your story and other people be inspired by that. So thank you so much.