Episode 112: From Hot Mess To Success: Own Your CEO Status [featuring Brandy Mabra]

🎙️Listen to more episodes of the All Things Private Practice Podcast here
🎙️Spotify
🎙️Apple
🎙️YouTube Music
▶️ YouTube
✈️ Check out available Retreats
🗨️ Join the free Empowered Escape FB Community
🗨️ Join the free All Things Private Practice FB Community 

A Thanks to Our Sponsors: The Receptionist for iPad, Alma, & Therapy Notes!

✨ The Receptionist for iPad:

I would also like to thank The Receptionist for iPad for sponsoring this episode.

As you prepare for the new year as a private practice owner, one area of your business where you might be able to level up your client experience is from the moment that they enter your office and check in with you. For many private practices, the client check-in process can be a bit awkward and confusing.

Clients often enter into an empty waiting room. And chances are you're wrapping up a session with someone else, so there's no way of knowing when they arrive. With a visitor management system like The Receptionist for iPad, you can provide clients with a discreet and secure way to check in for their appointment while instantly being notified of their arrival.

What's more, The Receptionist offers an iPad list check-in option where clients can scan a QR code to check in, which negates the need for you to buy an iPad and stand. Go to thereceptionist.com/privatepractice and sign up for a free 14-day trial. When you do, you'll get your first month free. And don't forget to ask about our iPad list check-in option.

✨ Alma

I would also like to thank Alma for sponsoring this episode.

Alma makes it easy and financially rewarding to accept insurance. When you join their insurance program, you can get credentialed within 45 days and access enhanced reimbursement rates with major payers. They also handle all of your paperwork from eligibility checks to claim submissions, and they guarantee payment within two weeks of each appointment. You can also attract clients who are the right fit for your practice with a free profile in Alma's searchable directory. Additionally, Alma offers time-saving tools and administrative support, so you can spend less time on paperwork and more time delivering great care to your clients.

Get your first month free with Alma by visiting helloalma.com/ATPP.

✨ Therapy Notes

I would also like to thank Therapy Notes for sponsoring this episode.

TherapyNotes™ is a complete practice management system with everything you need to manage patient records, schedule appointments, meet with patients remotely, create rich documentation, and bill insurance, right at your fingertips. Their streamlined software is accessible wherever and whenever you need it. Go to therapynotes.com and get 2 free months when you use code ATPP.

Transcript

PATRICK CASALE: Hey, everyone. You are listening to another episode of the All Things Private Practice Podcast. I'm your host, Patrick Casale. I'm joined today by Brandy Mabra, is the CEO of Savvy Clover Coaching and Consulting and a CEO and coach for private practice owners and healthcare, 15 years of business management leadership experience where she has worked in diverse business climates and turned hot mess practices into well-oiled and profitable machines. I really like that line, and really happy to have you on today, as a guest. I think you're going to have a really cool perspective for private practice owners out there.

BRANDY MABRA: Thank you so much. I'm excited to be here.

PATRICK CASALE: So, tell us a little bit about who you are, and what you do, and why you do it?

BRANDY MABRA: Yeah, I'm Brandy Mabra. And so I have the blessing to be able to work with practice owners. You know, with my experience, and even what we were talking about a little bit before we started recording is that I've been hired specifically to come in and fix organizations. And so post acquisitions, you know, I've been hired by private equity. You know, after they've bought practices I've been fired to come in and just fix really hot mess practices. So, chaos, you know, where maybe the money's coming in, but the practice isn't profitable, if there's having problems with team engagement, or hiring, and you know really trying to make sure that the practice is running as efficiently and effective as possible. And that was kind of my role.

And so when I started my business, I dived into, you know, career, helping people because I've been able to get into the C-suite and all kinds of things. And so just senior level 16 plus million dollar budgets, you know, teams of 100 plus four people. I mean, just all kinds of things.

And so, ultimately, when I first got into my business people would ask me, like, "How have you been able to do what you've been able to do in your career?" And I finally landed on working with practitioners to help them run their practices, make sure that they understand the business side of their practice, what I say on a deeper level, own their CEO mindset, and making sure that they're able to make an impact in the world.

You know, I love the healthcare industry, even with all of its flaws. I think that the amazing work that we get to do on a day-to-day basis is important, but we have to make sure that our businesses are in order to be able to help more people. And so that's where things start to get more complicated.

PATRICK CASALE: I love that. Yeah, that sounds like a really cool career trajectory so far, and a lot of impact as well. So, I know you bring in some experience of having a different background than a lot of our guests who are mental health practitioners. And you have a background in business, is that right? And obviously, a lot of leadership experience.

Now, when we talk about hot mess practices, so to speak, I'm doing air quotes, I see that a lot in my coaching and in just the conversations I have with a lot of mental health practitioners. And I think a lot of the time it's because grad school does not prepare you to be a business owner whatsoever for, especially, in the mental health field. You're kind of like almost persuaded to not start that business venture, always told that it's too scary, there's too much risk, you don't know what you're doing. And then you're flying by the seat of your pants. And you may create something where you have a lot of clients coming in, but you're not getting paid appropriately, you're not getting paid in a timely manner, you're chasing down insurance claims constantly, you may just feel like you're pulling your hair out all the time and putting out fires. So, it sounds like a lot of what you do is helping untangle some of that behind-the-scenes stuff.

BRANDY MABRA: Yeah, that's exactly what I do, exactly. And what you're saying is facts. And it's not just even with the mental health, like, field. It's just clinicians in general, you know? And so I've worked with a number of different types of providers. And so learning the business side can be challenging. And one of the things I always hear is that I didn't go to school to be a manager, I didn't go to school to be a leader, I didn't go to school to be a CEO. And so now that I'm here, either, you know, because they started out working with an agency or working for someone else, and they were taken advantage of, or they were burnt out, or they knew that they could start their practice and do something better, right? Or something bigger. And some of it has to do it, too, especially, for me and my business, I wanted to own my days, I wanted to be able to say what my schedule was going to look like. When I wanted to take time off, I love to travel, I love being able… I'm a mom, you know. And so I really like to be able to call the shots.

When it comes to the business side, which is truly my expertise, it can be challenging, right? Because all the little things that can come up, whether it's like, okay, I'm booked and busy, but what do I do? I don't feel well paid. I'm burnt out. I'm working early mornings, late nights, the weekend, you know, insurance claims aren't working, you know?

And so it's really easy to take on like a victim mindset compared to thinking about like, what can I do? What can I control? And you have more control in your business than what you think you do, you can control how much you charge, you can control whether you're cash pay, or if you're, you know, requesting an increase when it comes to insurance companies, you can control who you hire, you control who you fire, you can control, you know, the clients that you see, you control the market, you can control how you market. So, there's so many things that once you start to realize like I have control over what's happening in my practice and what's not happening in my practice, and then you put data with it, that's where you're able to see like, oh, I can have structure, I can be profitable, I can be well paid, I can take time off, I can actually, you know, enjoy what I'm doing on a day-to-day basis. But you have to learn business, truly.

PATRICK CASALE: Yeah, I think you're so right about that. And I think so often, like, the preventative here is the fearfulness or the anxiety that comes with saying like, I don't want to learn the business side, or I'm not a business owner, or I didn't get trained to do this. I think there are a lot of things that I hear people say pretty often, like you mentioned, like you do have control whether or not you want to change that mindset. And if you open up a business and you're charging fee for service, you are a business owner. So, the whole, like, hiding behind the statement of I don't know how to do this, or I'm not prepared for this only goes so far.

And I see a lot of people who leave their agency environments or their corporate settings, and then recreate their agency environments or corporate settings that they were trying to get away from in the first place, because what you mentioned, like autonomy, and freedom, and control of your schedule and control over when you take time off, these are all the common responses when you ask or poll people about like, why do you like being an entrepreneur? And those are always the common themes.

But if you are creating systems that don't allow for you to do these things, it can really get frustrating and discouraging very quickly. You can dig a hole that can feel really hard to get out of.

BRANDY MABRA: Yeah, absolutely, absolutely. And it's like you have to make your systems work for you. And you can make the practice work for you. And so even with the clients that we work with, one of the things that we first start with is mindset, we start with what's the lifestyle that you want? You know, what are the hours you want to work? You know, who do you want to see? You know, who's part of the team? So that way they have the clarity for truly what they want, because in the beginning, let's be real, you know, the whole goal is to get clients in the door, to get the money in the door. And so it feels good to see like, yes, I am a business owner.

And you're right, like the first dollar, you are now officially a business owner, right? Because now you have people who are actually paying you money. And now you have to provide a service. And you need to make sure that even the practice experience is on point as well.

But you have control after you know how you're doing things. And so when it comes to systems, processes, operations, you know, that's where you can really leverage the practice to work for you. And so it's really fun even to watch our clients when they start to own that CEO status, they start to really think about like, okay, how am I doing things? What days do I want off? What schedule do I want to work? You know, I'm starting at 8:00, but really, I don't want to start till 10:00. Okay, well, what do we need to do in order for you to start at 10:00? Or they have team members that they've hired that they're not leveraging, "You know, I'm scared to delegate or I gave them this one thing. And so now, they didn't do it, right? So, I need to take it back." And so it can be challenging, but at the end of the day, you definitely, definetly have control of what's happening and how you're doing things.

PATRICK CASALE: Yeah, I think that is a really good point, the delegation piece, especially, if you're hiring. And I know for myself, I've talked about this openly, like I own a group practice, I have employees, and at first, there was this fear of like, I can't delegate, I can't outsource, because I do it the best or like, I know it in the most comprehensive way, I convert all the clients on the phone. But in reality, I was like, but I don't want to be doing these things and my time could be better served elsewhere. And it could help make the practice more money if I can change my focus and place it into different places.

But ultimately, it's so hard for people sometimes to take that step back and kind of operate with intentionality. I think the intentionality behind your decision making really, really important from the time you start your day, the hours you work, the amount you need to make. Like a lot of people are just starting their businesses flying by the seat of their pants instead of really having that plan or that strategy in place to say like, I want to work 20 hours a week and make X amount of money, and I only want to work these hours. Well, then that helps you inform your rates, right?

But like, way too often what I see is like, "Oh, I scrolled through a bunch of Psychology Today's in my area, and I just assumed because everyone else is charging X amount, that's what I should charge." Or like, "Everyone says, I need to work nights and weekends, so I know, I have to work nights and weekends to make myself successful." In reality, that is not true, but if you don't understand the marketing side of your business, then it it's very easy to fall into those pitfalls.

BRANDY MABRA: Yeah, absolutely, absolutely. One of the things that we work with is there's seven steps of delegation. And it starts off with before you even delegate, you know, what do you want to delegate? What are your strengths? What are your weaknesses? And so even what I do, like there's a piece of paper that's to the side, as I'm going through things, I write things down like I don't want to be doing this, I need to delegate this to my team.

And then after that, making sure that you're setting them up for success. So, what's your team member's strengths and weaknesses. Oftentimes, you're giving them something that they don't fully understand, or maybe they don't have the skill set, or you're explaining it, and they're nervous to actually say I don't know what to do, or I need additional training, because they might be nervous I might get fired, or they're going to think I'm not able to do the job. And so when you're delegating, it requires deeper conversations.

The other thing, too, is following up. So, after you delegate, follow up. Like what's the follow up? Is it an email? Is it a phone call? Is it another meeting? You know, making sure that after you've delegated that you are on the same page, giving a due date. You know, oftentimes, that's one of the things that I see as missed the most is a due date. When is it due? You know, because what's priority to you might not be priority to your team member, right? So, if it's due at the end of the day, let them know it's due at the end of the day, if it's due at the end of the week, let them know, it's due at the end of the week.

So, there's a lot that goes into delegation, and making sure that you're set up for success, and your team is set up for success. But you can work the hours that you want, you can you know, definitely make the money that you want. And all the things that we do read on social media is some of it is true, some of it is very exaggerated. However, when it comes to your business, because you're entrepreneur, you know, the world is your oyster, the sky is the limit. That's how I always like to think about it.

PATRICK CASALE: Yeah, I think that's really important to notate. And I think that the communication piece behind delegation is so important. And I also see a lot of people who find themselves in these leadership roles, maybe they've expanded their practice taking on an associate-level clinician or started hiring and they just really have a challenge with the conflict that can arise if you're being really transparent with expectations, even if it's healthy, constructive criticism or feedback. And so instead, they shy away from having these conversations, and then resentment builds up, because things aren't being done the way you think they should be done, or they're not being done as quickly as you want them to be.

But in reality, you never really gave transparent, clear communication in the first place. So, it leaves your employee or your teammate feeling really frustrated, it leaves you feeling really frustrated, then you feel like I have got to take it all back on, because very clearly, nobody else can do what I'm doing. And then again, you're in a situation where tasks pile up, things get really overwhelming, you can no longer turn your attention to the things that make the business money. And then you feel yourself bogged down and you're like, "I just can't hire help, because nobody can do what I need them to do."

BRANDY MABRA: Yeah, yeah, so many limiting beliefs for sure that we can place on ourselves when it comes to our businesses. But that is so true. It's always the communication piece. So, you almost want to over-communicate, you know, and especially in the beginning when you first hire, just to make sure that things are going well, and so not to hide, not to back away, not to get to a point like why just need to fire this person, because you've never really gave them the opportunity to be successful.

So, a lot of times our clients come to us, and it's usually maybe like an admin or another provider that they've hired, and it's not going to work. And so when we implement is really the seven steps and we're like, oh, it's amazing, you know? And it's just because of the communication piece. And so it's really, really important just to understand that when you hire a team, like you are going to have to step up as a leader, there are going to be uncomfortable conversations, you're going to make mistakes. And that's okay, that is okay. You know, we're all learning.

And even with me, I have 15 plus years, have managed large teams, and I still mess up. I'm still, you know, in places where I'm like, "Oh, I should have gotten that off my plate." Or, "Oh, I didn't communicate the way that I thought that I should communicate." Or, "I could have done a better job." And so that's going to happen, you know? And so, you know, it's not perfection, you're an imperfect leader, and that's okay, too.

PATRICK CASALE: Yeah, I like that. How important do you think accountability and transparency is or are as qualities for leaders and CEOs?

BRANDY MABRA: Oh, it's critical. I mean, it's critical. Like, you have to be accountable. Not only like your team has to be accountable, but you have to be accountable as a leader. And so, oftentimes, what I find is that you're going to fear of I'm going to come across as being mean, or I'm going to come across as you know, even with like my old job, I had a boss that I hated. And I remember how I was treated. And I don't want my team to think that I'm that same way.

And so it's important for you to be transparent, to have deep conversations with your team, to partner with your team. That's one of the things I always say, it's a partnership. It's not like I'm the owner, you're the team member, and you do what I say. No, it's like, that's why having the clarity for mission and vision is so important. What's the goal? What are we moving towards? And it's all about we.

And so as you're having these conversations, the deeper conversations, being honest, you know, then it's eye-opening, it allows for increased engagement, it can become really fun. And so just having honest, open conversations is important. And allowing for your team, you want to be able to give your team feedback, but also too, you need to be able to receive feedback. So, ask, "How am I doing? You know, is there anything that you need from me? How can I support you? And so when you start to have those types of conversations, it allows for the team member to open up and to realize like, okay, it's okay for me to say I didn't understand this, or it's okay for me to say, can we maybe do this a little bit differently, or I like to be communicated with differently.

So, team members they like to be communicated in, might be email, might be a phone call, it might be a meeting, it might be, you know, all kinds of different ways. And so really understanding your team as a collective, but also to how they roll individually is so important.

PATRICK CASALE: Yeah, I agree 100%. And I think that really makes for good leadership is to be able to be accountable, and also own your own mistakes, and be transparent. And it allows for more trust to be created and it allows for more rapport. I don't want my staff to feel like they have to exist in like a yes-man society where like, everything I do is perfect. I definitely make mistakes. And I'm happy to own those internally. And I think it goes a long way, in terms of just fostering that mutual respect for one another of like, hey, sometimes we're going to get it wrong, sometimes we're going to, you know, communicate in a way that wasn't intended. But let's remediate this, let's resolve this instead of allowing it to linger, or to build, or to fester.

And, you know, I think there are lots of ways to have autonomy and control over your entrepreneurial journey. And if you are finding yourself in the CEO seat, then these are definitely good strategies.

Now, what would you say like some common pitfalls are of practices that, you know, are really messy behind the scenes that you're going in and you're saying like, this is something I see a lot of or these are common things.

BRANDY MABRA: Yeah, lack of policy and procedure, a lot of things can be cleared up just with a really good policy, you know? And so it's like you're speaking expectations, and you're saying so and so should have done this, or I would have done it this way. And you know, they're not answering this email, I would have answered it within 30 minutes but they've taken an hour. And so that's where like a policy, a procedure, so all emails will be answered within 24 hours or all emails will be answered within three hours if it hits this criteria.

So, making sure that documentation is one of the best things that you can do for your team. Also, explaining when it comes to onboarding and training, you know, what is the role? And that starts with hiring, right? So, that's why it's really important for you to understand, who am I going to hire? So, if it is a provider, what is this provider going to do? You know, how many people do they need to see? What are they going to be responsible for? Is there any additional responsibilities that this provider needs to do outside of just seeing clients? Like really having an understanding of what is required in the position, so that way, when you bring on folks, they understand.

The other thing, too, is once a policy and procedure is written it doesn't mean that it's done. You know, and so your operations are always evolving. And even though I talk about well-oiled, well-oiled is a process and part of it is going back, and looking, and asking the question, what is working? What is not working? You know, do we need an update? Recognizing if there's a complaint, not so much like, okay, we got a complaint, fix the complaint? Or, why did the complaint even occur, right? And so it's the operation things, which is probably the most non-sexy conversation that can happen inside of a practice, but it's one of the most important things because that's where money can be lost, that's where time is, you know, absorbed, that's where now you're paying extra money to your team with maybe you don't need to. So, all those things, and it comes down to strictly a policy or procedure and recognizing when a workflow is off.

PATRICK CASALE: That's so important. And, yeah, I agree, it's not the topic that gets the most traction or attention a lot of the time because it's not, like you said, the most glamorous or sexy topic. I almost look at it as like your informed consent documentation when you're a solo practitioner of how that is kind of the lifeline of the practice of like, all of your expectations for the therapeutic relationship, and the policies, and the procedures are all transparently laid out. And if you don't have those, for your staff, or if you don't have those in general, it's really hard to then circle back to something and say, "Hey, this wasn't done the correct way. Or this could have been done in a way that made more sense and saved us more time." If you don't have anything to circle back to.

And I think, again, this is just another example of people shying away from, one, creating it, because it's like, oh, this is uncomfortable or too overwhelming to create policy and procedure. I don't know what I'm doing. Or two, I don't like having these types of conversations with people. And those can all be avoided. And I think that makes it a much smoother environment, a much more well-rounded or well-oiled, like you said, operation, because then it's very easy to say, hey, when we're onboarding, this is what this looks like. Or, hey, when we're receiving communication, this is how we'd like to respond, and how quickly.

And if we don't have those things in place, your staff member or your teammate is going to be like, "But I was never told this. I didn't even know this was an expectation. How can I possibly do something?" And it's almost like we're expecting people to read our minds. Like, this is how I would handle it, so this is how I expect you to handle it. And that just doesn't make for a healthy work environment.

BRANDY MABRA: Yeah, exactly. And it goes back to what you were speaking to accountability, right? And so one of the things that you do want to be able to do is hold your team accountable. Well, it's a policy and procedure, and so it's the folks who understand the policy and procedure take the time, but you have to give them the resources that they need to be successful, which is so important. And so that's resource number one, is how am I supposed to do this job? And what is the criteria for me to do this job well?

The other thing too, is that you want to be able to take time off. So, like, one of our clients, she's now incorporated where she's able to take months off at a time. And so how was she able to do that? Because everything is now written down, you know? So, her team knows exactly if there's a complaint that comes in or if something's happening, where, you know, they're having to blow up her phone, or send her emails, or give her phone calls, or anything, no. The older they pull the resource that they need, and follow it, you know? So, it's really nice.

And then if something is off, or something needs to be updated, you'll know because your team member is going to ask a question or a situation might happen. And then you go back to the policy and go back to the procedure, and say, okay, what's off? What needs to be added? So, it's fluid. The process is fluid, but it's the best way to give yourself freedom. And so that way you can step away and not have to worry.

And for me, I did take a vacation with one of my practices for two years. And part of it was because I had a revolving door of help and just feeling just so burnt out. Once we got our policies and procedures in place, once I gave my team the resources that they needed to be successful, and once I started, actually, instead of answering the question, referring them back to the policy and procedure, it was a game changer, you know? And so my life got so much easier. The amount of hours I was working became less, my team became more empowered, they were now telling me like, "I think we need to update this policy, I'm going to go ahead and update it. Are you cool with that?"

So, it's really fun once you start to empower your team to give them what they need, and you'll make more money. You know, you will definitely make more money if you actually take the time to sit down and pay attention to your systems and what you have documented.

PATRICK CASALE: Yeah, I think that's perfectly said, I agree 100%. And it's allowed me, you know, to have internal trust in chain of command and policy and procedure that's really laid out to step away pretty often, because my other business, I travel a lot, I hold entrepreneurial retreats all over the world, or a lot of times where I'm in different time zones, and I don't even have to like look at my email or look at the internal chain of communication that's happening, because I know everything's going really smoothly.

But it's taken a lot of energy and a lot of intentionality to get to that point. And it does allow your teammates to feel empowered. I think people want to feel empowered to make decisions, they definitely do not want to be micromanaged. And you've got to find that balancing act where you like, you can still hold people accountable to expectations, but you're not looking over their shoulder to see like what they're doing, when they're doing it, and why they're doing it, too. So, lots of cool conversations that can come up around this topic.

Any last-second advice you would offer anyone or anything that really feels really important to hit for anyone that finds themselves in the CEO seat of their business that their own?

BRANDY MABRA: Yeah, take the time to look at things from a high level, you know? And so one of the things that we definitely focus on is scheduling the time to pay attention to your financials, to look at your operations, to make sure that your team is in a good spot. You know, making sure marketing, you know, how's marketing doing? How are you doing? Making sure that you're setting yourself up for success, but you have to schedule the time. It's so easy to go from one day to the next day being stuck in the weeds and not giving yourself the ability to actually see how is the business doing. And so when it comes to owning CEO status, it's important for you to definitely just take the time that you need, so if you don't want to go into the office, don't go into the office, if you want to go find a nice spot, if you want to take time off.

And so even… I work with two co-founders, they took vacation. They went off to the beach and set themselves up in order to look at how things were going with the practice to get really clear on where the next step that they wanted to go.

So, take the time that you need to make sure that you're in a spot to get reacquainted with your mission, your vision, make sure that things are in alignment, so that way you can control your practice and your practice isn't controlling you.

PATRICK CASALE: I love that. That's great advice. I hope everyone can start incorporating into their day-to-day. Thank you. It'll give you a lot of breathing room, a lot of intentionality, and a lot of clarity.

Brandy, thank you so much for making the time, and coming on, and sharing all this awesome information. Tell the audience where they can find more of what you've got going on in case they want to work with you or check out what you're offering.

BRANDY MABRA: Yeah, yeah, you can find me on Instagram. That's kind of my favorite place to hang out social media wise. So, I am @savvyclovercoaching, S-A-V-V-Y C-L-O-V-E-R coaching. Also, you can find me on my website, www.savvyclover.com. There is a couple different resources that are there for you. So, we have a really great on-demand training that goes through the nine principles to scale your practice for growth, sustainability, and profit. So, we dive into all the business side of things. And so that is there waiting for you. Also, too there is a private practice health assessment so that way you can assess the health of your practice as well. So, thank you so much for having me. This has been fun.

PATRICK CASALE: You are welcome. Thanks for coming on. And for everyone listening, all of that information will be in the show notes so that you have easy access to all Brandy's information. You can use all of those resources to help your practice get started and get healthy today. To everyone listening to the All Things Private Practice Podcast, new episodes are out every single week on all major platforms, including YouTube. Like, download, subscribe, and share. Doubt yourself, do it anyway. See you next week.