Episode 171: "Adapt and Succeed" in Group Practice [featuring Maureen Werrbach & Gabrielle Juliano-Villani]

Show Notes

In this episode, Maureen Werrbach, Gabrielle Juliano-Villani, and I have come together to discuss some major insights and solutions for the challenges currently faced by group practice owners. We also are excited to announce our co-hosted, value-packed, 3-day event, "Adapt and Succeed," happening from January 21st to 23rd, 2025, that focuses on the exploration of group practice realities and opportunities.

3 Key Takeaways:

1. Values-Based Recruiting & Hiring: Authenticity in your job advertisements is crucial. Make sure they reflect your practice's culture and values, and don't rely solely on generic postings. Define your voice and be clear about what you offer and expect.
2. Building a Cohesive Leadership Team: As you scale your practice, creating clearly defined roles and responsibilities is essential. Avoid promoting someone just because they're a great clinician. Leadership requires a different skill set.
3. Diversifying Services & Preventing Burnout: Exploring multiple income streams within your practice not only adds financial stability but also helps prevent burnout. Our panel discussion on the last day of the event is set to provide actionable steps to diversify effectively.

More about Maureen Werrbach:

Maureen is the founder of Urban Wellness, a group practice established in 2012 in Chicago, and The Group Practice Exchange, a group practice business strategy company. Maureen helps group practice owners build sustainable, thriving businesses. With a deep understanding of what it takes to scale successfully, Maureen focuses on leadership development, team-building, and creating systems that allow practices to run smoothly and efficiently. Her mission is to empower group practice owners to step into their roles as Visionaries so they can focus on growth while maintaining the heart and integrity of their practice.

More about Gabrielle Juliano-Villani:

Gabrielle is a business mindset coach, consultant, and former group practice owner who successfully sold her thriving business in 2021. With a deep understanding of the challenges faced by therapists and small business owners, she helps entrepreneurs scale and sustain their businesses without sacrificing mental health. Gabrielle’s holistic approach blends practical business strategies with mindset coaching, empowering her clients to overcome burnout and achieve a balanced, profitable life.

***Join the 3-Day "Adapt and Succeed" Event here: thegrouppracticeexchange.ac-page.com/adapt-and-succeed

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

✨ The Receptionist for iPad:

I want to thank The Receptionist for iPad for sponsoring this episode.

From new patients faced with an empty lobby and no idea where to find their therapist to clinicians with a session running over time and the doorbell ringing, some of the most anxiety-ridden moments of a therapy appointment happen before a session even starts. The Receptionist for iPad, helps you tackle some of that pre-appointment apprehension and anxiety.

The Receptionist for iPad is an easy-to-use digital client check-in system that helps your visitors check in securely to their appointments and notify their practitioners of their arrival via SMS, email, or your preferred channel.

No more confusion and less lobby checking or having clients sign in on paper logbooks. It can even help you upgrade and update your demographic information for your clients as well and even validate parking.

Start a 14-day free trial of the Receptionist for iPad by going to thereceptionist.com/privatepractice. Make sure to start your trial with that link and you'll also get your first month free if you decide to sign up.

✨Alma

I want to thank Alma for sponsoring this episode.

Building and managing the practice you want can be challenging. That’s why Alma offers tools and resources to help you build not just any practice, but your private practice. They’ll help you navigate insurance, access referrals who are the right fit for you, and efficiently manage administrative tasks — so you can spend less time on the details, and more time delivering great care. You support your clients. Alma supports you.

Visit helloalma.com/ATPP to learn more.

Transcript

PATRICK CASALE: Hi, everyone. Welcome back to All Things Private Practice. Today, we are going to do a special podcast episode where we are also hosting this on Maureen's Group Practice Exchange podcast, which is cool because we are talking about some things that we are seeing in the group practice landscape, the struggle areas, the concerns that people are bringing up a lot, ways that you can overcome them. And I think it's a really cool idea to do it this way. And having Maureen Werbach and Gabrielle Juliano-Villani, who I don't think I need to introduce because they've both been on here multiple times and you know them elsewhere. So yeah, this is a cool event that we are about to get ready to host at the end of January.

MAUREEN WERRBACH: Thanks for setting this up, Patrick.

PATRICK CASALE: Set the stage.

MAUREEN WERRBACH: I'm excited about it just because we have three whole days of, like, pretty cool content between all three of us that we're doing. And so, I don't know, we figured we would just chat for those that want a little bit more context about the event before jumping in and purchasing, we figured we could talk a little bit about some of the topics that we'll be discussing during the event. So, I don't know, let's see. I'm looking over at our sales page to see what we're talking about each day.

But we got for you, Patrick, two of them that, like, I think we can start with, which is retaining and supporting your team. And like values-based recruiting and hiring because I feel like those two kind of flow really well together. And of course, we're seeing this and in our own group practices, but also all three of us with people that we coach, just the struggle of getting the right people into your practice and retaining them.

PATRICK CASALE: How often do you all hear, "There's nobody out there who wants to work? We can't hire anybody. And we have no applications coming in."

MAUREEN WERRBACH: Yeah.

GABRIELLE JULIANO-VILLANI: Yep. I hear it.

MAUREEN WERRBACH: Every day.

PATRICK CASALE: Every day. I hear it every day as well, not just in like social media spaces, but even when I'm in, like, retreat hosting mode, and people who are attending are group practice owners, I hear it from them as well, of like, "Our advertising, like we're on LinkedIn, we're on Indeed, we're on Facebook, nobody's applying. And the people we're hiring, none of them want to work."

And I admittedly will say, like, I call bullshit on that completely. And I just don't think that's true. I think it's oftentimes like your job advertisement or your job posting is really vague or generic, and it doesn't, like, list out pay. It doesn't really define company culture. It looks like you just copied it off another Indeed page or a ChatGPT page. So, I see that as an issue a lot of the time.

And I also see, like, there are plenty of people who want to work and there are plenty of people who want to join group practices. I just think that sometimes the messaging is not feeling congruent with the values of the practice.

MAUREEN WERRBACH: Yeah. I also think that our screening process as a whole might not be very good either. So, like, even if you get to the point where you've really looked at, you know, your job description and what you're posting out there, I think there's a lot missed in the interviewing process to really… Because, you know, a lot of times people will, if they're really looking for a job and need a job will sometimes agree to things that if they weren't in a space where they had to, like, right now get a job, they might not agree to. And so, I think there's some lost space in the interviewing process, too, of like, how do we make sure that the stuff that we have in our job application we're actually talking about during the… Because a lot of people will kind of skim through and just sort of assume that all practices are made the same, and then really miss out on the opportunity for discussing what was in that job description to make sure that there's real buy-in to it.

PATRICK CASALE: Yeah, absolutely. I think that's a big piece. And I think that leads directly into retention as well. I think you were going to say something though, Gabrielle.

GABRIELLE JULIANO-VILLANI: I was. Thanks, Patrick. I was going to say this also makes me think of what I'm speaking about, which is more like CEO mindset because, Patrick, I use your website all the time. It's an example to some of my clients because that's what they do. They just put in ChatGPT, "Write me a job description." And it's very generic.

And I'm like, if I go to Patrick's website and I look at who you're hiring, I know exactly. And the person who's coming to that and who is looking at that, they know who they are, and they know that they're the right fit for that. So, do that stuff from the beginning instead of just slapping shit together and not really thinking it through and trying to do it the easy way.

MAUREEN WERRBACH: Also, go ahead and use ChatGPT, but then do the work at creating a GPT that knows your voice, you know? Don't just go in there and ask for, you know, "I'm a group practice owner. I need a therapist. Build me a [INDISCERNIBLE 00:06:08]." Like, do the work initially to create a GPT that knows your voice at least. So, just to as an aside, to not hate on GPT because I use it.

PATRICK CASALE: I use GPT also.

MAUREEN WERRBACH: Yes, I spent hours building a GPT that knows my voice, that knows my values, so that when it creates the content for me it makes sense.

GABRIELLE JULIANO-VILLANI: Yeah.

PATRICK CASALE: Yeah, I think it's like such a wonderful resource, you know? I even use ChatGPT to respond to emails. Sometimes I'll be like, "Respond to this with this type of tone and this type of impression."

But, yeah, I think it's about making it unique, making it your voice, but more importantly, like really getting clear on what your voice is, really getting clear on what your values are as a practice, right? Like, what do we stand for? What do we believe in? What is our mission statement? Who are we trying to support? Why do we care about supporting this population? Like, all of those things are super important because otherwise, you're really just like casting this net for employees.

And like Gabrielle said, anyone and everyone can apply. And like you said, Maureen, if you need a job, you're just like throwing your name out there. But unless you get really clear on who your practice supports, what the niche is, what the values of the practice are, what your leadership style is, you're going to just hire people just to hire and you might blame it on them when they transition out a couple months later because it's just not a good fit.

MAUREEN WERRBACH: Yeah, I see also an overpromising and underdelivering around the job descriptions being like, "We're offering all of these amazing things." Right? And then, clinicians come into the practice feeling like, "Well, those things aren't really being delivered."

You know, whether it's workplace culture or flexibility, right? Those are a lot of these, like, key terms that are used now is like work from home flexibility, the ability to control your schedule, and all these things. And then, when you are, like, in the practice you realize the flexibility is, like that is an example, so what does flexibility mean in your practice?

For one practice, flexibility can mean you completely can control your schedule, work from home whenever you want. For another practice, flexibility might mean you get to work two days out of your week from home that you have to pre-determine, like choose, and those are the two days, right? Both mean flexible but mean something different. And, you know, if it's not kind of explicitly listed a clinician who's applying might wrongly assume what flexibility or whatever means.

And so, I see that a lot, too, where practices are adding all, like, this jargon and these offerings, and these like things that are in their business that really aren't there once you're in there. And of course, that creates kind of resentment and turnover by clinicians.

GABRIELLE JULIANO-VILLANI: Yeah.

MAUREEN WERRBACH: Okay, so we were talking about retaining, kind of values-based hiring. In that frame of mind, I'm talking about creating a leadership team because, of course, as we grow our businesses there's going to be a point where having just a clinical director or one other clinician who's helping you lead isn't going to be enough. And there's this real need for you to be able to create a cohesive leadership team that can really help manage all aspects of your business, especially, as you scale. So, that's something I'm going to be talking about.

Do you guys both have… Well, I know Gabrielle you, but did you have a leadership team when you had your practice or did you sell before you got to that point?

GABRIELLE JULIANO-VILLANI: I did. I was, like, just starting to implement that, actually, when I sold. But I think that's really important because that was something that actually came up in the masterminds that I was doing for The Group Practice Exchange is a lot of, I actually was very surprised at how few of them had, like, real leadership, and how much they were still doing, and very big practices. Like, 25 plus clinicians. And you're the practice owner. And you're still seeing clients, and you're still doing supervision, and you're still worrying about, like, the water delivery, and if the snacks got delivered. And I'm like, "Why are you doing this shit?"

MAUREEN WERRBACH: And I did the same thing. I think it's almost feels like a natural progression if you're not intentional and very aware of your next steps. But it's really easy to just get to a point in your practice where you're like, "I just need a little bit of leadership support." And you just bring some on, and you kind of think of the tasks that you don't want to do anymore and hand off.

And then, as it grows a little more you're like, "I need a little bit more." And then, you hire someone else. And then, you realize you have all these, like, siloed, random people who kind of do a little bit of different leadership stuff. And I can understand how we can get to that point where then things fall through the cracks, and we're doing random things still, like needing to make sure that the water delivery is happening on time, and things like this.

And so, one of the things that I talk about, which is something I didn't do, and wish I would have, is create a set of roles and the core functions that those roles have from the beginning because those roles all exist. Every group practice has pretty much the same roles. Of course, when we diversify services, we can, you know, differentiate ourselves a little bit, but we all have, like, the same core roles. And it might just be that us as group practice owners are still in all of the roles, and maybe we aren't even doing all of the roles. But they still exist, whether they're being neglected or not.

And so, I feel like one of the easy, like, first steps is before starting to just throw a new, like, clinical director role out there and just handing off some random things, is to really get a sense of, like, what are the core functions in your business? And what things go within those functions? Like, what are the main things that they do? Because then it becomes easy to, like, hand off a whole role with a whole set of functions connected to it, versus, like, "I just need some help. Why don't you start supervising?" You know?

I don't know if you've seen this, but in Facebook groups, I see it all the time, where people are like, "What does your clinical director do?" And then, everyone says things that are so different. And I'm like, some things that people are listing, like, that's not what the role of a clinical director is. And for other people, like, it just is so different, or practice manager, you see that, and everyone's practice manager does completely different things. And I think this is where kind of putting together a set of roles and what those core functions are within those roles helps you kind of keep people in the right lanes.

GABRIELLE JULIANO-VILLANI: Yeah.

PATRICK CASALE: I also think, to your point, Maureen, and I've talked to you about this before, of like, not just promoting someone to clinical director because they're a good clinician.

MAUREEN WERRBACH: Yeah, yeah.

PATRICK CASALE: And how your accountability equation really, like, does a great job of mapping out roles and responsibilities because it's so easy to say, like, you're a great clinician or you're a great supervisor, but that does not, again, mean that you're going to be a great clinical director or a great office manager, etc.

MAUREEN WERRBACH: Yeah, that's probably one of the biggest areas of concern that I see happening in the leadership realm, is elevating a really great clinician into a leader of clinician's role because they think, "I just want more of you." Replicate yourself, and you know, if you teach these people to be like you, then they'll be like you. But in reality, a person who has knowledge on something doesn't necessarily mean that they're going to be a good teacher of that knowledge.

And so, similarly, someone who's a great clinician may not be the greatest supervisor or teacher of clinical, you know, theory, and how to be a clinician, and all that stuff. And so, yes, it's probably one of the most common errors that we make in our industry when it comes to leadership growth, is putting the wrong people in the wrong roles. And so, yeah, we're going to talk a little bit about that in the Adapt and Succeed, as well.

What else are we talking about? Do we want to talk about? I don't even know, the last day we're doing a panel discussion. So, obviously, we each have some topics each of these days that we're going to be talking about, from leadership to selling your practice, burnout, hiring and retention. But then on this last day, us three are going to come together and sort of do this panel discussion on diversifying services. We want to talk about that.

GABRIELLE JULIANO-VILLANI: Well, yeah. I mean, I think, I'm most excited for that day because all of us have diversified services, added other income streams, started other businesses. And I don't know, I think it's exciting, especially, for those of us who have ADHD, and like to do a million different things.

I mean, I think it's really easy to see on the outside, or even I know people who follow my social media and they're like, "Oh, my God, you have 15 streams of income." Which I do, however, they did not just all, like, appear overnight. And so, I think group practice owners need to remember that you are also entrepreneurs. And there are lots of other things that you can do within, like, you know, clinical group practice ownership stuff that can add more income or just change how you're working to prevent burnout.

MAUREEN WERRBACH: And when I look at like us three right now because we're on video, it's wild. We actually have, I think, you started, Gabs, with saying this, that we all have like different things, but it is wild. Actually, we all touch almost every single diversified service I can think of, between, you know, having retreats, right, with Patrick. And you, with your 8 million streams of income. I mean, you just have figured out how to take every piece of knowledge that you have and like, turn it into something that can create consistent revenue.

And then, for me, you know, more internally in my group practice diversifying services with other provider types and other, you know, well-being at work programs, and things like this. I feel like we cover so much in the diversifying services realm.

And then, books, right? Patrick and I. Shit, [CROSSTALK 00:18:10]. Did I just out you on that?

PATRICK CASALE: No, not at all. I'm just, like, waiting for, like, finalization, you know? So, it's like walking on eggshells on my end. But yeah, I'm excited for that as well.

MAUREEN WERRBACH: Yeah, a whole nother diversified service for us, right? Is book sales. Yeah, so that's what we'll be doing on the last day, is sort of having this panel discussion on, you now, what ways we can diversify services? How do we get there? And, like, how do we make the decisions about it? Of course, as you mentioned, you know, all three of us being neurodivergent, that plays a role in, like, our decision-making. And, you know, I know, with me having ADHD, I'm just, like, wanting to throw 800 things against the wall. And like, what process do we go through to, like, ensure that we're really throwing the right things out there, and not all the things. So, I'm really excited.

PATRICK CASALE: Super excited too. And I think it's value-packed for three days for us to sit there and really get hands-on with everyone who's going to be attending, which I'm really excited about. I like doing that stuff, where we can really do some breakout and some processing about stuff that comes up for those who are attending, and really break stuff down, and give tangible action steps to step away with, too. Because I know when I go to trainings and it doesn't feel engaging, I check out and I probably don't revisit it. And that's just not my style whatsoever.

MAUREEN WERRBACH: Yeah, I also like that it's not just, you know, all three of us each create content, and courses, and things on our own. But there is something about collaborating, not only from like the opposite of scarcity, abundance mindset of like bring… I always have loved and it's something that I've had a hard time with our industry of coaches and consultants as a whole, is like, everyone likes to stay very siloed. And I've always been like, "Oh, my gosh, we have so much knowledge when we put our stuff together." But I also think it makes the actual like events better when there's multiple people. So, I'm excited about it.

So, we'll both be putting in the footnotes or whatever it's called, the link to it. But if you're anything like me, and I've never looked at show notes once in my life for a podcast, just Google, Adapt and Succeed, The Group Practice Exchange, or Adapt and Succeed, any one of our business names. I have looked when I wrote TGPE, Adapt and Succeed, it shows up right at the top, the page for you to learn more about it. So, if you don't want to go to the…

PATRICK CASALE: To the show notes.

MAUREEN WERRBACH: Show notes, yeah, just write Adapt and Succeed, and one of our business names, and it'll show up on Google.

PATRICK CASALE: Yeah. And the event is January 21st to the 23rd. It's going to be recorded. You're going to get lifetime access to the replays, so that you can continue to circle back to it when you need support or accountability. And we definitely still have a few spots left, so make sure that if this resonates with you, then get registered. And we will definitely see you in January.

MAUREEN WERRBACH: Yeah, and it's a great way to start off a new year.

PATRICK CASALE: It is a great way to start off new year.

GABRIELLE JULIANO-VILLANI: I think a lot of us, I mean, most of us, all of us being group practice owners, I mean, like the world has changed. We know this. We know that things are changing. And I haven't really seen too much, anything like this, actually, at all, where, like, multiple people are coming together and giving you a space to talk about that, and giving you, like, expert advice and Q and A's, where you can really set yourself up for how things are going to be in the future.

MAUREEN WERRBACH: I agree.

PATRICK CASALE: Well said, well said. Well…

MAUREEN WERRBACH: [INDISCERNIBLE 00:22:11] chatting with you guys about this.

PATRICK CASALE: Yeah, Hudson has been howling for the last 15 minutes. So, I've been like super quiet and staying on mute because, like, [INDISCERNIBLE 00:22:09] stops, so I'm going to wrap it up before he starts again.

MAUREEN WERRBACH: I haven't heard him yet.

PATRICK CASALE: I've been on mute. But like, yeah, he's been nonstop for 15 minutes. So, it's like, I'm sitting here I want to jump in, but I'm like, I cannot unmute myself.

GABRIELLE JULIANO-VILLANI: Is that a dog back there?

PATRICK CASALE: Oh, yeah, that's Lucy scurrying around.

GABRIELLE JULIANO-VILLANI: She look like a little cat.

PATRICK CASALE: It's like a gremlin.

GABRIELLE JULIANO-VILLANI: She is gremlin. Poor thing. She's got so many problems. She's happy today.

PATRICK CASALE: So, when you take this three-day event, you're probably going to hear Hudson howling, and you're probably going to see Lucy scurrying around looking like Gollum from Lord of the Rings. And you might see Maureen's cat slinking around somewhere. Who knows?

MAUREEN WERRBACH: I don't know where they're at right now.

PATRICK CASALE: But anyway, we will have all that information in the show notes. Like Maureen said, if you Google Adapt and Succeed in any of our names, the event will pop right up. It will be in the show notes. It'll be in the social media posts that we make from this episode. And we will see you in January. And everyone have a Happy New Year. So, doubt yourself, do it anyway. And we'll see you next week.