Beyond Productivity: How to Build a Sustainable Practice

[00:00:09] DAMIEN:

Hello, everyone, and welcome to today's webinar, Health Practice Buzz, Beyond Productivity: How to Build a Sustainable Practice. My name is Damien Adler. For those who may not know me, I'm one of the co-founders here at Zanda, and I am also a registered psychologist. Previously, along with my wife, we grew a large group private psychology practice, and that was sort of the origins of how Zanda came to be — we needed practice management software, and we developed it along with my brother and co-founder. Now, today joining me we have Jessica. I'll throw to you, Jessica, to introduce yourself, and then we'll dive in.

[00:00:55] JESSICA:

Perfect. Hi, I'm Jessica, I'm the Chief Buzz Officer here at Zanda. I have about 15 years in marketing experience, and in the last five years I've spent the time chatting with people just like you in the healthcare industry, and I work closely with a lot of healthcare practitioners, as well as industry experts, so I can learn about their practice, what's worked, and communicate it to you guys so that you guys are able to build and build a sustainable practice. So that's today, and I'm going to go ahead and move this slide — give me a second.

Okay, so today we're going to dive into a lot. We're going to keep it high level, but also cover a lot of tips and suggestions from the marketing perspective, as well as from Damien as a practitioner or psychologist, as well as a practice owner. So we'll dive into all of these nine: identifying your North Star, the efficiency trap, pillars of sustainable practice, building for sustainability, the importance of diversification, increasing the impact of your time, people over butts on seats, avoiding the race to the bottom, and then the tips for building your practice, and then we'll close out for the day.

[00:02:04] DAMIEN:

Sounds good.

[00:02:10] JESSICA:

There we go.

[00:02:10] DAMIEN:

So I'll kick off with identifying your North Star, and I think this is a really important foundation thing to do, whether or not you're brand new to private practice or you've been established for a while. If you haven't done this, or haven't revisited it in a while, it's a good thing to do. So what this is really about is identifying what success looks like and where you want to actually go with your practice, but also for you personally. So defining your ideal client, what makes your income, your working hours — as examples — so thinking about what is it that you want to actually get from your practice, what do you want life to kind of look like.

And one of the ways that you can sort of think about this — and there's different frames you can put around it, but one way that I like to think about it — is the old rocking chair test. And that is good to give you a little bit of perspective. Imagine you're zooming forward in your life, imagine when you're retired sitting on a rocking chair, and what do you want to remember about or feel proud about, and feel good about — not just with your practice, and I want to emphasize that, but also with your life overall. So thinking about your career, but also about family and what is meaningful to you, because then that allows you to kind of define what success looks like — you know, more, it's got a broad view rather than just it be financial, which is often where our brain goes straight to.

And then use that as a sort of guiding principle, so that — you know, and that's what we say about letting it sort of be the vision and thing that kind of helps you and pushes you towards those goals. And what I find really helpful, when you've got that identified sort of North Star, is that decisions along the way become a lot easier, because you can look at it and decide: does this actually sort of take me further or away from my North Star? And that actually simplifies a lot of things. Often in business you have these different — like forks in a road, do we go this way or do we go that way — and when you've got a North Star, then it actually clarifies those things really easily. So that takes a lot of the mental stress, I find, out of decision making and growing a — okay, let's jump to the next slide.

[00:04:34] DAMIEN:

I think you're a master of slides today, Jessica. So you've got us.

[00:04:38] JESSICA:

There we go. Wonderful, thank you.

DAMIEN:

So let's talk about what this sort of efficiency trap is. And the efficiency trap is where we have this drive for constant productivity, but that can actually sometimes distract from that kind of long-term sustainability. And so you're efficient, but you're still stuck. And we'll often talk about efficiency, because Zanda is designed — you know, everything around Zanda is designed to help build efficiency, and don't get me wrong, efficiency is sort of vital. But you can still be efficient in lots of ways but still kind of being stuck.

And so this is kind of where, you know, if you're looking at sort of warning signs — you know, is where people are feeling depleted, maybe they've automated everything but still working kind of evenings to kind of save time, losing the kind of drawing of the work that you're kind of doing, maybe the system that you've developed is improving their output but it still does not really create enough space to recover and to sort of step outside and kind of think strategically. So we can be highly efficient and still not strategic, and that is the trap. So efficiency, of course, is a great thing, but by itself doesn't necessarily mean that we're being sort of strategic in how we are developing our practice. So we want to flag that as something to be mindful of, because often we can get focused on efficiency alone. All right, let's jump to the next slide.

[00:06:14] DAMIEN:

Okay, so this is talking about really the way that we view it, and we get to work with them, where — you know, over, I think it's 16 years now of Zanda — you know, we get to work with practices all over the world, thousands and thousands and thousands of practices, and lots and lots and lots of conversations. And we get sort of, I guess, an inside sort of view of what leads to sustainable and successful practices. And as we were talking about before, it's not just defined in financial terms, but broadly — that when we're talking to people about how satisfied they are with their practice, and we've noticed that there are key pillars and things that are common among successful practices.

So the first one, which is sort of no surprise, is that a practice really needs to make a consistent profit — so, of course, financially that is going to be a pillar of sustainable practice, so I don't need to go on too much about that because that's self-explanatory.

The second is really clinicians being well supported by admin processes, and that can be admin team members in some cases, but it also can be the way that your system is set up, the way that your practice sets up its admin processes to deal with all the kind of paperwork, the insurance, the billing, all the different things that we have to juggle, compliance, etc. So when clinicians are really kind of well supported by admin processes, what it allows them to do is to focus on the things that they love doing the most, which is actually providing treatment and care to patients or to clients. And then that has a whole lot of additional benefits, because clinicians, then, when they're well supported, they can do more of the work they love — if they are working with you or for you as employees or as contractors, because it's part of the business, they're also likely to stick around more, so retention goes up, their enjoyment, their work-life balance, everything — the positivity improves. So having those sort of — a sustainable practice means clinicians being well supported, and that's a key pillar that we see.

Okay, third thing here is around getting the right — the right people, but in particular here it's the right people doing the right jobs, and this is where we're really looking at kind of alignment between the people that you recruit and the people that you might have as part of your broader team, but doing the things that they are best to do. And the way that we'd often — look at this, and look at this actually the same in Zanda, it's universally applicable — but I think about people having kind of superpowers. Everyone, if you think about it, has things they're super good at and things that they're not so good at, right, myself included. So making sure that you've got the right people doing the right thing — so if you have, I've got a clinician who is an amazing clinician but maybe not so good on the admin side of things, or maybe not so good on keeping up with the paperwork and so forth — supporting that clinician to do, you know, the thing that they're really good at, whilst also being a safety net for them, means that you've got the right people doing the right things. I'd much rather have like an admin team member who is helping a clinician stay on top of some of their paperwork and things that might drop off their radar, to make that practitioner sustainable and happy and compliant with everything they need to be, then trying to like, you know, force that clinician to be good at everything.

So getting the right people and the right job alignment is super critical, and I would — if you do have admin team members, this — the admin team itself, like, it's a job, for instance, I couldn't do, and I would tell people that in — well, employee admin team members, it's a job that requires a certain set of skills, skills that I don't naturally possess. So I would look for people that had the exact right set of skills for those admin roles, and they were able to hold multiple things in their head at once and be highly organized, great with follow-up, etc. So right people are doing the right thing.

The final key pillar is around regular evaluation, and we see this time and time again when we're working with practices that really have got a very good sustainable rhythm going to their practice and they're doing really well — is that they are routinely evaluating their practice. They're utilizing the reporting in their practice management system or whatever system they might be using, but they are regularly evaluating how the practice is performing, breaking that down to the different aspects of the practice. So looking at new clients coming in, retention, and looking at solution performance, and then also looking at, of course, the financials. So we see that regular evaluation, and what that allows is for there to be constant adjustments and adaptations as we need to.

So they are the sort of four things that we have identified over many, many years. So have a little think about, okay, how you're doing across those four. And then I will hand over to you just to look at what building for sustainability looks like. All right.

[00:11:52] JESSICA:

There's a slight delay on mine. Okay, looks like I see it now. Okay, so one of the biggest risks that we see, and I see as a marketer, is when you're building your brand and it's dependent entirely on one person or one thing. And really what we see is the expertise and the reputation — reputation matters early on, yes, like if you're known in your community, people know who you are, they've seen and heard of you, it's great. But over time, your clients are not only going to just trust you and the clinic's mission, they're going to put that as the standard, and you don't want that as your standard. You want them to be able to know you as a practitioner and your clinic as something completely separate.

So as your practice grows, you know, you're shifting some of the spotlight from you as the owner to more of like your team, so that you're able to focus on like the client experience that you want people to have when they walk into your practice. So I would say that the biggest point here is the aim isn't to really sideline yourself and saying, oh, you know, you're on the sidelines — it's just more focusing and prioritizing that for the client experience and for those as well that are either working with you in your practice.

The other part is, you know, it also protects the overall — last-minute changes, the unpredictable that we all deal with in life that we can't control. And like, for an example, with Damien — his practice experience, you know, during COVID, a lot of people experienced the unexpected, didn't know what to do. And when someone got sick in his office, he was able to take a step back, focus, and make sure that his practice is running without him, being — you know, managing and making sure that things are being — help continued throughout the process. So, I think the biggest part here is making sure that you put some stuff in place that allows you to step forward and make sure that your practice is taken care of, so that when anything were to happen, you were able to take a step back and know that your practice is being managed, and the people that are in your care are being cared for.

Damien, if you don't mind me asking — is there something that you put in place that you can share with us, that put your team to have that confidence to be able to step up and make sure that it was being managed when you took your step back?

[00:14:03] DAMIEN:

Yeah. So around COVID, just to put a little more detail around it — so it was my wife and I. We were — my wife's a psychologist, for those who may not know, so we grew our practice together. And so as Zanda was growing and my role in the practice was reducing, my wife was a key component — she got quite ill around that COVID time. It was unrelated to COVID, but it became a complicating factor because of the issue — was going to be a lot worse. And so it meant that both of us had to be out of the office, and we needed to really kind of step back — I needed to focus a lot on Zanda, because our Zanda customers were going through a lot of change, like we were, and so we needed to be very focused on that.

But we had fortunately built the practice in a way that had some of those pillars that we were talking about well in place, and so that we weren't the key people — we can kind of step back from the direct day-to-day operation of the practice, because we're sort of diversified. It wasn't our — we've been, in fact, exactly what we're talking about here — we were promoting the mission, and had been doing that from the start. So people were not — they were referring to the practice, and saying the practice provides this range of treatment with this sort of philosophy, right, which meant that the referrals weren't like linked to people referring to either myself or to my wife, Bec, as being the sort of principal psychologist. But in fact, we're just referring to the practice, because there was an expected reputation of providing a certain standard, if that makes sense. And so, therefore, it didn't matter, in a sense, when we were able to kind of, or had to, step back, because referrals were already diversified, and we weren't — in fact, like on our website we were like the very bottom of the list, we would promote everyone else — in fact we're at the very bottom of the list.

But also operationally we had done the same thing, so that the operation of the practice was not dependent upon us. We had a more diversified team, and we had systems in place that were — that you know could operate, so it meant that we were able to elevate the role of some, both practitioners and also in the admin team, to be able to step in and fill some of the gaps that were left. And that was, you know, very — I don't know what we would have done, honestly, if we hadn't kind of set that up before — if it was very dependent on us, and this thing came out of the blue, where, you know, the double whammy of, you know, being unwell along with COVID at the same time.

But that was again one of those examples of, you know, things sometimes come along, and when a practice is built with sustainability in mind, has multiple pillars sort of holding it up, it means when one of those things does happen, then the business does — can continue on, and in fact the practice grew over that time rather than actually contract. And in fact, we ended up — leaving in place, post-COVID and post those things — that, you know, the people that stepped up actually remained in those positions for a number of years, until eventually we sold the practice. So it just really does emphasize, and we see this with — because we've got thousands of practices around the world, inevitably we see those unfortunate things that happen, and we're often working closely with practices to support them and help them. And you can see the way they get through that often depends on those sustainability things that they have kind of set up before. So this is why this is one of my personal passion topics, and as Zanda as a whole we're really kind of focused on this, and you know, it's why, you know, we want to do this actual webinar.

[00:18:01] JESSICA:

Nice. Okay, I'm going to move on because that was great. Let's move on to the next one that dives into diversification, since you were just chatting about that.

Okay, so as you see here, here's the importance of diversification. I'll cover a couple things, you know — the multiple referrals to the group sessions and things like that, but overall, I'm just going to just chat on making sure that you protect yourself from one single income for your practice. One could be multiple reasons, but when I chat with a lot of practitioners, and I've heard Damien's story when he ran his practice — is when you stick to one, you have unforeseen things that you can't control — government policy changes, you have like COVID changes with the government, stuff like that, sicknesses, things that you can't control. And focusing on one thing can also hurt you as a practice.

What I'm going to share is a couple examples. One big example that kind of stood out to me was one here in the U.S. — it was a healthcare sector, well-known one, I won't make mentions on that — but overall, they put a lot of their funding and a lot of their practice in government policies, government services. And when they shut a lot of those mental health funding that they were expecting, it cut their practice by almost 75% of the income that was coming in. And that's a big jump — that's a big funding that you're going to be missing, you know, paying your employees, you know, keeping the lights on, making sure that you're, you know, sticking out and, you know, reaching out to your community — all those things, all those financial burdens will start to kick in if you stick to one and focus on diversifying for that same reason.

The other part is, you know, Damien, when he had his clinic, he added multiple — not only did he have the single, but he opened up into corporate work, that allowed his practice to depend on like Medicare funding and referrals that he had mentioned. Another practitioner that I spoke with in the UK — she also did like group sessions as an additional funding or additional diversification income. She also worked on like training practitioners and helping them also overcome either marketing or reaching out to their community, and that helped them create additional income streams that allow them to not have to handle the unforeseen changes that come and go when you're in this industry.

So a lot of these, you know, examples that we share here are great examples from like referrals, you know, communicating with your networking and keeping those partnerships intact, and working with group programs and corporate partnerships, and also making sure that you're including maybe like digital resources, or like the UK, like doing some sort of training — you're an expert as well, maybe you can share your expertise with others in your community, and using those specialized offerings to keep those, you know, continuous stream of income for your practice.

And so I wanted to ask you, Damien — what is, like, a form of diversification that you see worked well, either for yourself, or for other practitioners that you know in the industry, that has helped them, you know, expand that and not stick to one core service?

[00:21:00] DAMIEN:

Yeah, I think it's reducing the vulnerability of unexpected change, and you see that in all countries — you see these changes to, you know, the things that you mentioned. All the things that you listed, like, I've seen work really well. And one of the things I would say is that there is, I guess, two elements. One is a bit of trial and error, right — so you're trying different things and seeing, you know, what works commercially. But the other side of it being what you personally — what personally kind of resonates with you.

So, as you mentioned, you know, in our practice we diversified fairly early on into providing corporate services, as sort of an insurance policy against changes to — in Australia, there's an Australian Medicare system that, you know, in our case for psychology, you know, provides some rebates for people. But the government, you know, like all governments around the world, governments change, policies change, and in fact we saw that in psychology, in the early days there were significant reductions in that program.

And so, by diversifying and seeing what fits — so in our case, we developed relationships with corporates and larger businesses in our area, and then would provide things like training, employee assistance programs, mentoring, supervision, all sorts of different things for — that was outside of our core bread and butter. And I think you can sort of do what's comfortable for you, and the way that I would view it — or the way that we sort of set it up anyway — was not — we didn't make it our primary. We kept — like our primary being where, like our bread and butter, being where the, you know, most sources of referrals are now — we're coming from, but the way I like to sort of think about it is where we have these side elements of the business that if something changed, we could pivot to that, and we wouldn't be starting from zero. So we, you know, developing those relationships, developing some contracts and things like that, and then saying, okay, if there was a drastic change to something that was part of our core business, we're not saying — we know what works and we would just be able to scale that up very quickly.

And so it's almost like I viewed it almost like carrying an insurance policy, that we had it there if we ever needed it. It also gave us confidence in terms of hiring and growing and developing the practice, thinking, okay, if worst-case scenario happened and there was a change, we can pivot to this, we're going to keep everyone employed, the business is going to continue to be commercially successful. So it is a little bit of trial and error, and a little bit about what people are comfortable with, you know, so what's in their wheelhouse.

Having said that, I also encourage people to step outside your wheelhouse and try things — don't just, don't, don't say entirely in your comfort zone, but if — what I guess what I'm saying is, if you're someone who just does not like social media, and you know it's not your thing and you really don't like it — okay, one of your side diversifications may not be to become a health influencer, that's fine, you don't need to. So really trying to find alignment between what you enjoy doing and, you know, would be happy to kind of step into if needed.

[00:24:21] JESSICA:

Exactly. And like at the very bottom, the niche development — every practitioner has something that they're known for, that they're an expert in. And maybe dive into that, to figure out, okay, I'm good at this, maybe figure out ways that you can expand that and share that with other people, because that can be your niche, and that can be a different way — like Damien said, you don't have to be an influencer, but it can be different ways of like trainings, or, you know, digital assets, reaching out to other practitioners and doing workshops or roundups and things like that, so that you can share your expertise with others.

[00:24:48] DAMIEN:

Yeah, and I think on top of that, the — as telehealth has become — you know, again, one of the things that came out of COVID, of course, is people accept telehealth far more readily now, both on both sides, practitioners and recipients. So that also allows people to go more niche and go more broad, right? So you can go — so, you know, if you have something that you are just really hyper-focused on and you love, well, one way of diversification, weirdly, is to have that niche, right, but to cover a much larger geographical area, and then you're not, again, subject to the local whims of whatever, you know, government or insurance or whatever, because you've got a very diversified client pool across geographical regions. So, and we can do that now, where before, in the — and I'll say the old days, before it was, you know, you — we were much more limited to providing services that were constrained geographically to a vicinity of the clinic. And this applies to things like manual therapies and things like that. We saw, in COVID, people were very creative in the way that they were actually able to continue to provide services, even where you would think that it requires physical attendance, because there's a lot of information and — store it in people's heads — that is useful and people will pay for, even if you don't have direct physical consultation.

[00:26:08] JESSICA:

Very true.

[00:26:12] DAMIEN:

Okay, so let's move on then to the next slide.

[00:26:18] JESSICA:

Okay, looks like this one's on me. Okay, so let's dive into increasing the impact of your time. You probably hear Zanda on our social, on our blogs, on our newsletters, we're always talking about your time, you know, your time back and having all that free time — time is crucial in today's world. And we want to make sure that everything that you put into your practice is allowing you to put, you know, the valuable in the resources that you need to be putting, you know, not putting in an admin, not putting it in, putting together forms — is focusing on helping care, and helping for those that you want to help. I think it's the biggest part, and this is what I constantly hear with clinicians and practitioners that I chat with, on the daily, globally, everywhere — they want to focus on helping people.

So let's dive in a little bit more into that. So time overall is crucial, you know, in health practices, you know, you focus on running, you know, helping 25, 30 clinicians — or sorry, not clinicians, patients — but then you also do the admin, then you also need to make sure that things are being handled on the back end. So it's a lot of time that you're spending throughout the week, and it starts to add up. So the biggest part, in like a marketing perspective, that I can share is: you know, position yourself and find a tool that allows you to have that time back. You know, what is it that you can find, what technology that you can find that you can put in place for your practice that is going to help you reduce all that repetitive work, that is going to allow you to simplify your day, that's going to allow you to focus and help your patients in what your passion came about, and becoming — you know, practitioner, and focusing on that will allow you to then find a tool that allows you to make that as your mission.

Another thing that I hear a lot with clinicians that I chat with, on the day-to-day, is they tell me, you know, busy — they use BizzyAI in the sense of allowing them to focus and help their patients and give them 100% of their time, versus typing up, writing notes, or forgetting key things, or thinking, okay, this is what I need to write, but this is what they're telling me. So it's allowed them to really focus and then cut down their time. So the last person I interviewed, she was telling me they used to take 15 minutes to do note-taking after, and they were back-to-back, they had back-to-back patients — they now cut it down to two to three minutes. So it gives them that extra time to breathe, refocus, and now work on the next person, and now close off the other patient. And that's huge when you're in this industry — a lot of them always tell me, like, I just need an extra five minutes to regroup myself to move on to the next patient, which I'm sure Damien, you saw a lot and you hear a lot.

And it's just one thing that you want to focus on when putting time for yourself, putting time for your team, and putting time for your patients.

[00:29:05] DAMIEN:

Yeah, absolutely. No, I think that's why it's sort of this impact and thinking about your own time — if you're a practice manager, I guess one of the errors that we see in thinking, conceptualizing, is that their time's essentially free, right — like, and they don't really account for that when working out, you know, like the profitability, all the rest of it — they're kind of factoring in their time as free. It's not free, it's actually the most valuable resource. And that, you know, when we're talking about converting your time into income, or converting that time into time with your family, time regrouping, time into sustainability, into — as the things you mentioned, having a little bit of time to regroup.

I've been there as a practitioner, booked back to back. And before we had BizzyAI, we were trying to do notes either between sessions or at the end of the day — it all just robs time. And so having that sort of mental space in between, you know, it helps them with sustainability, the energy you bring to each session, which all impacts or increases the impact of your most precious resource.

[00:29:58] JESSICA:

Yeah, or even using that extra time — when I spoke to a few people, they used that extra time that they got back from putting, you know, a tool in place for their practice, to now focus on additional marketing, or additional outreach, or just thinking out of the box on things that they don't have the time to do. So you can also use that time to focus on other niches, on either, you know, diversifying or adding new services, and really just thinking out of the box on time that you didn't have prior.

All right, let's move on to the next slide.

Okay, so this is people over butts on seats. So just let's unpack this a little bit and what we kind of really mean here.

[00:30:52] DAMIEN:

So often you see like where people will kind of scale the practice, so that I'll grow without really — I'm doing that in a way that is, in my view, going to lead to long-term success. So first of all, and the first step here is ensuring that the economics makes sense before scaling. So if you're not making a profit, enough of a margin, on a smaller scale, and then you scale that up, you're not really going to move the needle much, and in fact, sometimes as we grow, the admin and the complexity connect, actually grow with that, if it's not managed well, right. So make sure that the economics at a smaller scale makes sense before you grow something.

And like a good, you know, sort of example of where this goes wrong is that if there's not enough profit in each consultation, and you're barely breaking even — well, in the end, you end up, and you grow, and maybe you offer unsustainable remuneration to practitioners. It can look good on paper, right, like, you know, it's a vanity metric in terms of how big you might be, but actually underneath you're providing services for free to all the practitioners who are doing really well, and maybe you as a practice owner it's not making sense. So get the economics right before that kind of mindless growth — I think, definitely does more harm than good, because you end up then with a bigger practice that, as I was saying, can become more chaotic, and you can get interaction effect that we've all experienced, that when you grow businesses then you've got personalities that are also interacting, and that can be positive, but also it can be negative, in the combination of people. So you've got to make sure that it's built sensibly.

Now, what I would say is that: recruit for aligned values. And this kind of goes back to that — one of that first slides we were talking about, in terms of setting your North Star, and setting the kind of values, and what's meaningful to you, what's important to you. Now, so that means that, in the way that I sort of look at it, and when we look at what we've seen work successfully around the world — is it's not that you're recruiting practitioners that are all identical to each other, or all even have the same modalities or same personality or same stuff — you're looking for the commonality of the aligned values, because when you've got aligned values, everything else kind of flows from that. And so that means sort of defining your values, making sure you know what you're looking out for, and then recruiting for that alignment. And then you get a whole lot of sort of things that just start to work when that happens — you get people that share values and therefore have those as common ground, they'll tend to kind of get along better, their reputation, their practice tends to grow. Everyone's aware of the direction that you're heading, and what is important for that practice. So you can scale with alignment of values — I've seen much better results than any other kind of method.

So, and that's what we say over "butts on seats" — the mistake some people will kind of make is that "we need to grow", they will recruit — well, they'll recruit aggressively, that could mean, you know, overpaying and doing all sorts of things, not being too worried about the personalities and the mix. And then what you end up with is a practice that kind of grows quickly, it might grow as big, and then it kind of can either become chaotic and crazy to run, or you get a lot of turnover of team members, because there's nothing really kind of, you know, binding them together, or you end up with people that are like, I don't want to work with that person, or their values are very different than mine, and etc, etc.

So recruiting based on values is the single best thing that you can do. And I would always grow slower by keeping a high standard in relation to values and growing fast, and not being worried about that. So, it works out better — it might be slower growth, sustainable, much more fun and much more enjoyable for everyone.

Okay, then the other thing we sort of touched on before, but is finding the right admin team members. So if you do have admin team members — and not every practice has that, depending on their scale and their size, but it's a critical anchor for the practice. So thinking about the right admin team members, I think about it in terms of both that they're able to provide good services, both to the customer-facing, and also to the other stakeholder group, which is the practitioners, and how they support the practitioner. So getting that kind of right admin team members, and that is a critical kind of anchor point.

And for that now, one word of warning around that is: you can have a brilliant admin team member or team members, but if all the information lives in their head and is not systematized, then that becomes like a risk in itself, because you have one brilliant, you know, or two, whatever, amazing admin team members — they go on leave, get you know, get sick, or leave the practice, or whatever, then all that information walks out — the head, walks out, you know, with them. So you want to make sure your amazing team members are supported by, and have all information in a good system, systematized. And then you get the right combination of practitioners, right combination of admin people.

And with that, I will throw over to you, Jess, on avoiding the race to the bottom.

[00:36:28] JESSICA:

All right, so let's dive on to avoiding the race. So — oh, my screen just one sec, okay, sorry about that, you guys. Okay, so think about — I'm going to show you just like a quick example, think about — um, things like — so if my brain's getting a little scatterbrained here, let me take it back for a second before I step forward. Okay, so pricing is often uncomfortable for practitioners, who want to take care and want to make sure they're taking, you know, trust, and they want to build trust and accessible and things like that. But what I hear often is practitioners across the globe will either compare themselves with another practitioner, and say, okay, these are my rates. But what we have to do is we kind of have to shift our mindset a little bit, because when you undercharge, or when you compare yourself to another practitioner, or you say, hey, this practitioner is this rate, I'm going to be $10 less — it can really hurt you in the end. You really need to think about it, you know, for long term, you know, how is it that you want to be sustainable. You know, going back to what Damien said on the rocking chair, what is your overall — how are we going to get to that goal. So you need to put all that in mind when you're putting together your pricing, versus comparing.

Another biggest thing is when you're putting your rates together, you should reflect the full cost of your care — not including that, you know, the clinician, the clinical time, the preparation that comes with it, as well as the tools that you're using, but it should really account for the administration, the technology, and the downtime. And so recent private practices, you know, when they're putting their pricing guides together, they highlight really on the therapists that are, you know, setting their fees by comparing. And you don't want to do that — you want to make sure that you are comparing the numbers to what your niche is, to what you need to be spending for your practice. Your overall mindset needs to be shifted on the economic changes that can be happening in the government. So putting that mindset in what you should be charging for yourself and your practice.

Another thing is making sure that it's not too low, because then it goes back to the theory of — you know, you walk past a jewelry store and you see a piece of jewelry, and you're like, oh my gosh, that's beautiful, and then you see the other one that looks just the same, but it has a brand on it. So you really need to look at it as: every practice has a very similar storefront, but you need to be, you know, putting yourself out there, standing out, and putting that cost that aligns with your niche, what your services you're offering, the type of team that you have, that, you know, you have compared to somebody else.

Another part of it also is, you know, making sure that you remember not to, you know, decrease or inflate your pricing. You know, I know it's very complex — any practitioner that I talk to, they don't want to deal with pricing, they don't want to talk about money. And a practitioner I chatted with, she said she did the mistake of comparing herself to somebody, and she wasn't getting any, you know, people coming to her door. And finally, when she took a step back, she evaluated her team, what they brought to the table, her as her niche, she said she changed her pricing actually higher than the other practitioner, and she was mind-blown that she was actually getting calls. So something that she actually — her mindset, I thought she wouldn't get calls because she was higher than another practitioner in her town — so just basing that mindset of, you know, just because you guys offer the same services, or you guys are offering similar things in your community, stand out, put your niche in front of that, and you'll start to see that that also might help you stand out more than you would think.

[00:40:01] DAMIEN:

The other comment I'd add to what you were saying there, Jessica, is this sort of race to the bottom. And this happens across industries, and particularly — and using an example, before I was talking about how we all work working with corporate and government entities, things like that, at times, across our practice. So sometimes what would happen with these entities is, depending on their spend, they would have a mandatory requirement, especially if it was government, where they would have to put out to tender — sometimes like EAP contracts and things, there was an obligation to do that based on their own bylaws. And so what that would mean is that actually sets up a scenario of a race to the bottom. So they'd put out a tender, and you'd have all these different competitors, you know, bidding for that tender.

We would have a look at that tender — this might be with an existing, you know, corporate customer or government customer that we were doing a lot of work with, and they said, okay, we now need to put this out to tender because we're crossing a certain spending threshold. We would often, to the surprise of the government — the departments that we might be working with, when we looked at the tender, if they were opening that tender up where we knew that they were going to be actively encouraging people that really weren't — we knew they were going to be encouraging cheap. So that, for instance, instead of saying that in the tender, they might say — instead of their requirement being to be registered psychologist, they would say that it could be anyone with a basic counselling degree, or with some anything else, could apply for the tender. We would know then there'd be these multinational companies that would come in and have this really, you know, a very low cost base in terms of what they pay their team, and it'd be a race to the bottom.

And so we would often just not apply for the tender, right. So we would say, we are not getting involved in that race to the bottom, so we'd send out — because we're going to say, be focused on the values that we were talking about at the start, and our values are around providing the best people, the best treatment, the right support services, sustainability, etc, and we cannot do that at the prices that you're going to be looking at in the tenders. So we would just say, no, we're not participating in that, which we used to shock people — people expected that sort of put pressure on us to reduce prices.

What happened every single time — I mean, I'm not exaggerating, every single time — so the tender would go to some other company, but, and for about six months it would go quiet, because the work would all get redirected. And then, over time, what would happen is all that work would start coming back, because what they would find is that you get what you pay for. And so if you hire the lowest — you know, the companies would hire, you know, and they would engage the cheapest provider, then there's a reason that they're the cheapest provider. And after a while, they would see that that's actually far more expensive, right. So having those values gives you the confidence to say, this is what we're charging, this is what we're providing, you can stand firm in the market, and being confident about that means the market eventually figures it out as well, like you're saying that that, you know, that business sort of comes back, and it means you're constantly protecting your business because you're not getting tempted to race to the bottom.

And I've seen this happen across, you know, where people talking to us, or talking, you see on support groups and things, that people are talking about — oh, this is happening, that's happening, I've lost this contract to a cheaper — just hold proud, right, stay delivering high, high value, be confident in that, because you're a values-based organization, and it will all work out in the end. People will go for value, they'll pay extra for that. And it happened every time — like, it just would take, we could even predict the cycle, how long it will take for them to figure out that hiring the cheapest was not the smartest idea. Don't come back.

So it goes to that. And then in terms of, like, as you were saying with jewelry — price also does send a signal, right, as well, and people are often not, you know, there's an awareness, and they're not looking for the cheapest, right, or they're suspicious of the cheapest. So for all those reasons, build your pricing in a way that is sustainable, supports you, the values, and the type of service that you want to deliver.

[00:44:25] JESSICA:

Exactly. And there was even a practitioner I chatted with, the reason their rates were higher than even more than other practitioners in their area was because they also wanted to do a lot of more pro bono. So it allows them to do additional services and help the ones that couldn't pay, by also, you know, counteracting those prices.

[00:44:43] DAMIEN:

Which I thought was pretty smart that he did. Yeah, and that's one of the freedoms that you get, like when you're running a profitable, sustainable business — you actually then get to decide that, you know, if you want to provide some pro bono services or discounted services, you can do that without affecting the sustainability of the business, but you can then direct — though that sort of that goodwill, if you like, or that, to the people that most need it, if that's what you choose to do. So that's a freedom you get. And if you're running a practice that's barely breaking even, then it's very hard to do that.

[00:45:09] JESSICA:

Exactly.

[00:45:12] DAMIEN:

Exactly. Okay, on to the next.

[00:45:16] DAMIEN:

On to the next — this one is maybe boundaries as a business metric. So what we want to do is really understand and, you know, boundaries — sort of protect both, you know, the practitioner well-being, as well as the kind of quality, you know, of care that we're delivering. So without boundaries, what happens is that practices, they sort of become very reactive and inconsistent — you know, time, energy, availability, they're all business resources that we need to kind of protect. So we need to kind of ensure like — what we see, I guess, as a pattern is that the sustainable practices, they vary. We intentionally kind of protect that kind of non-clinical time. And what you see when you do that is that those healthy boundaries, they kind of reduce burnout, and they support kind of long-term, you know, sustainability of that practice.

So things like, you know, when we're talking about boundaries as a business metric, and you see this about, you know, having yearly audits to review finance and rates, and you think, what does that, you know, have to do with boundaries — well, part of that is actually understanding and looking at what services that you're providing, and making decisions about whether those services and the client groups, looking at any patterns that actually may run counter to what you're trying to do. So, for instance, if there are certain client groups that cause a lot of issues with, or requiring a lot of extra time that isn't paid for outside of the clinical time, or things that like affect the sustainability of the business, then that sort of, um, you know, allows you to highlight that and make a conscious decision about what you do, whether that is discontinuing providing services to that group.

Or sometimes it might be an organization you're working with, and you think, you know what, when you look at this, like this organization is sort of constantly wanting, you know, extra time and extra — they're not respecting the boundaries of how we might have sort of set things up, then you need to make an adjustment, which might either be affirming those boundaries so that they're not putting demands on practitioners that aren't paid for — all of that, put that into the rates, to say, okay, we need to renegotiate this, and seeing that as something that needs to be corrected.

Other things: using time blocking to set boundaries, you know, both with patients and with colleagues, and making sure that the time is being used sort of, you know, intentionally. And the other thing too here around boundaries is defining your goals for time away from work — again, this goes back to that anchor point, and why we started with that about setting your North Star, right, is to think about not getting caught up in the rat race, and all the stuff that goes with sort of running the business. But what are your goals outside of work, and making sure that your business is set up to support you, if you're the practice owner, but also I would say that you set it up so it supports your team as well.

So one of the things we did at our practice, for instance, has made sure that, you know, if practitioners needed to, you know, call in sick to look after their kids, or they needed the school holidays off, consistently, that we could build the admin support systems and the team to kind of allow that to occur. We used to make sure that the way in which the — you know, any emergency after-hours contact, if anything like that, that was managed — practitioners could literally switch off and not need to be thinking about their clients out of hours, or being contacted out of hours. Whatever makes sense for you. But thinking about setting those boundaries, defining them, and thinking about that for your team, and supporting that, you'll get great loyalty from the team, you'll get a lot of stickiness. Practitioners will want to stick around because they're living, you know, in a life that is — respects their boundaries, respects their life outside of, outside of work. And again, it all leads back to this idea of sustainability.

[00:49:12] DAMIEN:

It does. Do you want anyone to add to that, Jess?

[00:49:18] JESSICA:

I did not. We're going to go straight onto that slide.

[00:49:24] DAMIEN:

Absolutely.

[00:49:24] JESSICA:

Okay, so transitioning to sustainability. So this is like — I would say for most practices, realistically, it's a journey. So we started a new practice — it's ideal to start with the foundation. And of course, we're Zanda, we're a practice management system, where our whole thing is about building sustainable practices and having the technology to do it. So it'd be no surprise that I'm going to recommend that people start with, you know, some foundation technology, like Zanda, to run their practice.

But okay, beyond that, a new practice — the focus is: are we going to make enough money, is it viable, is it, you know, all the anxieties of starting any new business. That's okay. And so that may be that at the start of — a person spending a lot of time providing directly their kind of clinical services, right. But as time goes on, and the earlier you can do this, you know, the better — what, um, I see, you know, when we see sustainable practices, is to start to shift over time from doing, you know, all that — you know, kind of clinical work to pay the bills and to test — you know, is the business going to work — and to start bit by bit transitioning into spending more and more time on growing the practice, and more and more time into kind of systems, more and more time into diversification, as time goes on.

So realistically, don't feel bad if you're watching this and think, oh my god, I'm caught up, I'm doing full-time, overclocked, you know, with clinical work — that's actually, it's common, it's normal, it makes sense, because of that initial anxiety of, will my business work. But it's over time, bit by bit, blocking out time so that there is some non-negotiable time for business growth, diversifying, as we've been talking about, and then leveraging, you know, the economies of scale. Because once you've got the things we've talked about in this webinar, you know, those pillars in place, then you can really enjoy scaling in a way that makes sense, that's profitable, both, you know, financially and personally. But just see it as a journey, and so you don't need to go from, like, you know, busy to, you know, clinically doing everything, um, to fully diversify — just see it as a journey and just step your way through it. And that really, you know, begins with blocking out some, you know, if you're booked out two months in advance right now, then once you get off this webinar, go ahead — two months ahead, you don't have to cancel appointments, just go two months ahead if you have to, and block out whatever, your Friday afternoons, to start with, and then slowly build out the time that you're working on the business, and able to think more strategically, create that space. And then, before you know it, you will be running a sustainable, happy practice.

[00:52:18] DAMIEN:

Exactly. You hit it on the dot.

[00:52:25] JESSICA:

Okay, so I think this is the last slide for the day — let me double check, it is. Okay, I'll take this over from here, Damien.

[00:52:28] JESSICA:

So, quick, a couple announcements, like we always like to make sure — is I want to close out with these three. We have the ideas boards — if you have any ideas that you want to share with us, I'm constantly hearing from practitioners, they get shocked that their idea gets voted up and they start seeing it inside Zanda, which I love hearing. So make sure you go in there, share some ideas with us, go ahead and vote with others if you feel like that is something that you want to see in the system and our software.

Also, we have the Zanda Academy — Irina is brilliant when it comes to putting down how to do stuff in Zanda, get you up and running, get your team up and running. So make sure you go on to our Zanda Academy, as well as the book. I'm sure you guys have been hearing a lot about — Damien did write this book, so if you want to hear all of it — we have this special sticker on this particular one, we hit — we did hit as a number one bestseller in Amazon, which we're very proud of, so that's hence why I have our special, secret book on this — on this plate, we're very proud of that, making impact for practitioners and trying to distill some information that just helps them run successful practices. And in there, Damien dives in even more on the rocking chair, so if you want to learn more about that, definitely go check it out.

Okay, so I'm going to move on to the last slide, I believe — yes, so in here you have different ways to reach out to our team, via email or blogs, if you want to continue finding additional resources, support calls, as well as Practice Hive that is inside your — your platform and your software. So there's a lot of different ways to reach out to us, figure out ways how to do stuff and look into assistance. And that's pretty much it for today.

DAMIEN:

Wonderful. Thank you, Jess, for co-hosting with me. Thank you, everyone, for joining, and we will see you next time.

JESSICA:

Bye.

DAMIEN:

Bye.