The Practice of Therapy

Gordon Brewer
Okay, if you want to do the blurb

Jeff
Hi, I'm Jeff Russell, I am the author of fire yourself first. And it's my book with four steps on how to fire yourself from your practice, and so that you living the life that you really want to live.

Gordon Brewer
Perfect. Well, hello, folks, and welcome again to the podcast. And so glad for you to get to meet today. Jeff Russell, Welcome, Jeff.

Jeff
Thank you. It's awesome to be here.

Gordon Brewer
Yes. So as I start with most everyone, why don't you tell folks a little bit more about yourself and how you've landed where you've landed?

Jeff
Well, first of all, I want to be clear, I did not come from money. My dad was in the army, I was an Army brat moved around every three years, you know, for us, Big Five Star dining was going to the next town that had a McDonald's. So now fast forward, right, I have a family trust a family office, I have five companies. And the amazing thing is I don't work more than 10 days a month. Right. And so this is almost the 20 years to get to today, or the last couple of years. And so and one of those businesses was a medical office. So we did aesthetic medicine. And so my partner and I, we started that 11 years ago, and it's going strong. And so I do understand the health care space. And another one of my businesses is training physicians how to add aesthetic medicine to their practice. And so I've taught over 15,000 physicians how to do that in the last 17 years. So where it started was, yeah, I went to college, and I got a degree in computer science. So I am doing absolutely nothing that I was trained to do like many other people, I certainly take some of the coding the logical problem solving the process is I take from those college days. As a college graduate, I did what I'm supposed to do. And that's go work for a big fortune 100 company in America. So I went to work for Xerox, which in the late 80s was a fun time, right? Because Xerox is where the GUI was created where the mouse was created. You know, many people don't even know who Xerox is today. So right, but we're using their products every day. Yeah. And then, and I did that for about 10 years. And then I was really what I like to call on hireable. I never did a bad job. So I never got fired. But I did get packaged out and laid off and got that letter. And one of those letters was a guy gave me a year salary. And they gave me some counseling. And so I did all the the set personality assessments like Myers Brigg, and all those, those guys. And then I also did some counseling, and one of the counselors told me, you know, Jeff, you been kinda doing this employee thing for a long time, I don't think you're set out to be an employee, I think you're set up to be a business owner. I'm like, Oh, really, I didn't think that was an option, because I didn't know how to do that. Right? Right. They don't teach you how to be a business owner in college. And when your your parents are not business owners, right, you don't really learn that from your family. And so I decided to buy into a business opportunity where I learned how to become a leasing broker. So I spent $10,000 of my part of my year salary that I was given. And I did that, and then I found myself in the medical side of things. So I finance a lot of medical equipment. And then a lot of those doctors were asking me, Well, how do you set up and run a practice? I'm like, Well, you know, I don't know, I have a, you know, I have a computer science degree. I'm a good talker, I know finance. So I would tell them go talk to these other doctors, you know, they and learn from them, because they're doing they're really successful. After a couple of years of that those other doctors are like Jeff, stop sending people to PSI. I'm too busy for that. And so I actually interviewed them and created an entire training program on how to help the doctors do that. And one of the challenges is when you look at business failures, it's almost always about the money. It's never really about the the the the desire of the owner to do a good job and help people. And that's one of the things I love about working in health care is that most physicians and health care providers go into medicine to help people And it's something that really resonated with me. I'm like, Yeah, I want to help people the way I can. And so I obviously don't have a medical degree and can do anything medical, but I know the business, I know how to bring people in, I know how to set up processes and systems so that I don't have to be there. And right from the very beginning, I taught the physicians, this is what you have to do, you always have to think about who can do this procedure, not you. So the first concept I, you know, I want to kind of give to your listeners is, whenever you're doing anything in your practice, think who not you. So who else can do this, I know, when I started my business, the first person I hired was a bookkeeper. Like, I can do bookkeeping, and I can do taxes, but I don't want to, and it's really not the best use of my time. And so always think about who can do this better, you can do it really well. But if you don't get out of your own way, and start letting other people do that, then you're just going to have that challenge all the time. So when we teach physicians, we do a combination of clinical and business together. So it's kind of an experiential learning environment where you're actually experiencing it, I want them in a clinic, doing hands on. And then while we're doing that, where this is how you talk to a patient, here's how you, here's the business side of it, so that they kind of understand those. And, you know, physicians and providers are busy. So one of the things I know this is going to take a lot of time, and you're not going to like it upfront, but you really have to document your processes, from the time a patient calls in to the time when they actually walk in, how you see them, how you book, their next appointment, all of that really has to be written down. And it takes a lot of time upfront, but where it's going to save you is when you go and you hire your receptionist or your virtual person to kind of manage your clinic, they're going to have a manual that they'll just be able to read down and understand what to do. So I was a bit OCD. So I was always I was good at writing stuff down so hard for me, but it may be for other people.

Gordon Brewer
Right? Well, it's interesting that that whole thing because I was doing some consulting with someone, I think it was just yesterday. And that's exactly what we were talking about is particularly for, for those private practice owners out there that might be moving from having a solo practice to a group practice. As a solo, solo, entrepreneur, solo practice owner, we do a lot of things day in and day out, and we just know how to do it. And we don't really think about okay, if I had somebody else to do it, how would I teach them to do it? And that's exactly what I suggested to them to do is Okay, think about what you do from the time you get a client to call to the time that do discharge them is, is map out all the steps so that you can began to put your systems and processes in place, because that's the that's your your are really you're talking about some good stuff here, Jeff, and that. I think one of the mistakes that a lot of practice owners make is they hang on to the bootstrapping too long. And they and they don't outsource enough. They don't they miss a lot of low hanging fruit by not outsourcing things.

Jeff
Yeah, I couldn't agree more. And I'm absolutely guilty of this, right. And so if you are to your normal, right, so like, everybody, you've got to learn this. And sometimes you can't see what's over the hill. And you just seem to get steeper and steeper, and you don't want to go there. But trust me, if you start letting go of the administrator of the the boring stuff, the stuff that someone else can do easily and probably would enjoy it more than you. You want to certainly let that go. And so as I, you know, started adding businesses and for my practice, for example, I had a full time job, my partner had a full time job, and then we're opening up a new practice. It's like, okay, well, who's who's going to be here? So when we design that practice, we designed it to run without us. So we use those operating manuals that we had and then we hired our first person. And you know, our first person we just started with one. So you may start with a person, halftime I maybe 20 hours a week, it doesn't have to be a full time person, right? But someone to answer the phones to make sure the practice is all set up and ready for you. And then we hired when that person was too busy, we hired another person. So always think Is there an extender that can do things, right, so and group consultations and things like that as well. And so then all of a sudden, so I again, I did this, because we were busy with full time jobs, I didn't think anything of it. But when I look back, it's like, Wow, that really set us up, because now we have five full time people there. And they're seeing patients all day, while my partner and I are not in the clinic at all, I work maybe an hour or two a month in the clinic, and she works maybe two, three hours a month in the clinic. So very limited time, and she's doing what she enjoys doing. So I always think, take what you're doing now and throw out conventional and the way you've done it and think, how what would this look like? If I only worked five days a month? Right? What would have to change? Sometimes we just kind of have to think outside the box to think to come up with solutions. And so when you just say what happens if you're disabled and you cannot work? Okay, what what how are you going to set your practice up, right to run without you, you're going to do online? Are you going to do a self thing? Are you going to bring in a partner, a junior partner or as another partner? Like, you have to think about these things? And what you would do?

Gordon Brewer
Yeah, yeah. It's, yeah, one of the things that I hear from people a good bit is that they, in thinking about, like, the example you gave of hiring a, an administrative person or virtual assistant, or however, looks for for a particular practice, they think of they think, Well, I can't afford that. It's not, I'm not gonna be able to pay them. But the truth of the matter is, and I'd love to get your, your thoughts on this, is that by not doing that, you end up making less money?

Jeff
Absolutely. And, and I had that same mental block that you're just discussing? Absolutely. I was the one I answer the calls, I did the events, I created the materials because I have those, you know, I don't know, I'm not a clinician, but I think I have some variant of OCD. So I like to keep control over everything. And so it was probably more difficult for me than many people to kind of let go. And what you have to look at is this is look at how much money you're making a year, or how much you want to make. So maybe you're making 150,000, maybe you want to make 250,000 or 500,000, you divide that by 2000, because that's how many hours are in a year. That's your hourly rate and what you're worth, if I can hire anyone to do it for less than that. They're doing it. Right. So you're you have to look at your value, your value may end up being $100 an hour. So if you can hire someone for $15 an hour to do basic admin or bookkeeping, and why aren't you doing that? And many of you like, I don't clean my pool, I don't clean, you do my grass or landscaping, I don't clean my house, like, I just don't enjoy doing those things. So there's people that do them for a lot less, and they actually enjoy doing them. So I'm enabling these people to have some joy as well. So really think about that, you're you have to look at what you're do really well, and what makes you the most money and focus in on that around. And I think that's a big first step is to kind of change, you know, don't look at this $15 An hour person as an expense, look at them, well, I make 6070 100 an hour, they're actually making me now I can see two patients instead of just one patient.

Gordon Brewer
Right. Right. And that's a that's exactly the way I encourage people to think about it because, you know, it, you know, are in our profession. And the same way with with any medical profession, is that for the professional, if you're not in front of the patient, or in front of the client, you're not going to be making any money. And so if you're spending all your time doing administrative stuff, which Yeah, that part's important, because, you know, as far as the collections and all that sort of thing, but really, you've got to have that other person in front of you. And so, like you said, if you're, you know, if you're charging $100 an hour for your services, and you can pay somebody $30 an hour to eat Answer the phone and book other people, that frees you up. And so it absolutely pays for itself.

Jeff
Yeah, 100%. And the other thing that I want you to start to think about is, how can I add ancillary services to the practice that don't require you, and you can bring in somebody more inexpensive to do that. So for the aesthetic side of things, like doing Botox and doing microdermabrasion and peels, the physician doesn't have to do any of that stuff. That's an extender doing it. So in with therapists now think about okay, so what do you want to add, maybe be maybe you want to add, you know, the blue light therapy where people kind of lie down, and they have the light on them, that gives them the, you know, helps with their mental health. Because I'm seeing a big crossover here, too, right? We're seeing supplementation, we're seeing peptides, we're seeing a lot of things, people are now thinking, Okay, I look good from the outside, because I can do this aesthetic stuff, but I don't feel good inside. So how can I? How can I make that? So I see ageing, really combining the in and out in the next decade? For sure. And there's a lot of great things happening. So what else can you you know, hire. So always look out when you're visiting another city or going to a trade show, look at those procedures that don't require you to legally do, right and bring in someone to do that. That's how you really start to get one plus one equals five. Right is when you're able to have other people seeing patients that don't require you to be there. So really, and you probably have some suggestions as well, Gordon, and those type of ancillary things, but always be thinking.

Gordon Brewer
Right, right. I think and that's a, that's an important point. Because, you know, depending on, you know, how you get your practice set up, there is a ceiling, kind of a glass ceiling to the number of people, number of patients that you can actually see. And I mean, there's only so much time in the day, and only so many fought slots that you're capable of seeing folks. And so you're exactly right, looking for ways to diversify your income by going from the one to one way of providing services to the one, one to many, but also, you know, what one idea as you were talking about, you know, kind of medical kinds of things, but in our, in our world. One idea that I've heard thrown around and we're playing with it here, in my own practice is for folks that maybe work with like teens, you know, one of the things that is really helpful for teens is learning emotion coping skills, particularly, you know, if they're, you know, in high school, junior high, that's a volatile time for any young person. And so, learning how to navigate the emotions of all of that is an is an important skill for them to learn learn? Well, you could, you could hire an intern that can teach them that in a group setting. And so and then be able to charge for that. And so, yeah, there's just one little idea of what you're what you're talking about in kind of the mental health field context.

Jeff
Yeah, no, that's a great suggestion. For sure. Always think about how you can do like he said, The One too many are having someone else do them. And leveraging the technology too, right. So maybe you have like a monthly subscription program, where you have a group call right on Zoom or another technology, where people can kind of check in, you can ask questions, we that's what we do. Often with the acetic side, we all have, he may be inexpensive, it could be 199 or $99 a month. And often you can include maybe some supplements that you believe in, right, you know, maybe you're into vitamin D or whatever B 12. Or, you know, you're starting to see that combination in there as well. That, you know, it's a package that includes that and if you want to you can come in for unlimited support or a zoom, a monthly zoom call where you can ask specific questions and other people have them as well. So I always just try to push you to think outside the box and look in different industries like how did dentists do it? How to other people do it in different industries? How does the self help do it? Right and their industry? Right, they have masterminds and monthly things in a course that may be available. So really take examples from other industries as well to help you

Gordon Brewer
know, one, one area that's a real kind of a lot of buzz around a lot kind of Hot Topics, so to speak, is moving from traditional therapy type of model to a life coaching model of helping people solve specific problems, which doesn't necessarily is different than doing therapy with folks, but really is more about helping people problem solve and be able to just learn some new things around a particular issue. So that's, that's another little idea that a lot of people are, are playing around with. So.

Jeff
And you know, that's a great idea, Gordon, I love that. And when I'm look thinking of that, you always want to also think back to who your patients are. Do you have the right patients, in your practice? Do you have the ones that you enjoy seeing and helping, or that they drain you? And so like for this life coaching, that's their certain type of patient. And if that's the type of program you want to offer, then I need you to start thinking about who you have in your practice and who you want in your practice, that would be the ideal patient for that product or service that you offer, you know, because sometimes who you have is not going to get you where you're wanting to go. Right. That's a good idea. Yeah, no, that

Gordon Brewer
that's a very good point. It is a very good point. So what Jeff, does switch gears a little bit, tell folks a little more about your book and those kinds of things.

Jeff
Yeah, so I wrote fire yourself. First, it came out in April of this year. And my background really is working in the healthcare side of things. So a lot of this, even though it's meant for any business owner, you have to think of your practice as a small business. And you know, a lot of the tips and strategies you see out there are for big businesses, right, like walmart or amazon. Well, that doesn't translate if there's three or four of you in your practice. And so I really toned all those tips to have the small efficient teams. And the four steps that we have in there is how to basically unchaining yourself from your practice. And first thing is your personal purpose. So really think about that where you want to go. The second one is hiring the right people. I'll tell you the most difficult part of any business anywhere, doesn't matter if you're in health care, or real estate or whatever, is hiring the right people, and actually have an 11 step hiring process because I've hired so many. I hired amazing A players and I hired like psychopaths, right? Like so I'm talking clinical here, like I don't know why? Because they're the ones you have to watch out for, because they know how to manipulate the system hiring system better than anyone. Now your listeners probably have an extra hand up on identifying those but the 11 steps and then the other one is you. The third step is dashboards, right? You got to know what your key numbers are. I'm not an accountant by trade. My bookkeeper sends me my numbers once a month, I know what my profit is, I know how much I spend on expenses and how much I'm bringing in, you really have to know two or three key numbers. And the fourth one is okay, what are you going to do next? And so you have to really think about five years from now, where do you want to be, and then you start going backwards, just start building the systems and processes and hiring the right people to get you there. If you go to my website, fire yourself first.com, your listeners can actually download my 11 Step hiring guide. So if they want to start using that, I don't offer coaching, I don't do masterminds, I have nothing like I really wrote this book to give back. I spend most of my time now in my investment side and my family office and I looking at real estate investments and other stuff. And so I look back and I'm like, I've got all these other business running on autopilot. So why not kind of teach people because I'll tell you the stress you go through. When you're the only one right, it's so much easier to sleep at night, when you have a team in place that is really batteries included, fully charged, ready to come to work and do that. And so the book is really just to help providers and you'll see a lot of healthcare examples in the book as well. And if you want more information on the book, it's fire yourself first.com And there's links to Amazon or Barnes and Noble wherever you like, and a ton of free resources. I also have also have a weekly fire yourself Fridays where I give you a little tip. I was just writing a blog today about the Four Agreements and you No, there's some of these books that we can take a look at those simple things, we just kind of lose yourself, right? Being impeccable with our word. And you know, I'm like, yeah, that's, that was a great read. Right. So,

Gordon Brewer
yeah, that's great. And well, we'll have links in the show notes and the show's summary for folks to find all of that easily. So, Well, Jeff, I want to be respectful of your time. What what sort of parting thoughts might you have for our listeners?

Jeff
You know, the big thing is, if you're struggling, you're not sure where to go next. But you know, you don't want to be doing what you're doing your normal, right. So I don't want you to think you're just yeah, you're you're you don't there is a way, you have to start with one thing. And what's the one thing that you can start with today, that'll get you to a practice that runs without you where you're not a critical part of it, and just make that one change?

Gordon Brewer
Yeah, that's great advice. Great advice. Well, Jeff, I appreciate you being on the podcast. And hopefully we'll have another conversation here in the future.

Jeff
Absolutely. It was an honor and a privilege to be here, Gordon, thank you. Thank you.