The Practice of Therapy

Gordon Brewer: Well, hello everyone and welcome again to the podcast and I'm happy for you to get to know today T.
J. Slattery. Welcome, T. J.
TJ Slattery: Hello, Gordon. Great to be here today. Happy Friday.
Gordon Brewer: Yes, yes And as we were just kind of talking about before we started recording, we're really going to kind of focus in today on just how you're going to think about planning for planning your business and planning your practice, how you want to grow and scale in the, in the coming year.
But as I start with everyone, TJ, tell folks a little bit more about yourself and how you've landed where you've landed.
TJ Slattery: All right. So my whole background's been a series of. Really entrepreneurial endeavors. It's all been background in small business management and entrepreneurship. I went to school for as an undergrad, interdisciplinary business management, which is a mouthful.
It means I came out as a master of none, but a very good set to be an entrepreneur. You're still taking courses in finance, marketing, econ. economics, leadership, you name it, and set me up for a, my string of entrepreneurial gigs. So came out of school went up to the mountains started a rickshaw pedicab business, was pedaling around the hills and came back to Denver, got into real estate and then had an opportunity to go to London and spend a couple of years out there working in facilities management for the NHS, was doing blinds, curds, and healthcare laundry all around the UK.
And then pivoted, came back to the US. and did a whole 360 and 180 and got into back in the schools, did my MBA at the same time I was building a brewery here in Denver. It's about a million dollar startup, two years of planning and building, and three years operating in the black. And that was a great opportunity to put the master's class that I was taking into effect while planning and operating a business.
Successful exit in 2020, and then took another shift and said, what do I do With all this crazy entrepreneurial knowledge and experience I've gained over the years and looked at a couple of different opportunities and acquisitions and starting something else up, I actually found out that the next calling for me was going to be in business advising and finding companies similar to ones I had worked on, worked in.
That I can help to grow and scale and so found a calling in working with groups that are subject matter experts in their field that I can be the business acumen Ying to their SME Yang with and have a lot of success of the last three or four years working with those owners to grow and scale their businesses.
So that's how we. Came to be here today.
Gordon Brewer: Oh, awesome. That I love hearing people's stories and just how you get there. You know, what, one of the things no, this audience is aware of is, is that and really the reason I started this podcast. So this is a good segue is that most, most of us in the mental health field.
We got a lot of great training on the clinical side of things, but really very little training on the business side of things. And so going into private practice, you have to think of it as a business, you have to run it as a business. And so one of the things that I'm excited about to hear from you is just kind of your take on how you have the right mindset and things that you need to think about if you really want to scale and grow.
TJ Slattery: Yeah, no, it's a great question. I mean, the biggest piece on it is knowing where you're at, knowing where you want to go and figuring out everything that's in between, which is the juiciest part. And one of the things I always try to tell clients or anyone I'm talking with that are owner to steer clear from is getting underpants, gnome syndrome, which I don't know if you're a South Park fan, you ever watched that show?
Gordon Brewer: I occasionally I'll watch it. Yeah. So underpants, gnomes episode, I'll keep it brief. kid. He's got all this ki and he goes and talks to my gosh, the underpants n of the night again and th You know, that's impossibl no such thing as underpan whatever, come, come to m and you'll see. So they g kid's house at the stroke enough income dancing in gnomes and use the dress And they're stealing underpants and the kids turn the light on and they go, Holy cow.
TJ Slattery: They're one, they're real. There's actual underpants gnomes and two, why, why are you stealing underpants? And they go, Oh, it's simple for profit. And they have a big whiteboard pull out and they go, still underpants, step two, step three profit. Whoa, go back. What's step two? They go step one, still underpants, step two, big question mark, step three profit.
And they have, they're all scratched their heads and can't figure it out. And so the biggest issue I find with business owners is they have underpants syndrome and they're missing step two. And so as you're going into 2025, you're looking at, Hey, I want to go, Okay. 50 percent more in revenue or my double, or I just want to stay steady.
And so the end of 25, it's going to be this number up top. All right, let's go. You go, wait, you guys, there's no plan behind this. You're just gonna do what you're already doing and hope that things kind of meter out that you're going to hit some profit goal or, you know, top line goal without any real plan.
So what I always encourage owners to do is to say, what's really think through atomically each step of the plan, how you're going to get to that point. So let's say you're at 1 million right now in your revenue. You're trying to get to 2 next year. It's an ambitious goal. Hey, we can do it, but let's map it out.
What does that mean, seasonality? You know, we're putting together initially like a financial model for how this might look. And so let's look at your financial, your historicals month to month. How do you do on a monthly basis? Okay. That growth in a million, we can map out over the next year, but what does that mean for sales?
So each month now we're seeing, what does it mean for revenue in your business? Making that plan as you go forward, but what does that mean for marketing? How many new patients or returning patients do you have to have every month? And so really starting to think through Every corner of the business that you do have a really solid plan And say, okay, we have to do, you know, X amount of intake intake forms in February.
That's great. Well, what's your marketing plan to ensure that you have enough growth in new intake forms to hit that number. And that goes deeper into that's, you know, the gross side of the plan, but what is the holistic side of their business plan? If you're going to do 50 percent more revenue, You know, by July next year, what does that mean for your clinicians?
Do you have to hire new people? Do you need more intake staff? Where do the things start popping off inside of your business with this wonderful plan that you have to hit your sales goals? Does that actually fit the model in your business? How does your org chart, your accountability chart grow to meet the demand of the business as you move?
Do you have to spend more on marketing? Do you maybe have to tweak your profitability or revenue targets so you can pay more for marketing to make sure these goals actually happen? Backside, you're delivered. You have enough room in your clinics. Do you have enough staffing for those new patients? You know, is there a new hiring program that you have to put in?
Do you have new locations you have to open? So it's thinking through each part of the business to make sure that if that's your goal the next year or five What else has to happen? What are the action items and organizational changes that have to come into light in order for you to hit those goals?
Gordon Brewer: Yeah. Yeah. That, that, I love, I love that because I know even in, in, as long as I've been in private practice, I know I have these lofty ideas and say, well, I want to do X by the end of the year, but really figuring out, okay, what are the little steps I need to take in between now and then to, to reach that, that particular goal.
And so I I'm curious, how do you, how do you help people? Figure out those steps and the things that they need to keep on their radar.
TJ Slattery: Yeah, so when I kick off talking with any prospective client or anyone i'm already working with is we start building out that holistic pro forma Wherever we are in the year just to say what is the next 12 months 18 months look like build it out What does this look like on an excel sheet?
And then you start finding the gaps. And as you're thinking through pragmatically in the systems that you have, where do things start popping off? And you really are able to create a pretty in depth roadmap over that next year. And say, in your financials, we have to figure out benchmarks. We need to hire a new bookkeeper.
We need a CFO or CPA. These are all action items. Or we need to have a new lead gen plan. Maybe it's a marketing strategist we have to put money towards. Social media, whatever it might be, but you're creating all these miniature action items under the different hats and headers of your business. So step one is saying over the next 12 months, you know, what are all the little things that we see now that have to happen?
And step two is going through and let's prioritize those. So what is item one? What's the most important. And so having somebody that's a third party, look at those issues and give you some context on what those priorities might be. So you're not chasing a bunch of shiny red balls. That's another issue that I'll see clients working on is they've got, you know, there's a big burning building up the street behind them, but they're focused on the cat in the tree.
And so it's being able to help to say, look, the cat's going to be fine. Let's go focus on the building because clearly that's the issue right now. Let's, you know, some perspective on what has to get done first. And so once you have everything really laid out, at least what we can see now, what the issues are, then you can prioritize and start working methodically through those in order to start cranking up the business to hit the goals.
Gordon Brewer: Yeah, and I think it's you know, one of the, depending on the size of a practice of being thinking about what does scaling look like? And yeah, I know even when I do consulting with people, that's a big part of it. Okay. What is, you know, you're doing this much work now. You're seeing X number of clients.
If you're going to, if you're going to bring in more revenue, just using that one to one model, how are you going to, how are you going to accommodate that many more clients to get to that, that goal? You can either, you can raise your fees or you can take on more people or both, but they're reaching, you can, you reach a kind of a glass ceiling with that, if you're not careful.
And being able to think about, okay, at what point do I want to maybe start a group practice or bring on more people or hire an admin, all of those kinds of things, which you know, the other other thing, too, that I think probably a lot of. Private practice owners get themselves in the weeds pretty quickly with is that they try to do Too much of it on their own without getting without outsourcing without getting other people to do the work Yeah, you want to say something about that because I know that's pretty, you know, pretty universal for a lot of small businesses
TJ Slattery: I see it across all industries.
I mean, it's it's your baby, right? You started it up, you know every system at the back of your hand you built them You might have some imposter syndrome thinking This system is iffy. And if I step away from it, there's no way somebody else could take this off of my hands and do it properly. But that's one of the biggest steps that I've found with owners is the power of delegation and being able to hand things off or to systemize.
You just had an amazing guest on, I was listening to earlier this week, Nicole McCain was talking about that power, being able to delegate and automate your systems before you make that big step. Cause I look at, you know, you've got so many little issues to work on in your business, say in that roadmap.
And some of these little problems with customer complaints, there's a billing issue or X, Y, and Z you're fielding now. If you're going to grow, that's like a, a little sieve made of cellophane with tiny little holes, if you're going to grow it, just expand and all those problems are only going to exponentially get worse.
So I don't want to make sure you shore up the business and look for those areas where you can start handing things off. So to your point, it's, it's finding the right personnel and understanding what can I start moving off of my plate? And as if you're gonna get tired of my stories and metaphors, but Indiana Jones three He has to make the big walk of faith and it's terrifying.
It's 30 feet of a just, you know, vast expanse below him He has to make that first step And it's based on faith. You can't see the step, but when it finally hits footfall, you gain the confidence, you know, you can do it. And entrepreneurs have to make a thousand of those in the lifespan of every business that they do.
And so being able to hand things off and delegate to other people is it's a learned skill, not everybody's naturally that good at it, but it's finding systems that you can trust and people that you can trust, because there's no way that you're going to be able to grow from where you're at now. To where you want to be if you're still the one managing everything inside the business.
I mean, one of the things I talk about is, you know, I'm crow's nest consulting, right? It's the crow's nest mindset. When I start working with owners, you know, they're out to sea, the boat's doing fine, right? It's sailing. They're, they're not sinking, but they're not, you know, the owners below deck with everybody else just shoveling water.
They're just trying to stay afloat. But the problem is you're below deck, so you keep hitting icebergs and you can't see where land is because you don't really have any vision. So my job is to come in and help be a navigator, put in a bilge pump in the basement and get owners, A bit further away from all the day to day actions that they're kind of, you know, drowning in and waiting in so that they can start seeing where they're going, but trust into the people they're putting below deck and the systems on running the ship.
So that they, they have that spatiality that enables them to grow.
Gordon Brewer: Right, right. Yeah. And I think that's a, yeah, you know, two, I think one of the things that people struggle with is knowing, understanding that they need to invest in their practice. They need to put, put some resources into it. But also understanding that those are not lost resources.
You're going to get a return on that investment. And so it's you know, getting, getting people to understand that and really get their mind around that is really where a practice will grow and thrive.
TJ Slattery: But it's a, it's a change in mindset.
Gordon Brewer: I
TJ Slattery: dealt with this in my own business. I was running the brewery.
Like I can't hand off scheduling food trucks to somebody else. They'll never get it right. And I have to own this job because it's, it's irresponsible to me of the hand off the books or to do this or that. And getting some space from working in that business, you realize that I was actually doing the business a disservice because it's, it is way more worth it to the business and be focused on the bigger problems than it continually hold on to these.
These smaller pieces. I've heard stories with one client and she's, you know, she's working on getting up to, you know, three, three and a half million next year in her healthcare business, and she's still opening mail. Or at least she was a few months ago. She was like, I'm drowning. And I got all these little issues.
And I'm like, why are, why are you opening the mail? You've got a dedicated staff of seven really amazing admin and other people in leadership positions. Somebody else can be opening the mail. This is keeps dragging you back down. Isn't your time better spent focused on these larger vision aspects that we've been talking about?
It's being able to learn that skill of letting things go, trusting in systems and putting in backup systems so that you can go and manage those in quality control, but finding a way to really look at your role atomically. What are the things that I do every week? How much time does it take? And what are these things?
Can, can I actually start wrapping my mind around handing off to somebody else? And once you start learning that you can hand things off and somebody can do it as well or better than you can, it builds your trust and ability as a leader to continue hanging those things off and allow the business to grow by building in organization system to support you.
Gordon Brewer: Right. Yeah. And I think you know, that, that I know in my own, in my own practice, hiring the right admin person has just been a true game changer. It just it really you know, Taking care of those little day to day things and then also being able to empower them to do that. I mean you know, don't, don't come to me with, when we're out of toilet paper, don't come to me and tell me about that.
Just take care of it, you know, that, that kind of thing. And so, yeah, and I think, you know, But one of the problems that we have as as clinical people, we, we, we naturally want to help people. And I think sometimes in your business, you can be too quick to try to, to help too much and just let people figure it out.
TJ Slattery: We do that, don't we? We want to reach back in.
Gordon Brewer: Yeah.
TJ Slattery: One client, I said, talked with them earlier this week, and he said, the biggest thing he learned the last six months was to allow other people to fail. Like, that's a really profound way of looking at it. Because I was spending so much time, even after handing things off, I was still micromanaging.
I was still doing the job. Because I wouldn't let people fail. I wouldn't let them learn those lessons. But once you start letting people fail, but giving them the space to fail, like, okay, here's what went wrong. Let's go back through what was the issue in this system or, you know, problem with your understanding of it.
Okay. Now, you know, for next time, but if you don't ever let them fail or don't give them the space because you're so heavy handed, if they mess up, no, you won't ever successfully delegate that job, but allowing people to fail, knowing that they're going to have a couple of missteps. But trusting in that the next step for you is going to be way beyond that task.
You just hand it off.
Gordon Brewer: Right, right. And I think one one of the things too is and, and you kind of alluded to this a little bit before we started recording is having you're kind of your standard operating procedures written down and put in a four, at least a format that gives you. People will know how to do what you expect them to do.
You were talking about the, the, the the little metaphor of take, taking the, sending them into the forest to cut a tree. You want to say, you want to share that?
TJ Slattery: Yeah, absolutely. So, This is, this is all part of the, you know, recruitment, retention, onboarding system, but specifically into onboarding and retention.
And so, you know, whether it's building an SOP or giving somebody the guidance when they come on and a big issue that I'll have with clients is that they'll bring somebody on and there's their biggest fears. I'm going to train this person. invest in them, do the recruitment, and in three or six months, they're going to let me down and leave.
Like, yeah, that is, that's a legitimate fear because you did put a lot into them and you've trusted them and hand things off and it's gone. But what can you do to make sure that that person has retained? And there's putting a deeper strategy into making sure when they come on, they have a really clear step by step process Of knowing like a that you're hanging things off, you know, that they're being trained properly, but that they know that they're doing a good job and it's the validation and coming into a role and understanding what you're supposed to do, having metrics.
And having those check and say, I am doing a good job. Okay. This is the flow. This is exactly what you guys talked about when I was coming on, this is working. So my metaphor for this to put some imagery in your mind is it's the difference between somebody coming on and it's your first day in the job.
You're really anxious. You want to show you're doing a good job. And the boss says, meet me at the edge of the forest. I got a job for you. So you go to the edge of the forest and they hand you an ax and say, go into the forest. And I want you to cut me down a tree, bring it back. See you tonight. And yeah, the guys, you know, it's your first day on the job.
Like, what do you mean you cut down a tree? Big tree, tall tree, short tree, wide tree. Is it an Elm tree? Maple tree. How deep in the forest, how tall do you want it? You know, how many strokes do you want me to take to get it? And the timeframe. And all of a sudden that person's already spiraling because they're not really sure what their job is.
They don't know what quality is expected of them. There's no real guidelines to show that, Hey, I'm doing my job here. There's some stability for me and there's validation in the work that I'm doing. So that first day is already. Oh my God, did I make the right decision even being here? Not a good start with an employee that you want to invest in and keep on for several, several years.
They're already a foot out the door and they're going to be gone three or six months. The difference between having the first day on the job is the forest. Here's an ax. The tree is 50 yards in the forest. It's got a big red ribbon wrapped around it. You've got three hours. Here's a sled to bring it back.
Oh, I know exactly what my job is, and you gave me some guidelines, and I can tell, you know, based on my own metrics, what the good or bad job is. And so it's really making sure, especially for retention, that that person knows very clearly what their expectations are. And that you can do check ins weekly, monthly.
It doesn't have to be a big, you know, woomp on the head as a performance review. It's, hey, we gave you really clear expectations. Here's how we think you're doing. Make it a bilateral process as well. You came on to this job. These are your expectations of what you wanted from us. How are we doing as a organization?
Are we helping you suit your goals? Is this what you expected when you came on? How can we do better? And so it's finding these different met methods inside your onboarding and retention plan to make sure that person comes on, is comfortable and knows exactly where they stand. And it takes away the uncertainty that often leads to somebody saying, You know what?
I barely know what my job title is. I'm out of here.
Gordon Brewer: That's I love that. And I think you know, I've learned the hard way. Many times, like we were talking about earlier, I think making mistakes is the way in which we learn the best. I'm not setting clear expectations for people on the front end and just making sure that they understand what what it is that they're Yeah, you know, you're looking for from them.
And when you do that, they're much better employees. They're much better clinicians, all of those kinds of things.
TJ Slattery: Absolutely. And if it comes, you know, if it isn't a good fit, you don't have to really worry about making a subjective call on how this person did like, well, Nancy's not really fitting in. She kind of missed that, but we didn't really make it clear to begin with.
It doesn't as an owner give you a clear insight to how that person is performing because you never set expectations to begin with You never gave them keep the eyes when it comes down to if you do have to make a hard decision It's very subjective. You don't feel good about it. You might drag your feet for months and months with an employee That's not a good fit versus saying well, we made it really clear what the job was.
We gave them objectives and Objectively, they failed over and over and we get chances. This is an easy call versus a, I don't know. I got to, you know, think about a long time.
Gordon Brewer: And so
TJ Slattery: you're doing the work up front that makes your job way easier down the line.
Gordon Brewer: Right, right. Wow. Well, TJ, this is great stuff.
Tell folks and I've got to be respectful of your time. Tell folks how they can get in touch with you and they want to connect and that sort of thing.
TJ Slattery: Absolutely. You can find me on crowsnestmindset. com or feel free to drop me a line at tj at crowsnestmindset. com and I'd be happy to spend a time with any of your listeners that have a business that qualify for my strategic advising to spend a couple hours and go and deep dive their business.
And begin building out that holistic performa to plan for next year So shoot me an email at that address or look me up online And i'd be happy to spend some time talking with them
Gordon Brewer: Well great and we'll have links here in the show notes in the show summary for people to find that quickly and easily and so tj enjoy the the holiday season as we're recording this and thanks for being on the podcast