The Practice of Therapy

Julie Herres
Okay. Hi, this is Julie Harris. I'm the owner of green oak accounting. We are a firm that exclusively serves private practice owners in the United States. I am also the host of the therapy for your money podcast and the author of the upcoming book Profit First for therapists.

Gordon Brewer
Well, hello, folks and welcome to the podcast again and thrilled excited. Pick your pick your adjective to have Julie Harris back with me on the podcast. welcome Julie.

Unknown Speaker
Arden, it's so good to be back. Thank you for having me again.

Gordon Brewer
Yes. So Julie, Julie and I go back aways now that I think about it. We met each other. I can't remember what years it was, but it was prior to COVID. So that's how we date everything. Now Sarah post, and Julie and I partnered on a course that we're we've already been talking about revamping the course some but money matters in private practice. But Julie is the owner of Greenock accounting. And it's an accounting firm that specifically their whole niche is helping therapists and counselors and their practices. But Julie, tell folks a little more about yourself for those who might not know you and how you've landed where you've landed.

Unknown Speaker
Yeah, here I am. I am the owner of Greenock, accounting, we are a team of accountants, tax preparers, all things money related, who works specifically with private practice owners. And we started in this niche originally, because we had one, one, we started with one therapy clients who we still have and loved working with and he kept sending us therapy, you know, colleagues as clients. And so what we realized one day is, there's a lot of similarities between the practices that are doing well. There's also similarities with the ones that are struggling financially. And by sharing this information and does not take anything away from anyone, we're just sharing best practices. And we saw some practices transform before our eyes. So we became really intentional about working in this in this niche. But also, I find like, I feel like I have the heart of a teacher. And I find that therapists are, are very highly educated, obviously, in are hungry for knowledge around what exactly is going on in the business and understanding the financial side of their business. So that was just a good fit where they were, they were grateful for the education they were receiving, but also willing to implement some of the changes we suggested.

Gordon Brewer
Yes, yes. And that's, you know, it's as people have heard and know, you know, most of us, in this field, as therapists and counselors, social workers, you know, we get great clinical training, but the business side of things, the financial side of things, is, there's little or no little to no or little to none of that is what they say, in our training. So it's just really an important piece, especially in private practice.

Unknown Speaker
And I approach everything from the lens of every practice deserves to be profitable. And I feel like sometimes we are in a position that we even have to convince our clients that they deserve to be profitable, that they should be making money, which is so interesting, because in other industries, like you don't have to convince a surgeon to be to, you know, to be profitable. But you're you come from such a place of wanting to help people that sometimes that's how how far we go on the money mindset. And but it's so important, right? And you're, you're just able, in business, you have to put on your own oxygen mask first, you have to be able to sustain your personal life for all the other things to work into matter. And so that's part of what we do. And so I also started the therapy for your money podcast. That's where I talk about all things Money and Finance specifically for private practice. We have lots of little tidbits there. And then that's also why roads Profit First for therapists, because I can only as one person, and even with a team, I can only work with so many practices. And I want I think this message is so important. It needs to be out there. I want to help people implement profit first. But also, in the book I wrote in a lot of financial building blocks. I want practice owners to understand how the money makes sense in their practice. I included some tax basics, paying off debt, reverse engineering, your practice to make it work for your life. Compensation for team members, I include a lot of other things that are kind of adjacent to Profit First, but that are just so needed for practice owners to really understand the financial at their side of their business.

Gordon Brewer
Right. Right. Yeah. And I think, you know, for those folks that are listening that might not be familiar with Profit First Year We'll say some more about that.

Unknown Speaker
Yes, well, so I'll start with the premise that profit first turns the traditional accounting equation upside down. So when you look at a profit and loss, which hopefully most business owners have, that's also called the p&l sometimes or the income statement, that is a report that is going to show at the top income, and then you see all the expenses. So income minus expenses equals profit. That's the accounting equation on your profit and loss. So profit is what's leftover is what's at the end. So with profit, first, we turn that upside down. When we look at income minus profit equals expenses, when we carve out profit from the very beginning and make sure the practice is profitable, you're naturally going to have less resources left for expenses, but you can make that work, you're kind of reverse engineering your practice to make sure that it is profitable, and that is sustainable, it helps for growth, but it also makes sure that you as the owner are taken care of.

Gordon Brewer
Yes, yes. And one way I think about it, probably, if you really think about it, a lot of people operate this way, you know, all of us have just kind of standard bills and things that we are, we have to pay each month and that kind of thing. And so, you know, if we're, if we're doing our finances, right, we're going to preserve our amount of money to make sure we can pay those things each month. So you know, so like, our medical expenses, our electricity or gas, all of those kinds of things are things that most of us will, will pay out, you know, in our own home finances is what I'm thinking about, you know, we make sure that we get those things covered, because we don't want our electricity caught off. And so the way I started thinking about it, which was a game changer for me is just treating your profit, exactly like you would one of those other things, you know, because there's much importance with that,

Unknown Speaker
where you're being intentional. Well, and so one of the principles of Profit First is to use small plates. And in this case, the small plate is the, the smaller plate is a bank account, there's some similarities between how people think about nutrition and, and money as well. But so I am part of the finisher food generation, right where you have to clean your plate. And so for me, if I eat from a big plate, I'm just getting more if I eat from a smaller plate, I will eat less. So the way this principle applies, and Profit First is that we are using multiple plates, a K bank accounts. So instead of having one big bank account where all the money's going in, all the expenses are coming out there, it can look like there's a lot of money, right? You can you can look at that amount and say, Oh, well, let me you know, there's 10,000 50,000 100,000 or more in that account, let me just go spend because I have money. But it doesn't account for the fact that maybe your estimated tax bill is due or this time of year your tax bill, your rent is due in two weeks, you have payroll due in a couple of days, you haven't paid your liability insurance for the year, right, it doesn't take into account all of those things. So what's actually available to you is usually much less. So when we divide your dollar amount into usually five or six bank accounts, that gives you a really good gauge of what's going on. So typically, those bank accounts are going to be an income account. That's where all the money is coming into the practice. In most cases, for an insurance practice, your existing checking account is going to become your income account, you're not messing around with your insurance payments are still going to the same space. Then we add an OP X or operating expenses account. That is for your rent payment, your software subscriptions, your liability insurance or all the operational expenses, then we have an owner's pay account, that's the account that's meant to pay you the owner. So that can take a few different forms depending on the legal entity. But that account, the goal of that account is to pay for your household expenses so that you are okay no matter what, then for a group practice, or a practice that has either an admin employee or whether that's employees or contractors, we add a payroll account, I like to see a separate payroll account because in group practice payroll is typically your single largest expense. And that's one of the ways that we can really control that and see what's going on. So then on top of that, so that was for then we have a tax account where the business is saving for taxes to pay on your behalf. And then last but not least, we have a profit account where we're you're marking money for profit, so that at the end of each quarter, you can take half of that amount as a profit distribution. And that's really intended for doing something fun, not just you know, paying off the bills or paying down the credit card like we see. Your friend Uriah shared that he go goes out to dinner with his family. Every time he does a profit distribution, like that's part of their ritual. So the whole family gets excited about it, they go out to a nicer dinner. Some people will buy, like, take that money to go on a trip, we'll buy a hot tub, right, just do something fun, like a renovation fund. In q3, I use that trip, or that money to take my dad on a father daughter trip, we had a great time, frankly, whatever you want to do this Metrolinq Fun, fun things that is the profit account. So when you're when you have that many accounts, you can look at your bank account, it's, it's telling you something right, your bank account saying like, yep, you can afford to spend here or Nope, this is too lean, you can't you can't do that. So instead of trying to change who you are, and look at your profit and loss and your statement of cash flow on your balance sheet, all you have to do is look at the bank account, which is what most humans do. And that's going to tell you what you can do.

Gordon Brewer
Right? Right. Yeah. I love that. It's almost like you know, another way I think about it is just you have different buckets and every then then every bit of money that comes in you then allocate it to the particular bucket you put that amount or percentage amount to which I think that was when we're in for I don't think we mentioned here Julie, you know, the original Profit First by book by Mike McCalla wits is kind of where this term came from. And so yeah, and so it's, it's really more percentage based, rather than actual dollar amount. Yes. Yeah. So yes, yeah.

Unknown Speaker
So within the profit for system, and certainly this is all very much explained in the book, you go from your current allocations, which is where your practice is today, right? We've have on the website Profit First for therapists.com, we have a an incentive assessment calculator. So you can go get that and figure out where exactly your practice stands today. So you, you'd fill in your use your profit and loss, and fill in, you know, here's how much we're spending on payroll, here's how much on our backs and it will calculate for you. Your current percentages, we call that current allocations, then what we also provide in the book is target allocations for various sizes of private practice. So we look at a solo practice, a small group practice, that's usually, you know, one to five clinicians, a medium group practice, usually five to 10 clinicians or so. And then a large group practice, that's 10, plus clinicians, usually one to $5 million dollars in revenue. So we kind of covered the gamut of like zero to $5 million in revenue that covers most practices in the US. And so we we give you target allocations based on that size. So how much should you be spending on leadership? How much should you be spending on admin, right? All those things, so you have something to work towards. So it isn't uncommon for practice to come in and realize their current allocations are not within the target, right? And that's okay, there's no judgement zone. But then you can start doing the work to get towards your target allocation so that your your profit your owners pay your tax is where it should be. And there's an incredible sense of security and financial freedom that comes with that as well.

Gordon Brewer
Right, right. Yeah. I love that. And I like, I think the other thing, too, is, is recognizing that when you do it that way. I know that one, one of the things that you probably talked about in the book, and I'll bet we're going to talk about the book here in a second. But one of the things is that Parkinson's Law where you know, you will, if you limit the size of a room or a bucket or whatever, you will you generally fill that out, fill it up. And so yes, you're really kind of limiting the size of things. I mean, think about if you if you've if you've ever expanded a room or bought a new house, and it's maybe bigger than what you were used to, you'll quickly fill that up. And so this is kind of the same, same principle.

Unknown Speaker
Absolutely is Yeah, so Parkinson's Law says that supply or demand will increase to meet the supply. Right. So if you see a big bucket of cash, your demand of it will increase. And in the book, I tell the story of one of my summer jobs, I worked for a tech company, I was a temp admin for the summer, and I worked for this vice president. And so whatever he needed, I did right and so he that summer, he decided he was getting a bright yellow Porsche Carrera. And so I had one of my jobs that summer was to print out like his pay stubs and his stock sale, paperwork and all that stuff. And I could not believe how much money this person was making. Right? I was a broke college student at that point. So he probably showed on my face when I walked into his office with all that stuff. I was wondering, like, how in the world does even need a loan for this car, he's making so much money, I said something to me that I'll never forget. He said, Julie, the more money you make, the more money you spend. And that's true, right? Though, you just get used to this new standard of living. Every time you make more money, right? I don't live anymore, like a broke college student like I that doesn't work, that wouldn't work for me anymore. And so if you naturally restrict how much there is, then you just make it work. And that's why, you know, when we look at investing strategies, if you get a raise, and you just take that away, right away and just invest it, right, so you don't ever see the raise than your standard of living isn't increasing, we're basically saying the same. Same thing. If your operating expenses account has a certain amount of money, it will tell you can you afford to spend or not? And you'll naturally spend less, because you'll see like, oh, there's only $6,000 in that account, like I there really isn't room to do something else. Right.

Gordon Brewer
Right. Yeah. It's just, you create you create a system and mindset to, you know, slight, if you don't, you know, yeah, you know, I was just thinking about some of the, you know, this last few years, I've worked on my weight and all that kind of thing. And so, you know, part of the part of the thing is, is you just don't make the foods that, you know, you shouldn't have available to yourself and so to do the same thing with your money is is that you, you know, you know, if I want ice cream, well, too bad. I don't have any ice cream that I can have. And so I'll make that unavailable to myself. So it's really a mindset, kind of thing as much as anything, I think.

Unknown Speaker
Yeah. And what I love about Profit First is it doesn't actually ask you to change who you are, right? Most, most people will look at their bank app, they're not going to look at all the reports in their accounting software, they're just going to look at the bank app, Is there money, or is there not? So with Profit First, you don't have to change that you actually should look at the bank app. But when you see, you know, this dollar amount is in the tax account. And some of our clients call it like Uncle Sam's money or something fun, right? But like, you know, yeah, that money is there. But it's not actually your money, you should not touch it, it's not available to you. And that's so hard to see when everything is in one. One big pot, but also the some of the beauty of profit versus it's so much easier to identify where a problem is, like if you don't have enough money to pay your tax bill. Okay, there's a problem with that. But that tax allocation, or if there's not enough money in the payroll account to run payroll, why is that what's happening, but also if you're used to your the amount in your income account to be at a certain dollar amount, every time you make a transfer? If it's not there, you can get to work right away and figure out why is there not enough money here? Is it did United not pay this week? Is the biller missing an auction like what is happening, you can start troubleshooting so much faster than if the problem is buried with all the expenses, the rent payments, the like all of it is buried together.

Gordon Brewer
Right. Right. Yeah. So just switch gears here now. So let's talk about the book. That's out in May.

Unknown Speaker
It is so in the book I include like specifically all the details on how to run Profit First, in a therapy practice. In my accounting firm, we've we've implemented profit Profit First hundreds of times, and a lot of the clients that come to us like specifically wanting help with the implementation, always say, I've read the book, I love it. I just I don't understand, like how this works specifically for me in therapy. And so that is, you know, what we've included in this book, in addition to, as I mentioned, like building blocks, compensation, debt, right, it's not uncommon for our clients to have $100,000 in student loan debt, like we want to get kick that loan to the curb, like there's a lot of things that are really specific to private practice. I also include, like, fine specifics on processes that are financial, like financial systems, when they are what they should be. But for then you also have a big, big part in this book I ever used for you for the book. I'm so grateful for that. And I shared one of your stories that's just really poignant. Of like, how your profit first journey Do you want to share a little bit of that?

Gordon Brewer
Yeah. So you know, one of the things that you know, when I when I moved into group practice from being a solo practice, Owner, one of the mistakes that I'm made, which is really what got me on this whole journey of getting to know, Julie and all of that all of this is that I didn't really know my numbers. Well, I didn't understand. You know, I'm bringing this much and I'm paying this much out. And kind of the long the to shorten the story a little bit is that I had contractors that I was paying too much. I was having to supplement what I was paying them from what I was making for my clients. And so you should never have it that way. And part of it was is that I just came up with a random percentage that I thought, Oh, this sounds good. This sounds fair. But in reality, it wasn't. And so I went through this, this transition where I switched from having contractors to having employees who to people. And by doing that, I became much more profitable. And so that was, that's kind of the short version of the story where there are other things about that, like, it's been a little while since we did that interview. So I'm trying to do the other things that you that stood out for you with that?

Unknown Speaker
No, it's been a little while. And I think the interesting piece here is, for what I hear over and over again, is for someone hiring for the very first time, hiring a full time employee feels like so scary. Like it's so much pressure, right? Will there be enough work for all for both of us? Or for all of us? If there is more than one person? How can I possibly keep them full? Will their entire livelihood depend on me, so it feels a lot easier to hire a part time contractor, that's often the first hire. But the reality what the data shows us again, and again, is practices with full time employees just tend to be more profitable than those with part time contractors, there is there's something to be said for having a say in how the business is run, which, with contractors, you really can't or shouldn't, that doesn't mean that no one does. But they're having a lot of part time contractors is also there's there's a mental load to to managing one additional person, right. And so if they're only seeing five sessions, six sessions a week in your practice, you know, you have that mental load of hiring them and managing them. You also have all the software that goes with it, but you just don't have the revenue. That makes sense. And so I thought your, you know, yours was a very interesting story in, in part because of that. But then how you rebuild your practice, right after realizing that? Yeah,

Gordon Brewer
yeah. And it turned out that, you know, when I really did a deep dive into the numbers, actually, I was doing those people a much bigger favor, by switching them to employees, from contractors, even though it might have seemed on the front end, like, Oh, I was cutting their pay. But what they reaped instead was were the benefits I was able to provide them. And also the tax savings for them as well.

Unknown Speaker
Yeah. And I think, you know, I, I just always appreciate you so much sharing that story, because I know it's a vulnerable story, but it's, it's so incredibly common. Like we, you know, and my accounting firm we see under the hood of hundreds of practices, and obviously, all that information is confidential, but it's shocking how often an owner is doubling down and working harder to subsidize one of their clinicians. And, and the reality is that the math has to make sense, right? I believe every practice should be profitable, but also every session every clinician, so it has to make financial sense for the business, or you're better off not having an employee and you will actually have more money left at the end of the day or the month. Right? Because you're not working harder, right? And that's that's a hard like when you're in that situation a lot of practice owners have the gut reaction is okay, let me just work harder. Let me hire one more person, right, they the next thing will save it, let me expand but but when you're in that situation, hiring one more person just puts makes the hole bigger. expanding to a new location makes the hole bigger everything you do other than like, throwing a stick of dynamite in there and fixing the problem. Everything you do will just cost more and eventually like that's when practices get in trouble with predatory loans like I call it I call them the payday lenders of this space like where you're getting a loan based on accounts receivable, but the rates are so high, right? And like once you start in that spiral, it's really challenging to get out. And so in an industry where there's such a small barrier to entry, there really is no for no reason, other than, you know, the first maybe 60 or 90 days like, there has to be a profit in the practice is not a selfish thing to have a profitable business. Because you need that you need to live. And having a profitable practice makes everything easier hiring, right when your team can count on you and know that they're actually going to get paid on time your dog, their truck is not going to be late. That makes it easier. It makes it easier to grow your practice to pay yourself to get a mortgage on your own house, right? Like all those things just get so much easier. So I want to change the narrative in that in the mental health space that there shouldn't be profit, like you shouldn't be able to profit for, for helping people. I think you should, you definitely should.

Gordon Brewer
Yes, yes. And if we don't, you know, the bottom line is, is if you're not making a profit, you will not stay open, you just it'll it will eat itself alive from the inside out. And I think a lot of people, unfortunately, there have been a lot of practice owners that have experienced that, where they just didn't know. And it wasn't that they had bad intentions, but it's just that they just didn't know. They didn't know what they didn't know kind of thing.

Unknown Speaker
Yeah. And right now, we're seeing a cycle of that, right, where I don't believe I don't personally think that we're in a recession right now. But there still is very much talk of recession, right? We're seeing like, there's just things are slowing down in the mental health industry, to more pre COVID levels, right, where there's still, there's still demand, the demand has always been there will always be there. But it's not this like intense. You know, we have a 200 person waiting list situation anymore. And so with that, in the last few years, it's been really hard for practice owners to recruit in group practice. And so sometimes we see these offers, like someone's offering 70% 80% 85%, can I match that right? Our clients are coming to us saying, I really want to hire this person, can I match this other offer they received? And the if the math doesn't make sense, you're better off letting them go. Because we know that practice cannot survive. In those circumstances, you can't offer someone 85% split and make money especially like especially not as an employee, that means they're costing you 95%. Like the math just doesn't work. And so we have to let that you know, happen. And we're seeing some of those practices start to fail, and and other practices absorbing those clinicians, which unfortunately, the clinicians have to take a pay cut, but like that pay was never sustainable in the first place. Like it was just not something that was possible long, long term. So it's not an easy situation to be in. It is fixable. And you're living proof of that. Yeah. But it's been a weird couple of years on the hiring front,

Gordon Brewer
right? Sure. Sure. As Yeah, and that would be a whole other topic we could go into just about hiring and who to hire and that kind of thing. So Well, Julie, I know, I know. We've got to be mindful of our time and I want to be respectful of yours. Tell folks best way to reach you the things that you've got and all of that sort of thing.

Unknown Speaker
Yeah, absolutely. So first, the book is available for sale profit. First for therapists. It's available on Amazon, Barnes and Noble and most online booksellers. It's also available on Audible and on Kindle. So you've got kind of a slew of options available, you can go to Profit First for therapists.com/gordon. If you want to get our free Getting Started worksheet where you can get the instant assessment that we talked about, you could get the target allocations, you can get a getting started work checklist, all of that is included in the workbook. So definitely go get that. And then my accounting firm is green oak accounting. If you're interested in working with us, we always offer a free consultation. So that's a great way to get to know us and see if we might be a good fit for you always low pressure, non salesy. That's a good way to connect with us as well.

Gordon Brewer
Awesome, awesome. And we'll have these links in the show notes in the show summary and I will say this, Julie Harris, and her team are good people, so be sure and check it, check it out. And you're gonna be hearing more from Julie Harrison, check out her podcast therapy for your money. So that's, that's it's a great one. So be sure. Well,

Unknown Speaker
I forgot to mention too. We have a Facebook group as well for profit first. So if you're implementing Profit First and need some accountability, you need some questions. We have a free Facebook group. It's Profit First for therapists. So go go join that as well.

Gordon Brewer
All right. All right. Well, Julie, you're we'll be hearing more from you here soon. We'll be back Gordon yeah thanks thanks for being here