Recently, a friend who owns a private practice called me. He dove right into his reason for calling, starting the conversation with: “AJ, some of my very best counseling left my practice. I have issues with notes not being completed. Our culture and team morale are down. We have a lot of new clients come in, but many never come back. And now I’m losing money.”
To this, I ask about the size of his practice. He explains that it’s a “big practice” with three offices, 18 therapy rooms, and 20 counselors. I tell him, “Dan, the number of employees and offices you have are only vanity metrics. How many clients are you helping a week? In other words, how many sessions in total?”
Dan says, “About 165.” I explain that this means his practice is the equivalent of 5 full-time employees. To which he begrudgingly responds, “I guess…”
This mistake is all too common. Owners of private practice pay attention to vanity metrics, but they don’t pay attention to the figures that really matter! For the next 30 minutes or so, I help Dan explore how his practice is suffering as a direct result of his supernumerary size. So, my advice to you to keep your counseling private practice on track is to keep things small. Two areas in particular should be kept small:
1. The amount of counselors you have.
Hire as few as you need to serve the needs of your clients. Your practice’s success relies heavily on the counselors you hire as well as how you manage and train these counselors. Be picky about who you hire and only hire excellent counselors—those who can be coached to surpass their own expectations. Employing fewer clinicians will allow you to build a well-trained team of counselors who can manage well and keep administrative costs down.
As you cultivate high performance, you will have the ability to pay your counselors more. This helps to increase morale and also, of course, reduces turnover. Remember that part-timers tend to be less dedicated to the business. They are also harder to coordinate with.
2. Your space.
The second area that should be kept small is the space that you’re in. Think about how many sessions one single therapy room can accommodate: 40 sessions. If you need to accommodate more sessions, consider expanding your hours before you consider expanding your space. Do you currently hold sessions on weekends?
It’s easier to maximize your office space when you have fewer counselors that are working more often and more consistently. Now, when you’ve exhausted all options and you determine that you do indeed need more space, try to expand at your current location.
Back to Dan: even if he is having 165 sessions a week, his practice is a liability that’s losing money! However, it isn’t the end yet. If he can turn around his operations, he’ll be able to improve the care his clients receive as well as team morale and overall success.
Which business would you rather be a part of? The one with three offices and 20 employees or the one with one location and 5 employees that’s helping the same number of clients?