Scaling Without Selling Your Soul: Building a Business That Loves You Back

Aug 19

Therapist burnout doesn’t start with big breakdowns - it starts with tiny betrayals of your time, your energy, and your vision.

In this episode, we get real about the emotional toll when you scale therapy practices, the identity shifts that come with leadership, and how to build a business that actually loves you back.

We don’t just talk about how to scale therapy practices - we unpack what it means to scale with integrity, values, and your own well-being intact. If you're craving more ease in your practice management while staying deeply connected to your mission, this conversation is for you.

In this episode, we explore:

How therapist burnout creeps in - even when your business looks successful on paper

What we wish someone told us before stepping into leadership and practice management
How to scale therapy offerings without abandoning your clinical identity or burning out
Why alternative careers for therapists don’t always mean leaving therapy - and what that path can look like
The moment we each realized our business no longer felt like ours - and what we did to take it back

Whether you’re managing a growing caseload, hiring your first employee, or questioning if this path still fits - this episode will help you gut-check your growth strategy and reconnect with the parts of you that got lost along the way.

WATCH THE FULL VIDEO EPISODE HERE!

[00:00:11] Colleen Long: Okay. In our first two episodes, we shared our burnout moments and pivots today, how to scale without turning your dream into a bigger cage.

[00:00:19] Erika Bugaj: If growth has ever made you feel less free, you're not alone.

[00:00:23] Jen Politis: We've done it wrong and right. Let's talk about it better. I've personally had seasons where growth meant a bigger paycheck or a smaller paycheck, but it also came with bigger panic attacks. I've had seasons where growth meant more space in my calendar, more time with my kids. More money in the bank account, but there was a big difference how intentional I was in scaling and whether I was building a business I actually wanted to work in scaling can either be a staircase to freedom or a hamster wheel with a better view.

[00:00:59] Jen Politis: Let's make sure it's the first one.

[00:01:01] Colleen Long: I totally agree. I think that we all mean well. When we're trying to grow and expand on what we're doing, you know, we're like, okay, that makes more money, but does it make more sense and does it just make more busy work for us? Right. And so I hope in today's episode we can kind of help listeners think more intentionally about scaling and growth and not just growth for growth's sake.

[00:01:30] Colleen Long: Or for profit's sake, but truly does it move the needle for you when it comes to time or joy?

[00:01:38] Jen Politis: Right. There's a, you know, there's fantasy versus reality, and I feel like when was the last time you thought scaling would fix everything, but it didn't?

[00:01:48] Colleen Long: Yeah, I. I remember, uh, probably first time I ever, well, first time I read Four Hour Work Week by Tim Ferris. Great book. Read it a couple times since then. And, uh, one of the takeaways was essentially every time you're doing something, ask yourself, is this the best thing I can be doing with my expertise and training at this moment?

[00:02:15] Colleen Long: Or, can someone else be doing this for me? What is my time worth and can I outsource this task? So that was really the first time that I ever hired a practice manager and a biller. And it, it totally, I mean, changed my practice, my life, just, uh, overall, like not having to be on the phone with insurance companies, that sort of thing was the first like win I think for me as far as scaling.

[00:02:40] Colleen Long: But, When we started to hit our stride, and this was, I wanna say 2022, well, yeah, post COVID was the first time that I started to get or have more time and more money, and I was like, oh my God, I think I've done it. I think I've scaled and I've started to feel like I hit my stride. I think I got a little bit of an ego boost.

[00:03:06] Colleen Long: I was like. Okay. Yeah, yeah. I'm, I'm doing it. I really figured it out and I doubled down and invested in my learning on the ops side. So obviously clinical, I knew what I was doing, but had no idea what I was doing when it came to running a business. So I started to hire this like, personal mentor. He was, you know, he's pulling in 15 million a year.

[00:03:34] Colleen Long: I'm like, okay, that's where I wanna be, so I'm gonna work with him. I joined Vistage, which is like $2,000 a month. Um, I joined EO Entrepreneurs Organization, second in command by Cameron Harold. I mean, I invested tons and tons of money, probably $50,000 in my education in one year, and really loved learning about that.

[00:03:56] Colleen Long: But as I started to scale, I still had no idea. What I was even looking for and literally almost lost my house trying to do it.

[00:04:09] Jen Politis: Erica, how about you?

[00:04:10] Erika Bugaj: so I would say that yes, I have also had a similar experience that. When I'm able to hire external, services to support the practice, it takes something off my plate and allows people to focus on what they're really good at. And I found this practice ownership journey to really be a journey of me learning what I'm good at and , where my strengths lie.

[00:04:37] Erika Bugaj: So it has taken several tries in some cases, and that. Comes into contrast with my, you know, personality or my tendency, which is I would like to get it right the first time and just. Be able to go from there. But for example, with finding a good insurance biller has taken several tries. One that really works well with me and with the practice, who's willing to go the extra mile and do what's needed to support us.

[00:05:09] Erika Bugaj: And I think that's really important for scaling in. In some cases, I've. Uh, we have a great high school internship program here in DC and I have, uh, they're high school seniors. I've had them take on some roles in the practice. It's their first job, first opportunity. They're eager to learn and to please.

[00:05:30] Erika Bugaj: So this summer we had a couple guys do our social media and I was really proud of what they came up with. But knowing that I'm not the one scheduling the post. Gives me, liberates me, frees me up to do what I need to do, which is really, you know, the tasks of hiring and HR and working with my team. It's all challenging.

[00:05:53] Erika Bugaj: It's a juggling act.

[00:05:55] Jen Politis: is. It really is. We have a high school internship program too, and they're fantastic. I love having them.

[00:06:01] Erika Bugaj: Yeah, I've definitely received feedback from other business owners that they wouldn't, you know, touch high school interns with a 10 foot pole. But, you know, I, I really find that fits well with, you know, the type of leader I am and my bent for working with children and teens. You know, I think they really respond well to encouragement and to support.

[00:06:23] Erika Bugaj: So it's been a good. Investment of my time and and mentorship. I think

[00:06:28] Colleen Long: Erica, how many clinicians do you have right now?

[00:06:32] Erika Bugaj: always struggle to answer this question. I believe there are 11, maybe 12, and then two that are onboarding at the moment and we have some MSW interns as well that will be starting the end of this month.

[00:06:49] Colleen Long: Do you feel like you've had pretty good retention with the clinicians?

[00:06:53] Erika Bugaj: the past couple years? Yes. I, I think I've only lost one clinician. Um, and I'm honestly still uncertain as to why, but, um. rest of the team has really grown together and, you know, seems to the, the culture has developed and they're cohesive. They enjoy each other's company. They really seem to learn from one another and work well together.

[00:07:19] Colleen Long: How do you keep connection and build culture, cultivate culture, all of that in your practice? Because obviously that's being done to retain clinicians in this landscape where people could easily go and work for, you know. The better helps the talk spaces of the world and make more per hour. It's really the culture that then wins out in keeping clinicians, I feel, at least.

[00:07:46] Colleen Long: So how do you do that? Is that you that's building that, or have you also delegated that piece to a culture builder?

[00:07:53] Erika Bugaj: think it's a combination of both. Uh, the piece that I really have invested my time and energy in is a weekly team meeting where. we, um, have done a book club together. You know, we choose different topics to discuss. We have celebrations and um, mark anniversaries and things like that. And I feel that team meeting has really been critical in developing the team culture. We've also done some outside, you know, team building activities from time to time.

[00:08:27] Erika Bugaj: Like, uh, we've gone to paint your own pottery or bar trivia together. Um, I think the option of having those activities available for those who wanna participate helps a lot. So, um, that, those are the ways that I've, I've tried to do that. We've also had a retreat one year, which I thought. Was a really great opportunity for everyone to get together on a weekend day.

[00:08:55] Erika Bugaj: A big ask. Right, and

[00:08:58] Colleen Long: come up with those ideas? Is there someone that's like, all right, let's get everyone together, or are you functioning in that clinical director role as well?

[00:09:05] Erika Bugaj: I'm, I'm currently functioning more in that clinical director role, though. If a team member has an idea. I will like have them run with the idea. So for example, we had a, um, team member who was interested in having an uh, anti-racism committee. And I said, that's great. Let's see who else is interested and. they formed a committee and as a result of that, they created the anti-racism statement that's on, on our website, and I was really proud of that effort. And, the committee that worked on it seemed really proud of the effort and the work they did too.

[00:09:45] Colleen Long: Wow. What about you, Jen? Is that, is that sort of how your clinic is run? Do you, do you function in that clinical director role and are you the culture builder as well, or do you have that delegated.

[00:09:58] Jen Politis: So I'm not at that point when, when I was in the beginning, I definitely was. And when we were a smaller practice, I would say probably closer to 12 to 15 clinicians, that was easier for me to kind of manage and we would do more staff events at this stage. Um, I learned for me, I had to delegate that out because what was happening as we were getting bigger, it was just, you know, who was doing what, so.

[00:10:26] Jen Politis: Currently we have an event committee, so we have staff who volunteer their time to be on the committee, and they choose events that, you know, we do get together and do. Recently we did a workout class together, like a kickboxing class, and I was there, so it's coming from them. It's not coming from me, but I had to slowly make that shift because in the beginning it was mostly me and I felt like a lot of people were working.

[00:10:53] Jen Politis: For me, if that makes sense. And then what happens is as we continue to grow, I felt like we had some staff turnover and I realized at that time it can't be about me 'cause of my time. I, I can't, I would love to mentor everyone, I just physically can't. So I had to kind of get buy-in from everybody. So I had to have the clinical director and at the time, director of ops and the office manager.

[00:11:19] Jen Politis: They needed to be the people to build staff morale and connection. And then so they did that at four a point, and then now it's more on other clinicians who are volunteering their ideas.

[00:11:31] Colleen Long: Yeah, and I think that's the idea behind scale, right? Is one is delegation, but two is also figuring out what your strengths are and aligning your daily to do with those things that you really are. Good at and enjoy doing. And, and I know like for me, the culture building was always last on the list.

[00:11:55] Colleen Long: I remember when we had our monthly all hands meeting, I would be so nervous because I felt like I was like the president, you know, like I'm the face of the company and like you said. You feel like people are working for you, you feel like the product and you've got a, you gotta dance and it's sort of like when you're a therapist, you gotta dance and sing for your supper every hour, right?

[00:12:20] Colleen Long: Like, this is worth the $300 an hour, especially when you're private pay. So, um, I did not enjoy that role. I think it's partially because I'm a little bit of an ambivert and my battery gets drained really quickly when I'm. Around others. I, I think there's a little bit of that people pleasing aspect and so it just was not enjoyable for me.

[00:12:43] Colleen Long: Even though like Erica, as you're talking about the book club, I'm like, Ooh, I love that kind of stuff. Like I love talking with other clinicians, but not about work. I don't wanna be in that boss role where I'm like, did you meet your KPIs this week? But love to hear what they just read and connect with them on a human level.

[00:13:02] Colleen Long: Right. And that's so important. I have a clinical director now, and after our practice was sold, she was working as a clinical director before it was sold and then after. And honestly, it's been such a game changer for me and amazing to watch her because she is a culture builder. She defaults to checking in with people and like, how you doing?

[00:13:26] Colleen Long: And that sort of thing, and really is a connector and. Like, I wish I would've had her in that role years ago because it was not, it was not my strength.

[00:13:37] Erika Bugaj: I, I would definitely say that I have carved out a student internship coordinator role, and that individual does have a background in, um. Administration or management, and she's done a wonderful job of cultivating the intern program and taking that off my. Plate or list of things to do. And I think, you know, as I look at the numbers I do, I am hopeful to scale in the sense that I want to build out some additional roles in the practice.

[00:14:12] Erika Bugaj: But I also feel like as practice owners, we have to be so intentional, like as you've spoken to Colleen about who we choose to put into those roles. So ideally I'd like to hire from. Within and, you know, shift folks that I've seen functioning really well into clinical director or maybe director of operations roles.

[00:14:36] Erika Bugaj: But I'm approaching that with extreme caution because of the need to keep the practice functioning and intact. Uh, not wanting to hand over too much all at once. Um. But I know that's coming, Jen, and I relate to the numbers you mentioned, like I'm gonna kind of positioning right at that point that you said you scaled.

[00:14:58] Erika Bugaj: and so I, I see that on the horizon.

[00:15:01] Jen Politis: Yeah, I think something that, um, something I did, I, I wish I knew beforehand is when I was in your place and I had to slowly start hiring people in internally for different positions. I wish I just did trial and error. I wish I just like. Gave people a stipend to like, try this role on, let's see how this is for three months or six months, and didn't set things in stone. So if that's any, if that can help anyone out there, because I definitely felt like, okay, now I have to give them this, this position. And you know what it, it's trial and error for them too. Hey, is this a good role for you? Do you like this? Because sometimes too, people wanna please us, so they're like, oh, I'll do it.

[00:15:44] Jen Politis: And then maybe they aren't even really fullheartedly, you know, interested in it.

[00:15:49] Colleen Long: Totally. I think that's such a good tip, is doing a trial. So I'm hiring a practice manager right now for my, uh, practice out here in California and. Uh, her thing is I'm not doing, like, I'm not like you're hired and now you get PTO and here's your salary and here's your health insurance. It's 90 days.

[00:16:15] Colleen Long: That's the trial. Every 30 days we check in, we make sure she's hitting these KPIs, and I set those KPIs for her at the outset and we have actual quantitative metrics that she's gonna hit. And then if she does that after 90 days, she's the right fit, right. But you can have all of these interviews and everybody can tell you exactly what you wanna hear.

[00:16:37] Colleen Long: They're gonna tee up all of their references for you. So, so they sound great, but you really don't know if somebody's gonna work until they work.

[00:16:44] Jen Politis: You don't.

[00:16:45] Erika Bugaj: It is true. It's so true. I've gotten more, let's see, accountable or I've, I've created more accountability on those intro numbers, like the initial 90 day period. Um, also delaying some of the big ticket item benefits till. kick in and that's to, you know, safeguard the finances of the practice. Um, a lot of people told me along the way, oh, start off with all these systems, have them in place and.

[00:17:16] Erika Bugaj: Sure I received tons of mentorship and coaching around systems and people gave me what they used. But I think there is also a need to do it for yourself and see what works in your particular practice. And even if I started out with a number of systems, I had to take time to really figure out what works for this particular practice in terms of return on.

[00:17:42] Erika Bugaj: Um, commitments that people are making to be full-time versus part-time, you know, those sorts of things.

[00:17:49] Jen Politis: Absolutely Erica and I think so often what we. You know, in terms of systems, like you can have everything in order and you can do X, Y, and Z and you're gonna change it 5,000 times. So I always felt like you don't even need it all together in the beginning. At first, you just need like one or two things, you know, working well, and then you just kind of keep readjusting.

[00:18:15] Erika Bugaj: I've heard. I've heard it said, test and pivot. Test and

[00:18:18] Erika Bugaj: pivot,

[00:18:19] Erika Bugaj: which is a nicer way of saying, throw it at the wall and see what sticks. Which is my, which is my mantra.

[00:18:26] Jen Politis: like joke around. I'm like, I'm constantly doing a needs assessment on the practice all the time.

[00:18:32] Erika Bugaj: Totally.

[00:18:33] Jen Politis: Yeah.

[00:18:33] Colleen Long: So what about some red flags when our listeners are thinking about, you know, if they wanna scale or they wanna grow, that sort of thing. What are some signs that maybe you're scaling is gonna backfire?

[00:18:50] Erika Bugaj: I think offering too many. Benefits or perks upfront and not let, not giving the, the employees or the therapist the chance to show their capabilities in terms of caseload, building retention, you know, following practice rules, guidance, you know, uh, standards, metrics, things like that.

[00:19:16] Colleen Long: Yeah. When you, when you say that, I think about like the, um, like parenting principles that we teach people about, which is like, it's like the difference between being like the nice parent or the authoritative parent, right? It's like you, your kids don't feel great with no rules and no boundaries, and just give them everything that they want.

[00:19:38] Colleen Long: They actually feel better and have less anxiety if they know, if they have predictability, structure, routine. There's consequences for bad behaviors and not to compare your employees to your kids. But there is a parallel to that I think, where um, it doesn't feel like a real business or a real job to some people if we're just, they're coming in and we're like, yeah, so like, just check in whenever you want and just like, here's a bunch of money and like vibes.

[00:20:08] Colleen Long: You know, like you wanna, you wanna be like, this is what I expect of you and I'm gonna check in with you in two weeks and we're gonna make sure that that was hit. And if it's not, we need to talk about how we pivot.

[00:20:19] Jen Politis: For a while in the beginning, I didn't set clear expectations for staff, and then I would be upset that like notes weren't done within a timely fashion, and it was so hard to backtrack to get that in place. Whereas if you set that expectation, obviously we've all learned this, but from the beginning. Then it's like it's just done.

[00:20:37] Jen Politis: And you know, the new hires are just following protocol. It makes things so much easier. I think something for me is that I wish, I think some, uh, practice owners feel the need to like look to see what everyone else is doing, and then they add different services.

[00:20:53] Colleen Long: Mm-hmm.

[00:20:54] Jen Politis: I just hear it from everyone in just conversations with them like, well, this practice now is doing med management, now they're doing testing and I'm gonna do testing now.

[00:21:02] Jen Politis: And I just wish people would put blinders on and like, stop looking to see what people around you are doing and just solely focus on like your practice and what you're doing because. I just think, you know, things will be just more aligned and they'll fit in with your model and how things work in your practice.

[00:21:20] Jen Politis: Instead of adding an extra service line of something and not even having everything all together.

[00:21:26] Colleen Long: Yeah. I hear a lot about people like buying buildings, and I always think of Michael Scott in the office of like the first rule of businesses. You need a building.

[00:21:35] Jen Politis: Yeah.

[00:21:36] Erika Bugaj: I've heard this too, a lot.

[00:21:40] Colleen Long: It's like, I dunno if that's true anymore in, in telehealth practice. Like I ha I, if I had money to put on it. I would say probably 60 to 70% of all therapy sessions are conducted via telehealth these days. What do you guys think?

[00:21:56] Erika Bugaj: Well, I have therapists operating on a hybrid basis, so they all split their caseloads and. For each individual, I'd say there's plenty of interest in face-to-face. I am in, in a city that is, you know, has public transportation and is walkability. Um, so I'd say we do have de like strong demand and almost all of our offices are, are full with in-person clients right now.

[00:22:25] Erika Bugaj: But we also have the virtual component and so folks are doing half their time at from their home office. Um, so. I see it as split, though. I definitely think there is a big trend and desire for, for virtual. I find it challenging

[00:22:43] Colleen Long: dc.

[00:22:44] Erika Bugaj: yeah. Yeah. I find it challenging as a therapist who was trained and started off in person to fully make that transition.

[00:22:55] Erika Bugaj: But you know, the times are changing.

[00:22:59] Colleen Long: Yeah. What about you, Jen? Are you, you're in, uh, New Jersey, right?

[00:23:03] Jen Politis: So we're in New Jersey. Yeah. We have, uh, you know, our Hoboken in Montclair location, they're more urban and you know, people walk around, there's trains. So overall, all three of the locations though, we're mostly in person. People have a hybrid schedule and they might have a virtual day or they might. Flip flop between having a client be late and switch on, um, you know, switch to do telehealth. But I think overall in the industry, I would think you're right with those numbers. It's just my practice isn't at that. My practice is definitely more in person.

[00:23:37] Colleen Long: Yeah, so we're in Massachusetts in California, and I had, I hired sort of a more old school therapist that was very much used to the in-person model and I don't actually think had the technical capability to do telehealth. So we started saying to clients, if you want in person, we have someone for that.

[00:24:00] Colleen Long: And most people did not take us up on our offer. Most people were wanting that telehealth and

[00:24:05] Jen Politis: for both Massachusetts and California?

[00:24:08] Colleen Long: yeah. Yes. But it's also important to note that my practice. Is primarily testing. It's not therapy, right? So I think there maybe is more of a demand for in-person therapy when you're like building a relationship.

[00:24:24] Colleen Long: But when people come to us, they're wanting a diagnosis, they're wanting treatment recommendations, they're not necessarily looking for that long-term therapeutic relationship. And because there's so many fly by night testing. Uh, platforms that will report that they can do it online. I think they think their whole experience is to be virtual.

[00:24:42] Colleen Long: But for that second appointment, the, the actual testing that takes like four to six hours, everybody has to come in for that.

[00:24:48] Erika Bugaj: I would also add that as a psychodynamically trained therapist, there's, you know, a lot of folks in, in that school that think there might be something lost in a virtual interaction. Something you can't capture, like the essence of the person that, you know, you get a lot of it. On video, but you don't necessarily get it all.

[00:25:11] Erika Bugaj: And I feel like very much like I'm straddling, you know, those generations both. I see the value of in-person therapy and I think I'm able to do my best work as a therapist that way, but I also can understand the demand for virtual and why that may work better in our current times.

[00:25:34] Colleen Long: Yeah. Well, and I mean, psychodynamic I think is one, uh, pool for the in-person, but also just. Neurobiologically, we have mirror neurons, right? And so I, I do think being in the presence of other humans is medicine. And there's something that is lost when you're via telehealth, even though just, you know, interacting with you guys.

[00:26:01] Colleen Long: Uh, and I'm always virtual and online these days. There is a, I do feel a, a human reset still. But I think there's probably something that's deeper at the biological level when you're in person with other people that's also healing.

[00:26:16] Jen Politis: Right. I also think about the industry and I wonder with everything, with TE AI and technology will things, will that actually help our field in years to come where it's kind of like, let's get back to the basics of being in person and social interactions.

[00:26:31] Colleen Long: Yeah, for sure. I see that. Um, I was watching the. Today's show the other day, and they were showing this lady who does Pilates and it's like Rise, rise in something. It's in Chicago. She does it on the beach and it's for free.

[00:26:47] Erika Bugaj: I saw that. Yeah, it looks awesome.

[00:26:51] Colleen Long: it looks so, so cool. And I swear probably five years ago I would've been like, no thanks.

[00:26:56] Colleen Long: I'll just do my Pilates from home, being the introvert that I am, but. Now I do notice that extra sort of craving for just being around people because you don't necessarily have to in today's day and age, and her class is a, a testament to that. It's like the number of people, I mean it's in the hundreds now that show up on the shores of Chicago in the morning to do this Pilates.

[00:27:23] Colleen Long: And really I think it's for the human connection of all being in community. With other people. So yeah, I definitely don't think that AI will be able to replace the mirror neurons. Um, but yeah, I definitely think it can help.

[00:27:39] Colleen Long: Um, when I think about red flags, for me, one thing that I hope can be a takeaway from today's episode is the difference between qualitative versus quantitative. Uh, methods of measuring success and as a clinician, I used to speak in all qualitative terms, like, um, you know, I just feel such a strong sense of connection from them.

[00:28:11] Colleen Long: And my EVP would say, Colleen, that I'm just so impressed with this team synergy. And that would be my check-in would be this team synergy. Was, I was like, all right, everybody's doing good. EVP hired successful synergy, and then the biller quit on day two, and the practice manager then quit on week three, and it was not matching up with the qualitative check-ins that I was having with my now second in command.

[00:28:44] Colleen Long: Um, she was so impressed with everyone's synergy, yet there nobody had synergy. Everybody was going the other direction. And that was my first gut check where I was like, this I think is about to go horribly wrong. and I couldn't put my finger on it. At the time. I was like, something's not matching up.

[00:29:07] Colleen Long: Our cash flow's down. Uh, we're really struggling now to make payroll, which we've never done in years past. And yet my second in command is telling me everybody's vibing, and she's so impressed. And I started to look at what was going on in the company. We had two front office people who were in charge of intake, registration, patient, eligibility checks and that sort of thing.

[00:29:38] Colleen Long: And on RingCentral it showed 87% of our calls were going unanswered. These people were billing us a hundred hours per per pay period. So not only were we paying them a normal salary, we were paying them overtime, and they were just texting, texting, texting. Nobody was picking up the phone. Uh, and I think that's a generational thing, but.

[00:30:03] Colleen Long: Patients, especially parents, want to hear from a human that this is an actual practice and that this is like not some fly-by-night scam operation, that they're actually gonna take their kid to someplace that is, you know, licensed clinicians and nobody was answering the phone. Meanwhile, we were getting raped over the coals, WebMD health grades.

[00:30:24] Colleen Long: It was like nobody here picks up. I don't know if this is a real operation, like heart sinking type of feeling when you read that about your business. And, it was too late at that point. We had, our reputation had been wrecked by our front end and not only our reputation, but the registration was inaccurate.

[00:30:44] Colleen Long: So if you're not getting patients accurate billing details, you're not gonna get paid on the back end. And insurance companies love it when you've got one number off, sorry, untimely filing. So not only were we, our reputation was suffering. Our cashflow. We were hemorrhaging money, paying these people to do things that weren't moving the needle, and, uh, providing services for patients that weren't gonna get paid.

[00:31:11] Colleen Long: Um, so, you know, I learned a hard lesson really quickly, which was you need to figure out what moves the needle in your practice. Cash is king and. Really quickly, who's moving that needle and who's just wasting time?

[00:31:30] Jen Politis: So in terms of green flags of sustainable scaling, what are some, what's one scaling decision both of you did that actually gave you more freedom?

[00:31:42] Colleen Long: For me, I think, uh, it was going back to that 2000 and what was it, 2014 was when I read Four Hour Work Week by Tim Ferriss and it was, uh, talking about outsourcing the things that can be better outsourced to someone else. And at the time I remember just thinking. There's no way I can afford a practice manager.

[00:32:12] Colleen Long: Like I can't, I can barely afford myself. There's no way I can afford a practice manager or a biller like that's for big medical practices. So I started off with just one person that I hired on an hourly rate, I think it was like 20 bucks an hour. I was like, can you just like answer some phones for me and like take their copay?

[00:32:31] Colleen Long: And she and I over seven years built. A very rickety sailboat that sailed very well, but only she knew how to sail it.

[00:32:47] Jen Politis: Right.

[00:32:47] Colleen Long: So she sort of built the infrastructure of the practice operations, the billing, all of that. And I just kind of let her go. I was like, you're doing it. Like good job, girl. But the problem was she held all the keys to the kingdom and uh, was somewhat emotionally toxic.

[00:33:06] Colleen Long: And, um, and so it didn't, it, it didn't work for a larger organization as we tried to scale a, a person that makes everybody else feel like they're doing a terrible job every single day was just a culture cancer, and that was who she was. Um, and as we started to scale, accountability increased as it does.

[00:33:29] Colleen Long: And, um, a lot of the o the OGs of the operation did not like that. So, um. You know, it, it did quadruple our practice. The first move when, in, when I hired her. And that would be like the green flag for me is taking some of your tasks that are just like busy work that you're like, why I, why am I doing this?

[00:33:50] Colleen Long: Like somebody else knows how to do this better and outsourcing that. Um, I think that's your first step is getting all of that off your plate.

[00:33:58] Jen Politis: And I think Colleen, that's such a big step, like to do it. The first time I remember feeling like so hesitant and like I was micromanaging. But really when you take that first step, it's huge.

[00:34:10] Colleen Long: Mm-hmm.

[00:34:11] Jen Politis: How about you, Erica?

[00:34:12] Erika Bugaj: Well, you know, some of the first steps that I've taken have been to outsource the insurance billing, which I did for my myself many years, uh, to identify the staff member who could take on the internship coordinator role. And, you know, I did essentially what you shared, which is. Pay them a bit more hourly to do the administrative tasks related to that, uh, job.

[00:34:41] Erika Bugaj: And then I also have hopes of perhaps hiring a clinical director and maybe a director of operations, um, internally. Um, I can also say that one of my fails has been taking great, what I perceive to be great clinicians and making them, Clinical supervisors for interns. You know, I think I've seen folks give it their all, but not really have the experience or training or investment in order to really do that job well.

[00:35:16] Erika Bugaj: So I've noticed that after a year or after one academic year, I've had a couple folks step back from that and say, Hey, this really isn't for me, and. That's the best kind of test and pivot, right? When people identify that it's not for them. Um, but I won't stop trying, I won't, I won't stop offering that opportunity for growth.

[00:35:43] Erika Bugaj: so those are some of my experiences.

[00:35:45] Colleen Long: Yeah, I, I would also say that sometimes life will hand you lemonade and you think it's lemons. And I remember, uh, after I'd hired my first practice manager, I was like, oh my God, why didn't I do this sooner? Like, this is amazing. Like, just first off, just not to have to be on the phone with insurance companies was amazing.

[00:36:08] Colleen Long: But, um, I remember CMS, so Center for Medicaid cut our rates. So psychologist rates for administration, test administration was like, I don't know, like 120 bucks an hour on average. And they cut it to $30 an hour. And I thought, well, there goes my entire business. And I was losing my shit. I was on, I was reaching out to the a PA, the president, I was, you know, like, we're gonna change this.

[00:36:48] Colleen Long: And I was getting fired up in all the groups. Losing my mind, losing sleep. And actually what happened outta that is that my business quadrupled because with that came along the ability to hire a psychometrist. So no longer did only a psychologist be the person that could administer testing. They allowed you to hire a.

[00:37:12] Colleen Long: And really what they were doing is facilitating that model that doctors have used for such a long time. Physicians have PAs, they have nps, and so it allows them to be in multiple places at once with their license. That's what that rule did for us, and it immediately allowed me to scale. let's go into the next piece here. Uh, anybody else wanna say anything else about green flags of scaling before we move into frameworks and filters?

[00:37:40] Erika Bugaj: start

[00:37:41] Jen Politis: Maybe you just start Colleen with the framework.

[00:37:44] Colleen Long: Okay. All right, so let's talk about when we make a growth decision, what. Is one filter or framework that you guys might be used to make that decision to know that it's the next best step?

[00:37:59] Erika Bugaj: quarter

[00:37:59] Jen Politis: me, every quarter I literally print out a list of every service we offer and I calculate out what we're actually making after expenses. So I'll look at all the insurance companies exactly what we're making,

[00:38:12] Erika Bugaj: if something is,

[00:38:14] Jen Politis: if something is.

[00:38:15] Erika Bugaj: you know.

[00:38:16] Jen Politis: You know, just not making sense. Like we had one insurance payer that I was like, we can't take this anymore.

[00:38:22] Jen Politis: This is just, I don't know, I was paying like $30 a session outta network. It was just like, we, it doesn't make sense. I'm paying my clinicians more, so

[00:38:31] Erika Bugaj: what to call that, but I,

[00:38:33] Jen Politis: I don't know what to call that, but I, I kind of always say like, I do a little needs assessment, but literally I just look through all the numbers, the list, and I analyze.

[00:38:42] Erika Bugaj: as many of the numbers as I

[00:38:43] Jen Politis: As many of the numbers as I can, and I'm not a math person to begin with, but I think I just over time have learned that I have to focus on the numbers. So I just try to, I even analyze by location. I just try to look at the numbers from every possible angle to make sure that I'm not missing anything. Because I think at the end of the day, if you're not make, if it's not making you money or it's not making you happy, I feel like it's just costing you, you know, a lot in both.

[00:39:12] Erika Bugaj: Something I'm looking at right now is really, um, making my onboarding. Process more solid and thinking about what I need to communicate upfront to each clinician before they start to help them to get ahead of the curve. Because otherwise I find it's a, you know, I don't, I don't mind at all the Slack messages and outreaches, and I'm always willing to coach and answer questions and help and support, but I'd like to minimize that.

[00:39:48] Erika Bugaj: Drain on my time and give them the tools they need to from the start. Another way I'm implementing that is giving each clinician an onboarding buddy, someone who knows the ropes, who can, you know, answer some of those questions and, and give them insight based on their, you know, previous tenure with the practice.

[00:40:09] Jen Politis: That's great, Erica. 'cause then they can at least, you know, go to the mentor to ask some questions so it doesn't all fall on you. Yeah. How about you, Colleen?

[00:40:20] Colleen Long: For me when making the decision to say yes to anything, it's, there's two filters. One is, does it give me more time? And two, does it gimme more joy

[00:40:33] Jen Politis: Right.

[00:40:34] Colleen Long: and. In business. I think the third filter is obviously, does it make more money? Right? Does it make sense? Is there an ROI on this move? And um, I think before I was just sort of shooting from the hip, I was like, Hmm, I will add medication management.

[00:40:49] Colleen Long: I'll add another therapist. Like just kind of like saying yes to everything because that's just sort of the nature of who I am. But I. Read Essentialism. And I'm really along this track of like, sometimes there's more power in the no than there is in the Yes. Um, and there's only so much time right? In life.

[00:41:12] Colleen Long: And so you gotta figure out what you wanna do and then sort of laser focus in on that piece. And so, um, actually this weekend. I always like, I have a million business ideas. That's never the problem. It's too much execution and analysis paralysis. So just sort of being paralyzed by all the things I've said yes to.

[00:41:33] Colleen Long: So, uh, my family and I, we went to San Diego and we did like one of those like indoor skydiving things. Uh, I fly and super fun and of course my mind goes immediately to, we're gonna open this thing, we're gonna open this thing up in Orange County and franchise it. Birthday parties. All of a sudden my, I'm like ing ting ting and it's not cheap.

[00:41:55] Colleen Long: It's like $400 for a family of five just to do two minutes of indoor skydiving.

[00:42:00] Jen Politis: we actually did it a few years ago. Yeah.

[00:42:02] Colleen Long: y yeah, so it's a gr I'm like, this is fantastic. Um, and so I am like fully like into crunching the numbers at a Padres game on what it's like to uh, open up an I fly in Orange County. And my husband of course, is just at this point, he's like, he doesn't even like flinch when I'm talking about open up a business.

[00:42:23] Colleen Long: 'cause he's so, I mean I have 47 different domains, so he's like, okay, what are we doing now? Um, but I use AI now to figure out what the next best move is and AI really helps me like trim the fat. So I'll say, alright, so I either have this California practice, I'm gonna scale. Which is essentially what I did with the Massachusetts one before I sold it.

[00:42:46] Colleen Long: Do I do that? Do I do a get ready with me on TikTok and leverage my expertise as a psychologist, giving them tips? Is there a niche in that? Do I do wellness products? Do I do, uh, this podcast? Do I do, you know, so I've got a million different things. Uh, and it will say, here's the numbers. It does like a swat.

[00:43:11] Colleen Long: It costs $2 million to get a wind tunnel for iFLY, you have to have $2 million in just, just for the tunnel and then another 2 million just for the infrastructure. So I was like, okay, well that's out ' cause I don't have $4 million. but uh, TikTok, you gotta do four to eight tiktoks a day for your, for you to get above the rest in your niche category.

[00:43:36] Colleen Long: And it's starting to diminish in returns in terms of, uh, creators on TikTok versus YouTube shorts. So that is what is helping me now figure out the lowest hanging fruits. And ai, of course, goes your lowest hanging fruit is your practice in California, because you've already got the infrastructure, you have the license, not nobody else has like a license to do testing.

[00:43:59] Colleen Long: You've got the insurance contracts. That's the first thing that you do. And so. Um, that has been a really helpful tool for me in scaling and is understanding the numbers first before I just like act on a feeling.

[00:44:13] Jen Politis: Yeah. And Colleen, I do that too now. I mean, I'm sure you do Erica too, but I really am utilizing Chat, GPT or any of those other platforms to really help hone in and almost get all of my ideas in the right place. But just like you said, to kind of analyze like, what are my next steps and. How do I look at this from all angles?

[00:44:32] Colleen Long: Yeah. okay. Erica, you wanna lead us in on the last, uh, listener first steps?

[00:44:38] Erika Bugaj: Sure. So something that I did in my practice that really helped to, you know. Align my activities was to have a mission and um, to set up a mission statement for the practice. And it's currently under construction because this summer in our team meetings we've been talking about and workshopping our mission statement to reflect the practice as it's operating today.

[00:45:11] Erika Bugaj: But I think that setting a mission statement really can help to. You know, set your practice on track with your particular ideas and values. We also have a set of five values that we aspire to work. You know, work towards, and you know, a way that you can also incorporate this into your practices, adding the mission statement and values into your employee reviews or evaluations, you know, asking questions about that are related to values.

[00:45:46] Erika Bugaj: I also do that in the interview process to see how candidates align with. Our mission and values. So those are some tips that I have for, you know, making your work especially meaningful.

[00:46:00] Colleen Long: Well, as Erica was talking about mission and values. This is where I have like such a shame spiral. I'm like, I have no mission. I mean, like, I know that sucks to say as a clinician, but like yeah, I mean obviously you wanna help people, right? That's your mission and your values. Um, but my mission in owning a business is to make money.

[00:46:24] Colleen Long: That's my mission. And I hear that so much in our field, like our mission statement and our values. And I'm like, there must be a value to that because everybody says it. But like when my mentors go, what's your mission statement? I go to make money. Like this is a business, right? And so we need to be making money.

[00:46:50] Colleen Long: That's the mission. So what do the people want? Give the people what they need. Do it well, do it quick, do it efficient. And that has always been sort of the mentality that I've run it. Um, but I do like I. I'm envious of that piece that Erica's talking about, which is like, it genuinely does sound like for her, it starts with the mission and I think that's probably how a practice should be run.

[00:47:14] Erika Bugaj: felt that way

[00:47:15] Jen Politis: I felt that way, Colleen for a while. And then we really did narrow in on our values and our mission statement. And I will say it really helps myself and the team when we have to make a decision. Because if we're making a decision, if the decision aligns with our values, I feel like it's gearing us in the right direction.

[00:47:36] Jen Politis: Like let's just say one of ours is accountability. So if we're stuck on something and then I'm like, well, you know what, at the end of the day, we have to hold everybody accountable. So if they're not being held accountable, then it's time for them to go and that's part of our values. Do, do you know what I mean?

[00:47:54] Jen Politis: But, so for me, it's, I've looked at it that way and it's been very helpful and I think it's been very helpful. Again, when it doesn't come from me. Because I want people to lead with the same value, so I need to teach it to them, and they have to lead and make decisions based on the same that I would do in the same situation.

[00:48:12] Colleen Long: Yeah, yeah. That totally makes sense.

[00:48:14] Erika Bugaj: I think it also goes back to the challenge of running. A business that helps people. You know, the mission being yes, to help people, but also yes, a business has to make money. And I think a lot of therapists and helping folks sit at that, that intersection of dilemma about how to make that happen, how to make both happen effectively.

[00:48:40] Erika Bugaj: I know I still struggle with following my mission and you know, having. The practice continued to grow financially and to pay people well and to offer benefits. You know, it, it's an ongoing challenge and dilemma. So, um, I think both aspects are valid in, you know, for all group practice owners and practice owners to consider how to meet both the mission of helping people and making money.

[00:49:12] Jen Politis: I think most practice owners are on one are are too far over on one or too far over on the other. Right. That's what I always, it's like you gotta find that middle ground. Yeah.

[00:49:21] Erika Bugaj: tough. It's a challenge.

[00:49:23] Colleen Long: Yeah. Yeah. I would say, uh, in terms of what recommendations I would give for first Steps, it would be, um, every morning I do sort of like a mental connect and redirect with my own head. So if you like, think about Daniel Siegel's stuff of, uh, like the parenting, like connect and redirect with an emotional child.

[00:49:45] Colleen Long: That's how my brain is in the morning. It's this emotional child that has all these needs at once and it's so terminally unique and, you know, all my problems are so unique and no one has as much stress as me. And that's how my brain wakes up every morning. And then, so I just do a, a little sort of prayer and I'm like, okay, God, you're ultimately in control.

[00:50:05] Colleen Long: God is ultimately in control in, in my view. I am not the one that's making the plans here. I can think I am, but ultimately that's already set in place and we are here 4,000 weeks on average. And so at the end of the day, it's not that damn important. Whatever I think is important and the most important thing is my kids.

[00:50:29] Colleen Long: And my family and being present. And that's it really is your health and the legacy that you leave behind, right? If you wanna get in terms of how I see what my value is or what's perspective, so that first step for me every day is the mental reset that I need to have perspective on whatever's going on.

[00:50:53] Colleen Long: And as an owner, a group practice owner or business owner for any matter. You have decision fatigue every day you are faced with a hundred different decisions that you have to make. And it feels like Jesus. Like, when is this gonna stop? Like I'm tired of having to make decisions. So that little shift every morning has really helped me to be like ultimately like calling.

[00:51:19] Colleen Long: You can do whatever you want, but you're just like a little tiny ant just marching around in this world, and it doesn't really matter today whether or not your clinician's gonna quit or whatever, like, it's gonna be fine. You'll be fine. Everybody will be fine. The second thing I do is I do like a brain dump, so before I get on social media, email, text, anything like that.

[00:51:41] Colleen Long: I do a mental brain dump of everything that is sort of coming up, which is like I gotta get my son's, uh, prescription refilled. I need to set up times with my clinical director this week to make sure that we're on track with a new practice. All that's down before I even get into emails or texts because if I get into it in the email.

[00:52:02] Colleen Long: I'm immediately in this reactive place of like, oh yeah, I need to do that. Oh yeah, I need to do that. I need to get back to this person. And I haven't started with what moves the needle for me today. I'm just reacting to everybody else's needs.

[00:52:15] Jen Politis: I love that. I'm very similar to you, Colleen. I have a, a similar kind of morning routine with it. I will say in the mornings, I try to tell myself what are the three non-negotiables I have to get done today? And sometimes those things might be taking my son to the dentist and going to the grocery store, or other days it's.

[00:52:33] Jen Politis: You know, work related. Um, but I try to almost like prioritize my day and I'm trying to even do that even more so going into like when my kids are in school in September of I wanna fill my day with like more joy and more fun things. On top of the work stuff and on top of the house responsibilities and being a parent and everything else that comes with it.

[00:52:57] Jen Politis: So I don't really have an answer for that, but I do hope to like find a little bit more time to, to have a little bit more fun. what do you do for yourself, Erica, to kind of get in the right mindset of.

[00:53:11] Jen Politis: You know, have honestly, just trying to, I think also be the best you can be every day

[00:53:16] Erika Bugaj: Well,

[00:53:17] Jen Politis: and trying

[00:53:17] Erika Bugaj: Yeah, I think it's, it's, I'm sitting here taking a pause because there are just so many things, uh, in front of me every morning. It's a bit overwhelming, but I do utilize the notepad on my phone to make, uh, I have a, a long ongoing to-do list, obviously. Um, but I do also employ the, the.

[00:53:40] Erika Bugaj: You know, strategy of pulling from that list and looking at what today's priorities should be, um, and kind of, you know, realizing there are certain critical things that need to happen. In a day to get to the next day. So, um, just taking the big list and breaking it down to maybe three to five things I think is, can be really helpful.

[00:54:02] Erika Bugaj: I also take time to, you know, do the daily wordle and a couple other little, you know, fun rituals in the morning. I like poetry, so I'm reading through a book. Uh. Of, you know, a poem a day, and with that, those little activities that sort of give me a little meaning and inspiration to push me forward in the day. I love that.

[00:54:30] Jen Politis: I love that.

[00:54:31] Erika Bugaj: days I like

[00:54:32] Jen Politis: Yeah, some days I like to start my day with a quote

[00:54:34] Jen Politis: just because I feel similar to the poetry. It's like you just want something that feels good and you're aligned with, that's like bringing you into your

[00:54:41] Erika Bugaj: Yeah, for sure. And I also feel like the wordle is my investment in brain health for the future.

[00:54:47] Erika Bugaj: A little puzzle every morning. Can't hurt.

[00:54:50] Colleen Long: I was trying to find my prop here because you guys really teed it up for this. I do a bit with my family and I took my to-do list and I made it a long like Santa style scroll list. And so whenever my husband goes, well, I'm doing stuff too. I pull out the scroll as like a physical. And so whenever my kids go, Hey mom, can you get this for me?

[00:55:16] Colleen Long: I go, ho, hold. Let me just add it to my list. And it's like a bit that I do and they're like, oh my God. And everybody hates it. But I do think as women, you have to. Account for the, the mental load that you carry as well. So you've got your mom world, your, your personal life. Your business life. And then you have this mental load that you're constantly checking this list for everybody else.

[00:55:42] Colleen Long: Right? And that's this third job that I think is invisible to other people except us. And it was therapeutic for me to have that physical list now, because I'll go, oh, hold on. Let me just add that to the list. Let me see here where I can find some space.

[00:55:55] Erika Bugaj: I love that.

[00:55:57] Jen Politis: I love that.

[00:55:59] Erika Bugaj: It is so true. All the Um,

[00:56:01] Jen Politis: All the invisible emotional labor that we carry on every day. It's never ending

[00:56:07] Colleen Long: totally. Um,

[00:56:09] Jen Politis: when my kids got got older it would be less, and it's not.

[00:56:14] Colleen Long: no. Oh, no. It's, it's just different problems I feel like as kids. Yeah. As kids get older, it just becomes more psychologically complex. And when they're younger, it's more physically complex. Yeah. Yeah, yeah. Yeah. Um, Jen, you wanna bring us into the, the last segment?

[00:56:35] Jen Politis: So, okay guys, let's do one freedom fall and one freedom win takeaway for our listeners. Erica, do you wanna start?

[00:56:45] Erika Bugaj: Sure I can start. Um, well, I'll start with my win at the, be, you know, end of the summer or it is the end of the summer. At the beginning of the summer, I hired an intake coordinator for the practice and. I felt feel she really has made a difference in handling our intake process. All of the calls and emails that come in, um, it saved me a lot of time.

[00:57:11] Erika Bugaj: I just covered while she was on vacation, and it reminded me of what a heavy lift that is and how happy I am that I no longer have to do it. So that's a win, uh, a fail. I think, you know, it would probably, probably be, we have lots of sirens here this morning.

[00:57:36] Colleen Long: There's peaceful Rock Creek.

[00:57:38] Erika Bugaj: It's concerning. It's usually so quiet. Um, you know, hiring without accountability. Uh. Maybe not imparting to clinicians clearly what the expectations are for growing and managing their caseload. That kind of fits with my statement about onboarding. Just setting goals and setting expectations early on can really save a lot of work in the long run, and making sure to do those.

[00:58:10] Erika Bugaj: Initial, you know, three month or 90 day evaluations that are a guidepost for how the clinician is assimilating to the practice. You know, how the work is going, what? Always asking what they need from you. Um, I'd say that would be a potential fail. Not doing that. Colleen?

[00:58:29] Jen Politis: How about you, Colleen?

[00:58:32] Colleen Long: Well first I would just piggyback on what you're saying, Erica, which is, um. So important. And one thing that I don't think we get right when we start at least, and that was what was, uh, what was the book, Rockefeller Methods, and then they later wrote Scaling I, I forget what it was, but it was about oversight.

[00:58:55] Colleen Long: So yes, one half is putting the systems in place and the KPIs and make, and knowing what moves the needle in your practice. But the second half of that, and one that we often forget is oversight. Do you follow up on what you've asked people to do? And are they doing those things effectively? How are they managing their time?

[00:59:14] Colleen Long: How are they moving the needle? How do they work? Right? And so, uh, I just think we get so busy we're not actually, nobody's overseeing any of this stuff. Um, and so I think what you're saying, Erica, is so important, and I don't know if that's something that you came upon. Uh, if that's just naturally how you are, and that was an instinct for you, but it certainly was not for me.

[00:59:37] Colleen Long: It was something that I just had to kind of learn that hard lesson along the way. I would say a fail and a win is the fail for me was abdication versus delegation. Before I got into Vistage, I thought I was effectively. Delegating and uh, Vistage is, this is sort of like it was recommended. It's like a group of other people.

[01:00:03] Colleen Long: They might own lots of different businesses, but everybody has the same pain point. And the feedback I got was you abdicated, you didn't delegate. So as soon as I got that EVP in place, I was like, you good? Cool. Went on summer break with my kids, was like, awesome. You got it. You got this. Yeah. Vibe, synergy, and then.

[01:00:26] Colleen Long: Uh, we had the cashflow issue and, and I realized she was focusing on our font and our logo. Meanwhile, nobody's answering our phones, you know, like nobody was billing, right? And so I didn't effectively delegate. I just abdicated. And so that's the, the first piece I think is understanding the difference between those two is a big win.

[01:00:51] Colleen Long: And that was the win for me, is it was. That was arguably one of the more difficult times in my entire life was what happened in the last year, um, going into six figures of debt to keep my clinicians paid while trying to figure out why, why insurance wasn't paying us, and literally having my house on the line.

[01:01:13] Colleen Long: And then clinicians coming after me, like thinking I'm somehow like holding their money. Um, my reputation, everything. It was really a hard, hard year, but. In that past year, I learned more ironically about operating a business than I ever did in the $50,000 I invested in Second Command and EO and Vistage, like on, like boots on the ground in the muck was where I learned the, the best lessons was in this

[01:01:47] Erika Bugaj: I wa I was about to say that, uh, Colleen is anything I think I do well now it's from doing it not well, doing it poorly or mistakes I've made. I

[01:01:58] Jen Politis: So true.

[01:01:59] Erika Bugaj: that's the only way I've really learned the way that things can go better is by making mistakes and, um. I, you know, obviously there's always regret and a a wish that I could have known, but in reality, I think any business owner or operator is going to realize that you learn from making mistakes

[01:02:23] Colleen Long: Yeah.

[01:02:24] Erika Bugaj: you're gonna

[01:02:25] Colleen Long: Yeah, you can

[01:02:25] Jen Politis: you're gonna take everything that you learned for the one business and pour it into the other business, and I'm sure it will be extremely successful.

[01:02:34] Colleen Long: Well, I can give you an example. Just the trauma of being blind to my p and l for so long in the Massachusetts practice and what that caused for my family, for my mental health, for my sanity. Now in my California practice, I'm like on it like a hawk, you know? And I might be like a couple hundred dollars in, in the wrong direction, but not six figures, right?

[01:03:03] Colleen Long: Like it will never get there again, because I've got that. Hunger now or that, that propensity to make sure that I'm, that I'm monitoring that. So, yeah, I mean, I think it's so easy to read these things and be like, yeah, of course. Like you put in KPIs and you monitor them and oversight, and you read it and you hear it, and you're like, yeah.

[01:03:21] Colleen Long: But sometimes the, the hardest lessons learned are the ones that you never forget.

[01:03:26] Jen Politis: Right.

[01:03:28] Erika Bugaj: For me, my biggest

[01:03:29] Jen Politis: For me, my biggest freedom, I would say fail, was when we had the insurance callback of 300 k. I wasn't prepared.

[01:03:39] Erika Bugaj: I wasn't prepared as

[01:03:40] Jen Politis: I wasn't prepared as a business owner. I didn't really even think at that point that I needed three to six months payroll saved up. Naively, I should have realized that. I just never thought, wow, I, I need to have all this extra money set aside in case of a bad day.

[01:03:57] Erika Bugaj: So for me, that

[01:03:58] Jen Politis: So for me, that experience taught me, okay, I need to be prepared for anything that could happen in my business.

[01:04:06] Erika Bugaj: my business

[01:04:07] Jen Politis: What if my business shuts down and I still have these three leases, like I need money set aside.

[01:04:13] Erika Bugaj: that was probably

[01:04:14] Jen Politis: that was probably definitely my biggest, you know, fail. But it has prompted me to have money set aside now instead of having to take from my personal savings.

[01:04:27] Jen Politis: Loans, if this were to happen again, at least I have the money set aside for the business to that the business can jump in and I wouldn't have to do it myself.

[01:04:38] Colleen Long: Well, and Jen, to your level of comfort, obviously, what was the clawback about? Was it one particular service line? Was it one particular clinician? Because that's a huge clawback.

[01:04:47] Jen Politis: telehealth and I don't know if I should say the insurance payer, but it's UnitedHealthcare.

[01:04:52] Colleen Long: Oh, big shocker.

[01:04:55] Erika Bugaj: Yep.

[01:04:56] Jen Politis: Yep.

[01:04:56] Jen Politis: And some of that money, not all of it, some of it was

[01:05:00] Erika Bugaj: over a long

[01:05:01] Jen Politis: paid out over a long period of time, but we never recouped it, not all of it.

[01:05:06] Colleen Long: It's not slander if it's truth.

[01:05:09] Jen Politis: Yeah. And, and trust me, we, after that happened, we thought, should we not accept this payer anymore?

[01:05:15] Colleen Long: Yeah,

[01:05:17] Erika Bugaj: Reasonable to,

[01:05:18] Colleen Long: , and now I've, I've read that some of the payers are implementing AI just to deny every third claim

[01:05:24] Jen Politis: Oh, they are? Yeah.

[01:05:25] Colleen Long: their research shows that we don't have the bandwidth to fight it. So we don't, we

[01:05:32] Jen Politis: what I wish I knew is I wish I actually hired an attorney at the time. I was so, you know, in over my head with that was the time we like were scaling the practices. We were growing so much. I had the three locations. I was so busy with all the minutia of what goes on that I should have actually taken a pause and said, wait, this is not fair. I should have hired an attorney that could have fought that for me instead of having me and my office manager and biller be resubmitting things and trying to fight

[01:06:03] Colleen Long: Yeah. Yeah. Well, did you ultimately do that or you just fought it and won?

[01:06:09] Jen Politis: we, we fought it and we did not win, but we just kept fighting it. Yeah. But I should have, I needed help. I should have just been like, I, I don't know this stuff.

[01:06:18] Jen Politis: I, I

[01:06:19] Jen Politis: needed assistance and I wish I, I had an attorney jump in and help us at the time.

[01:06:25] Colleen Long: Yeah. Well, so the, maybe that's your win. I mean, it seems like that's the common theme here is our fails are our wins in disguise. But that's one thing that it sounds like to me is a difficulty is for you, Jen, when you, when the going gets tough, you get going

[01:06:45] Jen Politis: Yeah.

[01:06:46] Colleen Long: and you're like, all right, I'll fix. I'll figure it out.

[01:06:48] Colleen Long: I'll figure it out. And you probably do most of the time, but it becomes our weakness because sometimes there's someone that's their strength is better

[01:06:58] Colleen Long: at doing that thing, which is a lawyer in that case. Right? Yeah.

[01:07:01] Jen Politis: and I think something else I do on a smaller scale that I learned was. I, I'm not a micromanager, but because I've done, I've done all the roles in the practice, there was a level of like oversight that I'm kind of always like checking in to make sure that they were doing things properly before I had the correct term of KPIs in place.

[01:07:24] Jen Politis: You know, I didn't know that at first. I was just trying to do the way that I thought that, I'm like, okay, was everybody called back in a timely fashion? All the intake calls, was this done? Was that done? And in. Uh, it was just, I, so that was another thing that I learned is I really should have paused at that time and put KPIs in or another, or another strategy to be honest, instead of me coming across as micromanaging staff. So that was something else. And then I think a win is, I learned the hard way because I am somebody who does everything myself. I learned the hard way to have other people help me, so I ended up having. Really just turning, you know, having to build leaders within the company. And I had to really, I needed their help.

[01:08:10] Jen Politis: I needed their guidance, I needed their wisdom, and I needed them to understand my vision so they could assist. So that's probably my biggest win. I.

[01:08:17] Colleen Long: That's so smart to get people from within the company that already have that. I, I think sometimes it's hard to, we take for granted the tribal knowledge that our people have having already been there and knowing how it is versus bringing in someone else that's a perceived expert in their area and.

[01:08:36] Colleen Long: Ultimately, as humans, we all wanna feel, competent. We wanna feel like we're like a, like, uh, that what we're doing is making a difference, right? And so when you're building a leader out of the people that work with you. I think you're building on career pathing, really, for them, that's building retention because they're not no longer just trading their time for money.

[01:09:03] Colleen Long: They've got skin in the game for this too. They've got a sense of competency and like I'm building this as well.

[01:09:10] Jen Politis: Yeah, and I even to this day, I try to have my leadership team check in with all of our therapists to really understand what their goals are. And so we have career mapping kind of a path already for them, if that's something they wanna do, if they wanna be supervising, if they wanna do social media, if they wanna, you know, be out there in the community and do more, um, and speak, at least we have an idea of where they wanna go.

[01:09:35] Colleen Long: Yeah. your license doesn't have to be your life sentence.

[01:09:39] Jen Politis: Scaling isn't about doing more. It's about doing the right things the right way.

[01:09:44] Erika Bugaj: next time delegation disasters and hiring heartbreaks.

[01:09:49] Colleen Long: All right, ladies. We did it. All right. I have a meeting with my new boss in five minutes. Speaking of which.

[01:09:57] Erika Bugaj: Good luck.

[01:09:58] Jen Politis: Enjoy.

Off the Chair Podcast

Scaling Without Selling Your Soul: Building a Business That Loves You Back

In this episode, we explore:

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Colleen Long, Psy.D.

Jennifer Politis, PhD, LPC

Erika Bugaj, MA, MSW, LICSW

Episode Transcript:

Scale, Sell, or Stay: How to Know What’s Next for Your Practice

Group Practice - Business Growth or Burnout Multiplied?