46. How to Become Redundant in Speech Therapy Private Practice

PrivateSLP

In a busy, growing speech therapy private practice, there simply isn’t enough time to make everything happen: Referrals, Faxing, Billing, Payments, Accounts Receivable, Follow Up, Service Delivery, Cleaning, Payroll, etc. That’s why the goal of every private practice owner should be redundancy. The question for every owner should be not HOW to do something, but WHO is going to take the task. In Episode 46, I answer three listener questions and then dive right into the steps to become redundant in speech therapy private practice!

In this episode:
02:10 – Helping Others Through Speech Therapy Services
03:08 – Join the All Access Community
04:10 – Welcome Three New members
05:55 – Private practice flyer
07:20 – Private practice startup budget
09:50 – Deduction of fee for every Session
13:29 – What is redundancy
16:00 – Hiring and Training Staff
19:26 – You’re not responsible for everything

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And then all of a sudden, you’re farming out your payroll and you’re marketing to other companies or people in your business so you don’t have to do it all. I mean over time I found that the biggest question of, how am I going to get this done turn into this? Who’s going to do it?

[Commercial]

Well, Hello everyone you’re listening to the Speech Therapy Private Practice StartUp Podcast. This is episode number 46. My name is Kyle Meades and I’m a Speech Pathologist since 1993. And these podcasts are designed to help you improve your business and your life one Podcast at a time.

Welcome back to the show everyone. Today is January 26, 2019 and we have well over 44,503 listeners to the show. And I’m super glad you guys are all out there getting good valuable free information and you know me I’m going to say it every single episode, “Value is what you get in the absence of money”. And these podcasts are absolutely 100 percent free for you. So, if you wouldn’t mind just go to the iOS or Android platform or Spotify platform of your choice and leave some good five-star feedback, that way other people just like you in the same boat can get the good same valuable information that you’re getting. I would appreciate if you do that.

And I would also like to welcome the new listeners to the show if this is your first episode. Welcome, if you wouldn’t mind to just start at the beginning and work your way up through all these episodes and you’ll see what we’re all talking about. We’re all talking about how to improve our lives, the quality of our lives so we can spend more time with our families and friends. And at the same time help other people get the services that they need through our clinics and our Speech therapy services. So that’s what this show is about, it’s to help you grow and scale or start your own Speech therapy private practice. And if you would like some help doing that, I have a ton of experience I’ve been doing Speech pathology work now for 26 years.

And if you want to get some access to me it’s very simple. You can always just go to privateslp.com/membership, there you’ll see two ways to work with me hand in hand. You can do the Perfect student, that’s where you come into Tucson and you can just immerse yourself in our clinic and work with me one on one. Now that’s kind of difficult for a lot of people because they just can’t leave their job and take three or four weeks to get over to Tucson. But if you would like to work with me online that seems to be the easier option for most people and that’s where you can join the online All access community and you can work with me one on one. There’s a private coaching section in there. We just recently had our first online Zoom conference there where we had members from the All Access Community and we were talking about credentialing, contracting, billing in, pay rates and reimbursement. It was just a really good quality membership meeting. And so, we just finished that and we’ve got something planned for February and that happens once every month in the All Access Community we always get together and we’ll have a live webinar. There’re also private coaching sections, there’s forums in there, there’s forums and systems everything that we use to run our Speech therapy private practice in Tucson is in there. So, if you’d like to have access to that just go to privateslp.com/membership. Also, if you would like you can always ask me a question and I’ll be more than happy to answer your questions for you.

Also, I’d like to welcome three new members to our All access community. That would be Kimberly, she’s an Occupational therapist and she joined the Speech therapy private practice – All access community, Welcome Kimberly. And also, I’d like to welcome Dana and Kristin who are both Speech pathologists. Now I want to take some time now to answer a few questions from our listeners. We recently had a listener from New York, he was wanting to place a flyer for his Speech therapy services at a local coffee shop. And his question was pretty direct. He wanted to know if that was considered solicitation or was that an advertisement. And I was actually camping with my son and his best friend whose father is an attorney. So, we were in a cabin out towards the border of Mexico, very south Arizona. We ride dirt bikes and camp in and just eating dirt and having a good old time, eaten MREs and MREs or what they give to the military for meals and they have vegetarian MREs. So, I had one of those and my son and his buddy, they had the other MREs. But we’re out there and this gentleman emailed me and, on the way to bed I was able to check my email. And of course, I spoke to the lawyer and I asked him that simple question. Now again even though I’m not a lawyer but the other guy was we are not in the state of New York. But I did get a pretty nice answer for this gentleman.

Now I know solicitation is not recommended in any state for Speech therapy services. In other words, you can’t go to a local school with a Private practice flyer, imposes flyers in the school. But if you’re in a Starbucks coffee shop or a local coffee shop and when you put your cream or your sugar in your coffee you look up and there might be a bulletin board. I don’t think there’s really anything wrong with putting a business card or a flyer on that bulletin board there. But here is what the suggestion would be and again we’re not lawyers. I’m not a lawyer. I don’t give legal advice, but my suggestion would be in a small 10 font red at the bottom of the flyer you can put, “This is an Advertisement for Speech therapy services” and I think that would do the trick. I mean in the big scheme of things I think Speech pathologist, we have to get out of that mentality where we should ask for permission. I think we shouldn’t ask for permission but ask for forgiveness later because we have to push the envelope sometimes. Again, he can’t bring a flyer and put it at the school. But if you want to leave a business card or a flyer around town, I think that’s Okay. I don’t see a problem with that. And if somebody calls you on it, you just say, “Hey, I’m sorry I didn’t know that. Show me the law and we’ll fix it”. That’s what I would do about that one.

Second question, this gentleman wanted to know about starting up his new Private practice and he wanted some sort of a dummy budget plan so he could get a good friend of his who is willing to invest into a profitable and financially healthy business. He wanted to get that going in so I just simply wanted to respond to that question as well. I never had a dummy budget plan nor I really never had a budget. I never really had a business plan of any sort. I went to the Small Business Administration and I asked for help and they really didn’t give me any direction so I just did it on my own. I made it up as I went along. I started as a Single sole provider. I did all the work, I did everything and every penny I made I saved. I ate a lot of beans; a lot of rice and I didn’t spend any money and so I had no plan or budget to try to sell anybody really anything. So, my answer would be very specific. Number one, I would not mix your friends and your business at all. Because I’ve seen and talked to many Private practice owners and I will say this that friends and money don’t mix and I have seen a lot of partnerships break up. I would actually go the more Sole proprietor or LLC PLO sea route and just be a sole owner of your own business and start that thing yourself. And every bit of money that you make you save and you live on a financial budget as far as budget of your spending habit. Just meet your basic needs, pay your rent or your mortgage or your car insurance, get your food bill paid, if you’ve got credit cards it’s another thing. If you’re in debt get out of debt before you start your business. You don’t want to do that because it just makes it more and more difficult. But just keep it slow. Keep it simple and take your time. And you won’t have to pitch anything to anybody until you do have two or three or four locations and then if you want them triple that then you can start hitting people up and the dummy budget plan you would give that person would be your profit and loss statements from your CPA, that way you can get investors. So that would be my answer to that person’s question.

A third question I received recently was about a young lady who is working as a Contractor for a business owner in her community. And she wanted to know why that person was deducting a fee for every session. She wanted to know what that fee was called. Or maybe like a referral fee would she expected it’s reasonable to request that she purchase therapy materials or assessments for her. Was she covered under her liability insurance; should she expect reimbursements for travel? And she understands that she will send her a 1099 at the end of the year. She had to pay taxes on that money that she’s paid. But she was wanting to know more about optimizing her deductions and that never exceeds her standard deduction. So, I mean in a nutshell what she’s doing she’s contracting so the person she’s working for gets a lump sum of money and pays this person per visit to see kids for Speech therapy or adults for speech therapy. That’s not a referral fee. That’s just business the person who owns that company has every right to make a profit. And you would want that company to make a profit otherwise you wouldn’t have a job. So, there’s no name for that fee, it’s not a referral fee it’s just called business. You guys when you talk to someone and you accept a job working with someone on a 1099 basis you should be clear and under the full understanding that you’re not going to receive anything but that one lump sum payment for every visit that you perform. That person would not put you under their liability insurance. They’re not going to reimburse you for travel. It’s not reasonable to ask that person who owns that company to purchase therapy materials and or assessments, I mean they could but they really shouldn’t have to because if they did all that they should just hire an employee and pay the employee taxes and just hire somebody to do that. So again, it’s nothing to be angry about. Ask someone for clarity, “Hey, we’re going to be working as a 1099 contractor position. I understand that I’m going to get X amount of dollars for every visit. I’m going to cover my own liability insurance. I’m going to have my own bag of tricks, my own assessments, my own toys I’m going to put that in my trunk of my car I’m going to drive around and I know I’m not going to be reimbursed mileage but I’m going to get a very good rate and that rate is going to be directly deposited into my checking account every two weeks. Is that right?”. And you can ask for that in writing but it all goes back to clarity. And at the end of the day, I don’t think it’s fair to go back to someone like an employer and just secretly give them a little note and say, “Hey, can you help me on reimbursements for these miles”. You should do those and ask those questions before you take a job. Get all that upfront because again you really don’t want to have any ambiguity in any business relationship. You want to be clear, upfront and honest.

So again 1099 employees of the IRS.gov website has tons of information on that. It’s just very clear. You pay your own taxes and you can itemize your deductions. And if they don’t exceed the standard deductions, that’s Okay. That’s what standard deductions are for. So, I hope that helps. And if you go back to some earlier episodes, you’ll see the expense tracker application that I used to use when I had an iPhone and that’s a great app for tracking mileage and things like that so you can help increase your itemized deductions depending on how much work you’re doing.

I hope those were helpful for you. That was three questions from three different listeners. Today, I’d like to talk about redundancy and now, what is redundancy? We all know what that means but redundancy in its simplest form that’s the state of being no longer needed or useful. And as Speech language pathologist, when we’re trained with our master’s degree and PHDs for some people, we’re really trained to help other people. We’re trained to go above and beyond to assist people, family members and their children, and people who’ve had strokes, traumatic brain injury, dysphagia, stutterers, fluency issues, we’re designed to help people. That’s why we went into this profession in the very beginning so we can help others. I think when we start helping others it’s hard to pass those tasks on to other people. That’s always known as just delegating, in it something you have to get used to in Speech therapy private practice because when you’re first starting out you’re doing everything, you’re doing all the service delivery, referrals, billing, A.R. (Accounts receivable), all the general office cleaning or the janitorial work, I.T. work, you working with printers and credit card processors, and you’re getting all the supplies, Amazon and getting that stuff done. You go into Costco, you doing all the payroll and the marketing I mean as a Sole practitioner we’re doing everything. And it could be really challenging but these systems need to be run by others as one grows so it’s not uncommon for the first thing to go would be service delivery.

I remember when I first started my own business, I wanted to have more time so I could spend with my son and take him on his class field trips. I just wanted to be a father. I’d worked my whole career working at hospitals and clinics. I had that whole hospital phone / beeper thing attached to me the electronic leash and run down to the emergency room to do dysphagia evaluations and running back up to the NICU to look at a child in the nick you or the pick you. So, I did a lot of different things in my profession and my career, but it was really bad when I wanted to have time off and I just couldn’t have it. So, my first goal in private practice was not financial it was time. And so, one of the first things I did was I hired staff I saved every single penny and I hired staff I trained an SLPA, an assistant who still works with me today she’s one of the best people in the whole wide world. She helps me on a daily basis with other things but not SLPA at all. But that was one of the first things I did was train other SLPAs how to do really good top-notch therapy and over time I was able to replace myself. I was able to be redundant as far as being a speech pathologist which freed me up to start working on my referrals and working on my billing and accounts receivable. And then over time I just simply couldn’t do it myself. So, I hired our office manager Esther and she started taking that bull by the horns and worked on driving referrals and then doing our billing and our accounts receivable. And then as we kept growing and growing, we had to have the place clean because when you’re dealing with children you’ve got all the flam, coughing, sneezing, floors, walls, handprints and the bathrooms, that’s another subject. Even in the All Access Community we talk about how much toilet paper goes into a clinic. I know people laugh about that but it’s something you need to keep in mind how much cleaning supplies do you need to run a clinic; how much soap; how much hand sanitizer; all of that stuff we discuss in the All Access community. And so there came a point in my career where I had to hire someone to help with the office cleaning. It was every other day and then it was twice a week, then every other day, then now we have cleaning personnel that come in six days a week to keep our office spotless. And then it just came to from me being the I.T. guy and working with printers, credit card processors and software. I just had to hire other people to help with this task. Even utilizing services like Amazon to get a discount where you have your Subscribe and Save application, where you’re going to need how much toilet paper every month delivered and hand sanitizer, and things like that, things that the clinic’s going to need.

And then all of a sudden, you’re farming out your payroll and you’re marketing to other companies or people in your business so you don’t have to do it all. I mean over time I found that the biggest question of, how am I going to get this done turn into this? Who’s going to do it? Because I just simply didn’t have the time and that’s not going to be me. I am growing our business and scaling our business so I can’t really stop and change a faucet or it’s the plumber’s job. Let’s just call the plumber and pay for it or when the network is going down it’s time to call the I.T. guy. Have him come look at things or when we are looking for billing and accounts receivable, I just can’t stay on the phone and argue with insurance companies. There’s only so much that I can do.

So again, your goal in private practice is to become redundant and that is the truth because you’re not responsible for everything in under the sun. You just simply can’t do it all. And so, once we realize that we’re supposed to be redundant in our own businesses you’re making progress. I mean I don’t even have an office. I’ve been kicked out, moved around as we’ve grown over the last 11 years from this place to that space to this table and now it’s funny. We had a recent audit and the lady came in and she wanted to know where some of our records were and I brought her into our private bathroom which is under lock and key. And I went to the shower stall and she was surprised to see that I had a lockbox with records in there. MIKE Absolutely. This is my spot. So, she laughed I laughed, it was awkward but, that’s the way it goes when you’re growing.
Another little side story, the Government been shut down. I think they opened up yesterday which was Friday but we’re negotiating a building and I’ve got an SBA loan. But we weren’t able to close that loan because the government shut down. So, on a side note always have a plan B for finances because you will sleep a lot better at night knowing that you’ve got a savings account or some sort of line of credit or another deal with another bank, so you can get which you need to keep your business running. And again, if I weren’t redundant in all of these things I just described above I wouldn’t have the time to go get these other things in place so I can purchase a piece of real estate for our business or so it makes sense to free up the owner’s time so we can do more for our business.

So, I hope this has been a good episode for you guys. It’s nice to be back on the mic. We’ve been gone for about six weeks traveling and having family time and just work in and growing our own business. But it’s just so fun to be back behind the microphone and I appreciate the listener base and thank you for the questions and if you ever need anything just go to privateslp.com/contact and you can always find me there. Also, if you need help with billing or credentialing, we have a billing or credentialing service with PrivateSLP you can find that at privateslp.com/billing. And as always thank you for listening.

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