Are You Ready to Hire Your First Therapist?

We walk through a clear framework to know when your practice is ready to hire, from demand signals and admin bottlenecks to space constraints, lead flow, and pay structures. We share hard-won lessons so you can hire with confidence without risking your cash flow.

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Hey Physical Therapists! I'm currently writing the book Profit First for Physical Therapists and I'm looking for advanced readers. Go to www.pf4pt.com to join the waitlist and get early access. 

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King Around Here by Alex Grohl

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Why Hiring Feels Scary

SPEAKER_00 0:49

Are you thinking about hiring a therapist for your practice, but just aren't sure if it's the right time or if your business is ready? Well, you're not alone, and so we're gonna unpack that today. My name is Craig, and I'm the owner of Daisy Financial Coaching. Our team is on a mission to make your therapy practice permanently profitable. If you own a solo or group practice, we're here to help you build a business that creates more time, makes more money, and serves more people. This is the Therapy Business Podcast. I remember when I hired my first employee, uh, it was honestly long overdue. I was terrified. When I started my business, I genuinely had no intention of managing a team of people. I don't think my brain could comprehend anything beyond just self-employed. I was a teacher for so long, just working in the classroom, collecting a paycheck, and then I decided I'm gonna do this scary thing of venturing out on my own, starting my own business. And genuinely, I was like, if I could just make enough the same amount as I was making in the classroom, I'll be thrilled. I'll just be my own boss, things will be great. Well, it worked, and I got to that point, and then I surpassed that point. And there was probably a couple of years where I should have hired somebody, but I just was too scared. I was getting in my own way, I wasn't sure if the timing was right, and so I put it off. And when I finally did hire, it ended up being the best decision I've made in my business. And I wish I would have done it sooner. I wish I would have known exactly when my business was ready, and I could have taken advantage of that. And who knows where I'd be today. Now, I'm not gonna rehash the past. You know, I'm grateful for where I am and the path that I took to get me here, and I'm just enjoying the journey. But I don't want you to feel stuck. I don't want you to be like I was, where your time, your calendar is so full that you don't have time for the business side, you don't you're working longer hours, so you're neglecting your family life. So many things are getting in the way, and you're just kind of hitting this ceiling, this wall of revenue where you can't get over this hump. Because in the nature of your business, time is money, right? Time with clients is how you get paid. There's only so many hours in the day for you to work with clients. So outside of raising your rates, there's really not a whole lot of ways for you to generate more revenue outside of bringing in some support staff. So I want to walk through how to know if it's time to hire in your practice. Is your practice ready to bring on another therapist, another physical therapist? So let's look at this. Well, again, whether you're in a mental health therapy practice or a physical therapy practice, the same ideology applies. So let's guide through these steps.

Hitting Capacity And Demand Signals

SPEAKER_00 3:29

Number one is is there more demand than what you can handle? And I want you to be honest with yourself. This isn't like, hey, this month I've been swamped with clients that I have not been able to get to all of them. Let's go back over a stretch of time. Has it consistently been that you have a waiting list, that you're turning people away or referring people out because you just don't have capacity? I would say, are you have you consistently been 90% or more full on your caseload? Are you wishing you could pull back? Maybe you're seeing more people than you would even like to be seeing. If that's the case, is the demand higher than what you can handle? Oftentimes we get ahead of ourselves. Or again, we might have a small season of it's been really busy. Uh, so I need to go get some help because this past month has been just nuts. But then if we go back and look six months ago or three months ago, maybe you were not seeing maybe your caseload was only 60% full and you were really hurting for leads. You're like, I need to get more people in the door. We don't want to jump the gun too soon. So I like to say if you have a history, if it's consistently been for three to six months that you're at capacity, you're turning people away, you have a waiting list that's nice and long that you're just waiting to get to, that's the right time. Now, if you aren't there yet, or maybe you're just approaching that, a waiting list is a great thing to have so that when you do hire, you have a list of people that you can tap into and say, okay, we now have availability with this person. Maybe some of them have already gone and found someone else, but at least you have a short list of people who have raised their hand saying, I want to work with you and your company. So let me know when a space opens up.

When Admin Work Blocks Strategy

SPEAKER_00 5:09

So is the demand higher than what you can handle? If it is, start collecting that waiting list so that when you do bring somebody in, you can tap into it. Number two is are the day-to-day tasks preventing you from doing strategic work? Meaning, are you spending so much time in client sessions that you're barely able to get in time for the admin work? Which means that strategic work for growing the business, for marketing, for all the other pieces that you need to do in order to scale this thing, are those getting pushed to the wayside? If you are spending most of your hours seeing clients, that means you're probably scraping together time to do billing or to uh do background notes, collect paperwork, whatever it is that you're doing in the background, that you don't have time for the strategic side to think about your business and how to scale it, how to grow it, how to reach more people, how to analyze your marketing efforts, how to look at your website, all those other things that come into play, those tend to fall back because they're not time sensitive. So usually when we are swamped, that's what we're doing. Where it's it's client work first, that's what we're gonna focus on. Then it's the admin work because a lot of times that's time sensitive. I have to submit these notes in order to get reimbursed from insurance, so I have to get that done. I need to collect these co-pays or to collect this payment from this client, so I need to make sure I'm doing that in between sessions. Then the end of the day comes, you've seen eight clients or so that day, you're wiped, and you either call it a day and just don't get to the other stuff, or you bring that other stuff home and then you're neglecting your family time because you're trying to spend time doing the bigger strategic work. So if the day-to-day tasks are preventing you from getting to be strategic about your business, then yeah, it's time to get some support and some help. You don't want that's our role as the business owner. I'm not saying you shouldn't see clients. Um, you know, I would say most of the practices we work with, they want to see clients in some capacity. Me as the business owner, I used to see a lot of clients every month. And then when I started hiring, my team, they became the experts in client work, but I still want to work with clients. So I keep a small caseload, and you know, every six to 12 months, just depending on how long my clients stay with me, I will add one or two new clients just to keep it fresh. I want to stay on top of my craft. I mean, the whole reason I started this is because I love working with people and coaching people, and so I don't ever want to let that go. Although I do recognize that as a business owner, my time is not best spent primarily in coaching sessions. That for me is a small part of what I do now. It is something I like to again keep a pulse on and it fills my bucket in a sense. But I need to be spending time doing the strategic work of scaling and growing this business so I can hire more people, get them jobs, so that we as a company can serve more people, help more people. So that is so, so important. So if your day-to-day tasks are preventing

Start With An Admin Or Biller

SPEAKER_00 8:09

you from doing strategic work, it's probably time to get some help in some capacity. Which brings me on to this next piece, which is do you already have an admin person or a biller? If you don't, a lot of times that's the best place to start. So if you're deciding, do I need a therapist? Now I'm not saying you can't get both. I don't know the inner where you are in your business or the inner workings, but usually an admin of some kind is a great place to start, whether that's a virtual assistant or an in-person admin, somebody to help take things off your plate that really you have no business doing anymore. Again, that's the billing that could be calling clients to get them scheduled or to get them rescheduled, that could be calling to collect co-pays, that could be any number of back-end data entry, answering phones, responding to emails, intake, all those things can be done by somebody else. So that frees up time. What I would say is look at your day-to-day, your week. How many hours are spent with clients? How many are spent doing admin work? Usually it's more affordable to pass off a lot of that admin work, then you can turn around and start. So let's just say you're spending five hours a week on admin, five to five, 10 hours. Well, once you get somebody to take that over, now you can turn and that's five to ten more clients that you could start seeing that week, which is gonna raise revenue, which means you're gonna have more capacity, and you may not need to hire a therapist because you're going, well, now I can focus on that. So understand that if you don't have an admin yet, that could be a place to start that's still gonna raise revenue. A lot of times we look at admin workers um as, of course, huge and valuable, but because they don't have a direct ROI, and what I mean by that is they're not like a therapist who you're gonna easily be able to say, okay, I hired them. Now they're seeing X number of clients. So that's the ROI I'm seeing is I'm paying them this, they're generating this, voila, they're making me money. An admin is not usually gonna have that tangible thing that we can point to and say, look how much money this person has made the company. However, one way you can calculate this is saying, you know, how valuable is your time? If you make $100 to $150 per session, and you've been spending five to 10 hours a week working in the admin work. Well, there you go. Let's just say $100 per session, you've just saved $500 five hours. That's $500 a week that you are now recouping because you can go and see five clients, make $500 more, and there you go, direct ROI because they've taken things off your plate. They're also creating helping create systems so that when you do bring in a therapist, you now have a process, you have somebody who can help. Because let's face it, when you bring that therapist in, that means more clients, which means there's going to be even more admin work to be done. You don't want that all falling on your plate. So, an admin is a great place to start if you don't have one yet. This could be a virtual assistant, you don't need to spend a lot of money on it, depending on the nature of work. You could even look at international or you could stay in the US. Uh, you could start at just five hours a week if you want to figure out what makes sense, and you could slowly ramp it up as you need more.

Do You Have Room For Another Clinician

SPEAKER_00 11:09

All right, the next thing to think through going back to hiring a therapist is do you have the space for one? If you own an office, if you or a rent an office, I should say, if you have a space, do you have capacity for another person to see patients? Now, this doesn't necessarily mean you have to be in an office space that has multiple rooms already. So maybe it's a matter of, you know, you are only there seeing patients three days a week. And so you're going, yeah, I could find somebody. I'm there Monday, Wednesday, Friday. Maybe I could find somebody who could be there Tuesday, Thursday. Maybe I work the mornings um and they come in and do the afternoons. So maybe you're sharing a space, but it's just you find hours, they're filling in the hours that maybe you're just not available to do. Or again, if they're seeing clients and it's freeing up your time to go do other tasks, the office could be theirs. If you don't have the capacity, if you don't have the space for one, then we want to look into what does that look like? Because you're gonna need the space before you bring them in, right? Logistically speaking. Again, maybe that's the bridge is how can we share? And I recommend as best as you can, how can we share the space we currently have until they reach a caseload where we just logistically can't anymore? But start researching what's what does the next space look like? When does our current lease end? What does it look like if we need to terminate it early? A lot of these things will dictate if you're actually able to even bring somebody in. Could they be virtual only? Maybe that's the caveat here is you bring them in and they're a virtual therapist, they don't see people in person. Maybe you pivot your half of your clients to virtual. So there's a lot of ways to share that space until you are financially ready for something bigger. I would caution you against going out and getting a larger space and before you hire. The only time this could potentially make sense is

Lead Flow And Conversion Math

SPEAKER_00 12:59

if you are your lead flow is just crazy good and it's consistently generating a ton of leads that you're just turning away, and you have the excess cash to do it. So you've maybe that's you've been saving for six months to get this building. The reason is it could take time for your new therapist to ramp up. And so adding that excess expense of doubling your space that could put a hindrance on the business that could be financially devastating. What if you don't find somebody? What if it takes a long time? You find someone, they're a bad fit, you have to let them go, you have to start over. We don't want to add that excess expense on it if you can't afford it. So I would say, does it fit in your finances right now to add that space? Even if you didn't hire someone, could you afford that space? Then if that makes sense and the timing is right, maybe your release just ended. Okay, look into it if it's something you can afford. Maybe that's something you do. Otherwise, I usually recommend just sharing your current space as best as you can until very similar to what we were talking about. When your caseload is so full that you can't take anymore, that's when it's time to hire. When your office space is so full you you can't see any more people because you don't have any space for it, that might be when it's time to move on to a bigger space. All right. The next thing, and I kind of alluded to this already, but is are you generating steady leads? How will your new therapist generate leads? Are you getting them through insurance, through referral, through psychology today, through networking partners? Are you getting them doctors' offices referring to you other therapists? Are you doing content marketing? Are you getting people through Instagram? How are you generating leads? SEO, are people finding you online? What are you what's generating the most leads for you right now? I would say if you don't know your numbers, I would go back and just say, how many leads have we gotten every single month this year? On average, what are we bringing in lead-wise? And then I would look and say, how many of those are we closing? How many of those are converting into clients? Because that's going to give you a pretty good idea of how quickly your therapist could potentially fill their caseload. So if you're getting 10 leads a month and three of them are converting into clients every month, that's going to give you an idea of okay, if I'm trying to get them to X number of clients, here's how many months it could take at our current lead flow. Is that enough time? Is that going to be sustainable as I churn clients that I might need to take some on and make sure that my caseload stays at a good balance? So thinking through leads. Again, a lot of times it can be maybe you you are full and you're stressed and you're at capacity, but these are all clients you've had for years. And you've really only gotten a couple new clients this year. So you're not generating a lot of leads. It's just you're like, I'm I've had to turn some people away because I'm so full and I feel like I'm losing business. We want to see, are we generating consistent, are people consistently reaching out that you are having to turn down or put onto a waiting list? All right. And then lastly, I would recommend starting the process

Hire Before You’re Ready

SPEAKER_00 15:54

early. I was told when I made my first hire, one of the best pieces of advice I got is hire before you're ready. And that doesn't mean get out there and start paying someone before you're ready to pay them. That means start the process. If you're thinking about hiring your therapist, I would get started. And what that looks like is thinking through pay structures. What can I afford to pay them? Am I going to do a commission split, which would be a very financially easier transition into working, hiring somebody because you don't need to have the cash overhead? They're only getting paid for the clients that they're seeing. So is that how I want to do it? What's my pay structure going to be? What type of therapist do I want to hire? Do I want to go the intern route? Do I want to hire somebody who's new? Do I want to hire someone who's experienced? What am I looking for in that realm? And start really kind of going through that. What do what do I feel like is a fair pay structure? Research that we have episodes on the different pay structures. Um, and the ones we recommend are the ones that are super common. So go back through and you can listen to those of what if it is a percentage split, which percentages are common that we typically see, what could work for you? And again, depending on the if it's an intern or if it's somebody who is brand new to the field, they're gonna probably charge less for their sessions, but that in turn means they're they're gonna get paid less. So that could be a win-win for you. So looking at what's the best route to go when hiring this first one, what type of therapist do I want to hire, and then start putting your feelers out there. Start usually the best way to find therapists is referrals. So talk to their other therapists you know. Do you know of anybody who's looking to join a practice who um is looking for a job? And so just start finding people that maybe you could start the conversations with. You don't have to be ready to hire someone today before you can start interviewing them. How amazing would it be to start the interviewing process now? And then six to eight weeks from now, you are ready to hire, and you already have a pool of candidates who you've met, you've vetted, who you love, who you would love to hire that you can just reach out to and bring one of them on board. That's versus getting to a point where you are like, I need someone yesterday. Now I need to put my feelers out there and start the interviewing process. That causes rush. That means we rush through the process, we make a bad hire, it costs us money, it stresses us out, it creates a lot of issues. So starting the process before you're ready lets you take your time, allows you to, if you're gonna be posting job postings and doing interviews, to have multiple interviews with a person, to get to know them, see if they're the right fit, see if there's somebody who is okay with a slow ramp up. Because again, your first therapist typically it's gonna be a slow ramp up. It's you know, it may take them six months before they have a caseload that they would be, you know, really happy with. So, how do we ramp that up? And then one more piece of this is when I do hire them, going back kind of that pay structure piece,

Contractor Vs W‑2 Tradeoffs

SPEAKER_00 18:54

will they be contractor? Will they be WT? What do I want that to look like? Contractors are more affordable, uh, but the caveat is that you know you can't require them to go through your business only. Meaning, if a client refers somebody to them, they theoretically could go provide therapy to them on their own and keep 100% of that session fee. So just bearing that in mind, unless they're connected to insurance through your company and they're gonna be accepting insurance, then they are going, they're free to work for other people, they're free to do whatever they want versus a W-2 where they're under your umbrella. You can then say, you know, your any therapy you do needs to be through our company, but you're gonna have payroll taxes, you're gonna have other expenses tied to that. Typically, the first hire is a 1099 contractor. However, you know, decide what is best for you. What do you want? And if it's really, really important to you to make sure that first hire is a W-2, then we want to make sure that you can financially afford it because here in the States, is you are required to at least pay them minimum wage for the work they're doing. So that means if they're seeing nobody, you're still required to pay them something as they're training, as they're ramping up, as they're doing all these things. So, a lot of key pieces to bear in mind as you're thinking about it. Start that process now. If you have just begun to think about is it time? Am I ready? I'm kind of toying with this idea. Get started. Start the research process, start putting your feelers out there, start thinking through these things. And then you'll have some people again in the back burner so that when push comes to shove and you are ready to take the plunge, you already have some vetted, qualified candidates to jump into. Hiring your first hire. It's scary. It's scary. I'm not gonna lie to you. You are responsible for another person, you're responsible for another person's income. Now the finances no longer, if you make a bad financial decision in the business or if leads drop all of a sudden, it's no longer just you. It's now you have this other person. Person who's going to be affected by it too. However, like I said, one of the best decisions I ever made was hiring. Um, I've worked, I've had multiple team members, I've had for the most part

Avoid Overcommitting And Next Steps

SPEAKER_00 20:59

ones that worked out fantastically. And they've added so much value to my business, to my clients, and I would not be anywhere near where I am today had I not taken that plunge. So if you're thinking about it, I highly recommend you do it. But you want to be smart, you want to make sure it's done the right way. Because we've also taken clients where they've hired and it wasn't the right time, and it hurt them financially and it put them in a place where they overcommitted to these new clinicians that they couldn't afford. So if you are unsure, if you don't have a money system in place, then I would do that before hiring anybody because you need to make sure that the finances are stable, organized, that you're proactive with them. And so that's what we specialize in. Click on the link in the description below, talk to one of our coaches. Maybe that's the first thing you do is hire a consultant to come in to make sure that you can afford all this growth that you are just on the verge of. All right. We're rooting for you. We're here. Let us know if you have questions. You can always email us here at the podcast if you have questions about your hiring process, if you have questions about anything we talk about, dig into those episodes on the pay structure, and then we'll talk to you next week. Thanks for joining us on the Therapy

CTA And Closing

SPEAKER_00 22:04

Business Podcast. Be sure to subscribe, leave a review, and share it with a practice owner that you may know. If your practice needs help getting organized with the finances or just growing your practice, head to therapybusinesspod.com to learn how we can help.