Keep Your Best Clinicians From Leaving

We unpack why it’s normal to worry that your best therapists or PTs might leave to start their own practice, and why that fear can push owners into expensive, reactive decisions. We share practical ways to retain great team members by hiring smarter, talking openly about real business costs, and building incentives that create long-term buy-in.

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Transcript

SPEAKER_00 0:49

Have you ever worried that your team might decide to quit and go start their own practice? Maybe they have just seen everything going on in your practice or they're seeing, okay, you know, I'm working with these patients and clients and I'm getting this much. But if I were to go out and start my own practice, how much more could I possibly make? This is a common fear for practice owners that our best people might end up leaving to start their own thing. Today I want to walk you through why this is a valid fear and then some different ways that you can both keep your best team members, but also support and nurture them and overcome this fear that they might leave you. 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,

The Fear Of Team Members Leaving

SPEAKER_00 1:38

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. Hiring is tough, and the process of finding good quality therapists and PTs is it's it's a lot of work. And so when you do bring somebody on, it can be expensive, paying them for the training and getting them onboarded, and then you work to build up their patient and client load. And then there's this just fear in the back of our head that they may decide to up and quit and move and start their own practice, taking their patients or clients along with them. This is one of the most common fears that I see among practice owners as they're building and developing their team. And it's an incredibly valid fear. I mean, most likely you were that employee at one time. Uh, I maybe you you went straight from grad school to uh or getting your doctorate to jumping into your own practice and starting

Why Turnover Hurts So Much

SPEAKER_00 2:40

your own business. But most people start by working with another practice. Whether you're a physical therapist or a mental health therapist, you maybe were working for someone else for a short time or however long. And then as you were going, you decide, you know what? I think I want to go start my own thing. I want to be my own boss. Uh, I'm seeing how much we're charging per session and I'm getting paid this much, but maybe I could keep more of that. So if you were in that position and you had that thought process, I mean, the fact that you're a practice owner, at some point you had the crazy idea of starting your own practice. It became appealing to you to go do your own thing. And so, because we are that way, myself included, it's hard to think that for me. I just think that everybody thinks that way. So it's uh, I have to remind myself maybe that's not true, but if I thought that I wanted that, well then, yeah, of course, anybody's gonna want that too. And so there's this fear that if we are not careful, they're gonna go do that, and then we're gonna be starting over from square one, or we're gonna lose all their clients, or we're going to lose money from what it costs to hire and bring people on. Turnover is tiring and expensive. I mean, interviewing is such a painful process sometimes, it's long. And if we try and rush it, then we end up bringing making bad hires. So it's just this tiring, mentally exhausting experience. And then again, it's expensive. If you're hiring recruiters, or even if you just post on Indeed yourself and find somebody, the cost to have that employee until they start building their caseload high enough that they can generate an ROI is is real. You want to pay them more, but maybe you feel max maxed out. So a lot of times our instinct is to pay more. Uh, we don't want them to leave, so I'm gonna increase their pay. I'm gonna find different ways to financially incentivize them to stay. And then we put ourselves and our practice in a bind to where we are overcompensating our team. We have a whole episode on what to do if you're overpaying your team. I highly recommend going back and listening to that one if that's you, if you feel like you have just overcommitted to uh paychecks and what you can actually compensate. So we cannot. The truth is, and this is just taking a step back, is we cannot prevent people from leaving. We can't fully prevent it, I should say. There are things we can do to try and build a place where we s we retain employees, we retain the quality ones without overcommitting financially to them. But we have to understand, we have to come to terms with some people will leave, whether it's to start their own practice or for other reasons, it will happen. You are going to, if it hasn't happened yet, have an employee at some point decide to go start their own practice, and that's okay. It's okay. And I want to walk you through ways that we can prevent it or at least attempt to prevent it. But I think step one really is, or I'm gonna say step step zero, because I'm gonna go through some different uh numbered uh ideas and ways you can you can engage in this. But let's say step zero is just accepting that it's going to happen at some point. However, your whole team quitting and starting their own practice is probably unlikely. And then especially if we can implement some of these things that I'm gonna walk you through, that's gonna help mitigate it and just really retain the high quality ones because it's the high quality ones that we worry about going out and starting their own thing, right? They're our best PTs, our best therapists. We don't want them to run out and do their own thing. Uh, we want them to stay with us and continue to just be rock stars for our team and be that face for our team that's just really doing a stellar job with clients and patients. All right, let's walk through some of these ideas. And so the first thing you can do is look for PTs, look for therapists that love working with clients, but

Accepting That Some People Leave

SPEAKER_00 6:40

maybe don't love the business side of things. Maybe they don't love sales and marketing. So for me, when I was growing my team of profit coaches, uh I'm looking for people, coaches, to come in and work with business owners and help them learn how to manage the finances in a business and then help them strategize through growing their business, all these things from a business owner perspective. And when I was starting to make my first hire, I was going, okay, how am I going to find someone who's passionate about owning a business, who has a lot of knowledge and a lot of passion for it, but doesn't want to own

Hire For Love Of Client Work

SPEAKER_00 7:20

their own business. You know what I mean? Like they want to work for me, they want to be an employee for me. And so this was a fear I was struggling with. It's would they come to me? Would they get, you know, some clients feel like they really got a grasp on how to be a good profit coach and then go start their own thing because they have a love for business. What I found was that our my ideal employees are people who are fantastic at the strategy of business and all these things, but what they don't enjoy is marketing and sales for themselves. They they may not enjoy promoting and doing lead generation and prospecting and creating uh marketing content to try and generate leads. They may not enjoy the stress of trying to consistently have a lead flow coming in and being responsible for that. Maybe they love looking for ways to be more profitable and looking for ways to better price services and ways to uh grow a practice to make sure that you are paid well and that you're profitable. Maybe that's what they love doing and they don't want to have to worry about finding their own clients. They just want to work with clients and do that. So you may be looking for people who love working with patients, who love the art and the craft of therapy or physical therapy, but maybe they don't want to have that weight of generating their own patient patients or leads or whatever. And that is common. In fact, a lot of times you might find that you're hiring if you're if you own a physical therapy practice, you might find a PT who had their own practice for a while and hated it. You know, I've had clients who who owned practices, both in mental health and PTs, that decided to sell their practice and go work for somebody else because they just did not enjoy having a business. They didn't enjoy managing a team, they didn't enjoy all those aspects. And so those people do exist. You can find amazing, amazing employees who have no interest in having their own business. So this can be something you're looking for in interviews. It's uh getting to know how they feel about sales and marketing. It can be in the job description that you're looking for amazing people who'd rather spend their time pouring into their clients than they would doing admin or sales and marketing tasks. That this is what you're looking for. Really trying to craft almost like you're you're speaking to your ideal client, right? Your website and your marketing should all be speaking to your ideal client. We're speaking to your ideal employee, someone who loves the work, but they don't love the admin side or the business, businessy, the actual running the business part. So that's the first thing you can do. And this truthfully is one of the best uh reframings and things you're looking for. It's almost even just that lens as you're looking and interviewing candidates. It's does this to this, does this seem like a person who would one day want to run their own business? Now, I do want to say don't always turn those people away. If you're like, oh, I think this person wants to own their own practice. Doesn't mean you shouldn't hire them. In fact, maybe you you nurture this in them, and maybe that's something that you really hone in on if you bring them in that you're teaching them the craft of running the business. And so that that's number two is maybe you're nurturing and encouraging their dream of becoming a practice owner. And in this, either I guess here's the thing uh is if they're gonna leave and start their own practice, they're gonna do that, whether you pretend like it's not gonna happen or not. So sometimes we hold our cards so close to our chest, we're like, I don't want to teach them how to run a business because then they're gonna know how to do it, and that's gonna make them want to leave and start their own business. They're gonna do that either way. But if you don't live in fear of it, but you embrace it and you do this with all of your team, it's showing them the ins and the outs of being a practice owner. What does that look like? Helping the ones who want to do their

Teach The Business Behind The Curtain

SPEAKER_00 11:27

own thing develops that entrepreneurial spirit in them. And for the other ones who maybe aren't sure, it gives them a reality of what owning a practice actually looks like, how you spend your day, the things that you're in charge of, the budgeting aspect that you know, without you don't have to give them exact numbers, but just all these things that that you have to carry that how much of your day is actually spent providing uh treating a patient versus how much of your day is actually spent doing everything else, and what does it look like when things are stressful or when leads are down or fill in the blank? How much of and again you can do this in a way without getting into dollar specific, but how much of patient fees are you actually keeping? So uh we've there's an episode I did on sharing numbers with your team, and I go through this a little bit, but it's if a patient comes in and and let's say it's through insurance and they're paying a hundred dollars for simplicity, in uh employees' mind, sometimes they see that hundred and they think, I mean, I could go do this myself and keep that hundred. That's what I was talking about a minute ago. But if we go through the process of, okay, we make a hundred dollars. Now we had to pay for marketing to bring them in. And so the average client or patient costs X

Break Down Costs And Real Margins

SPEAKER_00 12:52

dollars to or percentage if you don't want to get into dollars. So you can say 10% of that goes into the actual acquisition of the client. Um, maybe another 10% or 20% goes into the overhead, then another percent goes into paying the uh the clinician to actually work with that person. And so how much does do you actually get to keep might boil down to 30% of it. And so framing that and kind of guiding your team through these things of here's the here's the the big picture revenue, here's what we brought in. Uh again, you can say the actual number, or you can just say of our revenue, this percentage went to employee payroll, and this percentage went to benefits, and this percentage went to uh paying for your marketing, and um, if you're if you have a psychology today profile or uh X, Y, and Z ads, all of these elements, so they can actually see wow, they're gonna do the math themselves. Out of all the money that were I would bring in, I actually don't get to keep all that, you know. And maybe it seems obvious, and probably to them a little bit of is yeah, I gotta pay for expenses, but they may not realize how much expense there is. And going through all of that, the ones who who love it and embrace it, they're gonna go. And the relationship you developed with them is gonna be really strong. And I know you care about your team, and so you don't want them to leave and fail. You're not holding holding it all in, trying to hide how to run a business because you're like that way. If they leave, they won't know what to do. No, it's I want them to succeed. You care about them. Uh, I would want that for my people. So if they leave, they've at least learned something about it. And if they many will hear what you're teaching them and decide, okay, yeah, I want no, I want no part of that. I just want to work with patients. All right. Number three is to uh kind of what I was alluding to just now, but it's just sharing the costs on top of everything. And so uh I like to do this on an individual basis sometimes. It can be part of annual reviews, it can be part of compensation discussions. Uh, it's just what parts outside of what you're paying them, what else do you cover? What softwares or licenses are you funding for them? Uh, how much do you spend on that lead generation for them? How much are you spending on billing softwares or CRMs or rent and payroll taxes, benefits, bonuses? So again, you can do this in a big picture for the whole company, the whole practice, or you can sit down with an individual and say, you know, here's uh here's how much you generated with your patient work this this year. You brought in this much to the practice. Here's how much we paid you, here's how much we spent on these other pieces. Uh, or once again, if you you can even just highlight how much you've spent if you don't want to actually show them what they brought in. But sharing those costs can be eye-opening, and it also just shows them that you are spending money on them, you're investing in them. Uh, if we don't share these things, sometimes it can get overlooked, and all they see is their paycheck, and all they're thinking about is I want more money. And this can be a picture of here's how we're investing in you and why how you're being compensated, and why we can't just double your pay or whatever that is. So sharing those numbers. And then finally, number four is just take care of them, make it a place they want to work. Uh, make it to where they don't want to leave because even the idea of, yeah, I can go maybe start my own thing and maybe make more money. Uh, well, I'm gonna say yes, long term you can make more money owning a practice. Uh, that is the the appeal of it. Freedom of time and freedom of money. So you go start your own practice. If you stick with it long enough, you can make more money. It just comes with more stress, it comes with more uh on your plate. And so making it a place where they maybe don't want to leave. Maybe you are uh I'm a believer in um coming up with bonus structures. Profit sharing is such a key element that I highly recommend doing. Uh if people have been there, if you're doing profit first in your business,

Retention With Culture And Profit Sharing

SPEAKER_00 17:00

as far as your cash flow management, you have an account, a separate checking account labeled profit. And a certain percentage of your revenue is getting allocated to that one account. So you have money set aside for that profit. And then every quarter, you're paying yourself a bonus out of that account. Well, you can include your team in on profit sharing. I do it with my team, and so at the end of the quarter, a certain percentage of what's in profit goes to me, and then a certain percentage gets allocated out to my team members, and so they are getting a cut. If we do well as a business in a quarter, they get more money. If it's a slow quarter, then their bonus is going to be less. It gives them buy-in. It's not tied to how many clients they're working with, it's not tied to how much money they're generating. It is as a whole. It's kind of one of those if the if the business is doing well, we all do well. And it gives them a little bit of ownership, a little bit of buy-in into what we're doing. And it what makes them want the practice to grow. It makes them want you to be profitable because they're gonna get a kickback from that. If the practice is profitable, then everybody wins. And the more profitable the practice is, the more everybody benefits from it. So profit sharing is a great way to compensate outside of just their traditional pay, whether it's hourly or per cli per patient or whatever that is. So taking care of them, making it a place where they don't want to leave. Ultimately, you cannot fully prevent this. People will leave, and that's okay. The sooner we embrace it, the better. But go back with your current team, start sharing, start giving them a glimpse behind the curtain of running a business. Uh find ways that you can really make it a place they want to work without just raising their pay. If you if you're underpaying them, then you may need to raise their pay. But if you are like, I want to pay them more, but I just genuinely can't, or else we're gonna be in trouble, then start seeking out different ways that you can you can do that. And then more importantly, as you're hiring new people, look through that lens. Uh, do they love working with patients and clients, but maybe don't want to do the businessy stuff? Because those are probably gonna be the sweet spot, the wheelhouse employees that you're gonna be looking for. Thanks for joining us on the Therapy 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 its finances or just growing your practice, head to therapybusinesspod dot com to learn how we can help you.