When starting a speech therapy private practice, we need to have lots of hope to start (and grow) the business. Alfred Adler said, “Hope is the foundational quality of all change, and encouragement is the fuel which keeps hope alive.” In this 30th episode, I start out by answering two questions from the listening community and then continue the podcast by encouraging the listening audience to remain persistent and driven and never give up! We all have a choice: We can either choose to make the speech therapy private happen, or choose to give up.
In this episode:
01:35 – Over 22,019 listeners
03:05 – Answering a listener Email
05:06 – Keeping a separate accounting log for the business
05:35 – Tracking expenses
09:29 – Legal standpoints for speech therapy private practice
12:48 – Employees: It’s about relationships
14:18 – Old Tucson Studios
21:28 – The right way to start a speech therapy business
You know I come from the point of view that when I hire a therapist when I hire somebody to work with me not for me. Yes I own the company, we have many people who work together and we serve our patients. But I’m not just looking for someone to come into the clinic and just bill and see patients. I’m looking for relationships and I talked about that in a previous episode. It’s all about relationships. And when I make sure that I’m providing the best possible treatments speech and occupational therapy treatments for these families that come to our clinic I know I’m going to attract very good solid people because when I do the right thing good things are going to happen.[Commercial]
Well, Hello everyone! You’re listening to the Speech therapy Private practice Startup Podcast; this is episode number 30. 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 Thursday September 28 2017. And as of today we have over 22,019 listeners to the show and I’m glad you’re out there and I really hope that you’re getting good valuable free information from these podcasts because again if you’re just starting out and you just happen to find us, welcome and I hope you have a good solid pleasant private practice journey. And I’m here to help you along the way.
When I started out there wasn’t much out there on Private practice and Speech therapy private practice so I started to do a podcast and to make a lot of information available through blog posts and audio so I hope you find this information valuable. And if you do if you’re getting value out of this please go to the iTunes store or the Google Play platform and leave some five-Star feedback that way other people will find us easier and I know you guys are out there listening. As of today when I look at the geography of all of our listeners around the world for that matter the United States is at the top, then there’s Japan then Australia, the U.K, Canada, Germany, India, South Africa, Singapore; now when you break it down into states on the U.S. side we’ve got California topping then Texas, New York, Florida, Arizona, Illinois, Pennsylvania, Maryland and New Jersey. So I hope you guys are enjoying the podcast and thanks for being. Thanks for being out there and ask me these good questions so I can help other people.
And so I just received an e-mail today this morning as a matter of fact. This is from a speech pathologist. Her name is Jenna. She says, “Hi there Kyle, I’m writing with the hopes you’ll be able to offer your expertise and some professional advice. I currently work three days a week at a private school or have two kids of my own at home a two year old and a five month old. I just wanted to say congratulations Jenna. That sounds like a wonderful age. I remember my son he’s behind this wall here so he hears him screaming he’s actually playing on line with some of his buddies at school. I miss those and I cherish those years. The two year olds and the babies and the infants it’s just congratulations. She says I have been wanting for some time now to find one or two private clients just to see on a consistent basis on the side and leave my current place of employment. This would allow me to have more time at home and bring in some extra cash. I’m not looking to start a private practice or anything like that but I want to know how to go about billing for these private practice services. I’m not going to take insurances I don’t even have an LLC. So if it would be private pay only do you know how I would file this on my taxes and or I’d have to do from a legal standpoint in that.” She signs her name Jenna.
So that’s a great question and I’m going to give you some points to think about. And again I always tell people I’m not an attorney I’m not an accountant but I do work with attorneys all the time. We have a wonderful attorney here in town that we use on a regular basis. I have a CPA and a tax preparer that I meet with him on a monthly basis who looks at my books and we deal with finances all the time so I’m going to give you some pointers and just some things to think about. Now if I were you I would go ahead since you’re not going to take insurance since you want to just see a few people on the side.
I think the easiest way to do that would be just keep a separate accounting log. I’ve mentioned this on a previous podcast if you go to Privateslp.com and you look at those podcasts there at the very top there’s a link for Podcasts. There’s tons of information there’s one on payroll, there’s also another one dealing with finances and tracking your finances and what I like to use especially when I had an Apple iPhone. There’s an app out there it’s called Xpense tracker with an ‘X’, Xpense tracker. I don’t get any kickbacks at all for mentioning these things so. But it was really helpful for me early on and what that app allowed me to do is every time I got in my car when I was starting my private practice, when I went to someone’s home or when I saw a patient I would log it in there. And I would log in how much the payment was in.
What you could do as far as getting your payments at the time of service you can simply download the square app and get a free card reader or a chip reader and you could take credit card payments that way on your smartphone and just hook it up to your bank account so you could actually see someone in their home or it depending on where you see these clients you could just charge them that fee at the time of service so your patients would come to you or you go to them and you have a negotiated fee and you charge them that fee for service and once you have that fee for service you would go and open up your Xpense tracker log, put that patient’s name and date that you saw them and how much you collected at the time of service and you keep a separate log. And at the end of the year you would talk to your CPA or your accounting professional and you would say hey I have some more income right here and you give them that printout because on the Xpense tracker logs you save them and you print them out in a PDF or Excel spreadsheet format. So it’s really a great tool to have and it’s a very good way to track all of your expenses.
If you’re going to see someone in the home and community you can log your miles from your home to the client’s house and you can log and write those off depending on what your CPA or Accounting professional tells you. So again I’m not giving you that advice just some things to think about. Also I’ve got six apartments here in town I’ve had as many as 10 rental units and one time and I kept all of my expenses for those rental units on the Xpense Tracker app and I still do that today. And when I go to my yearly appointment I go to the CPA monthly. But when we do our annual filings I give her the PDF’s with all the pictures of the receipts and things like that. And I turn all that in but the Xpense Tracker app is really nice to have.
Now when you talk about legal you said specifically from a legal standpoint what I would have to do, “Yes”, Whenever you treat somebody I don’t care if you’re treating them in your home or if you have a lower office in the back of your house or if you’re going to that place in the home and community to see that patient, you want to make sure that you have insurance. So you need to really consider going to Mercer, if you go to the ASHA Website, there’s a place to get professional liability and you can also get general liability. If you have a claim against your license for malpractice, God forbid that would fall under professional liability insurance. It’s cheap. If you’re a sole practitioner you need to really think about that because you want to protect yourself. Now if you have someone coming to your location or if there’s a slip and fall or someone gets hurt on your property you need to have that insurance just in case something happens that’s called general liability. If you have access to an attorney for instance our attorney advises us on all the legal standpoints regarding insurances and things like that or you could maybe even talk to someone who just sells insurance in your area.
So those are a few things I would think about. Again that’s how you get paid is through that credit card Square app. It’s kind of expensive I think it’s 2.75 percent. But it’s convenient you’re getting paid at the time of the service. The second thing is you want to track all of those extra money coming into your bank account through the Xpense tracker application. And then three legal standpoints you want to have obviously a state license, you want to have professional liability and some general liability insurance so that’s how I would answer that question if you wanted to see a few people on the site.
Again I think having an open agreement with the families about what your fee for service is, what happens if you have this appointment the standing employment and they don’t show up. You’ve got to have some sort of agreement how you are going to get paid for no shows or late cancellation you have to have a policy for that so keep that in mind too. I had a question the other week. It was a clinic owner in the Phoenix area wanting to know how to attract and retain and hire SLPs for their clinic. And so I have a few thoughts about that as well. Now as an owner and a therapist as a speech pathologist I’m going to have 25 years of experience as an SLP here in December and I started my business as the sole provider for my business so I grew it over time. I hired people as I saw fit to meet the demands of people coming into our clinic and so I didn’t have a lot of space at first I only had one room that I went to two rooms and into three rooms and in the four rooms so I grew very slowly.
Now when someone approaches me and says how can I find SLPs to work in this office. Again I don’t know the exact situation of that Private practice but I’m assuming there’s enough work for all the therapist in that environment. So again you may just want to advertise on Craigslist. We do a lot of advertising on indeed.com. There’s also ziprecruiter I’ve heard pretty good things about ziprecruiter. There’s all kinds of private job boards out there. But again I come from the point of view that when I hire a therapist when I hire somebody to work with me not for me. Yes I own the company, we have many people who work together and we serve our patients. But I’m not just looking for someone to come into the clinic and just bill and see patients. I’m looking for relationships and I talked about that in a previous episode. It’s all about relationships. And when I make sure that I’m providing the best possible treatments speech and occupational therapy treatments for these families that come to our clinic I know I’m going to attract very good solid people because when I do the right thing good things are going to happen. So don’t forget we have to make sure that we are always doing the right thing for our patients and meeting that need and providing the best possible treatments. And I believe that it would attract other people who will want to work with you in your facility. So again there are many companies out there these big-big companies you know who they are. We’ve worked for them and I’ve talked about that in another episode. The frozen pies and working all night on the holidays at these nursing homes, not all of them but a lot of these big major companies want someone a warm body with a license to Bill-Bill-Bill and I just don’t like that.
That’s why I started my own company because I wanted to create a place where people want to come to work and who want to have fun and joke around and not have to dress up everyday or wear scrubs. I mean we don’t even have uniforms at our office I mean people walk around in jeans because we’re on the floor with kids all day. But when we want to have a uniform people go out and buy their own shirts. They bring them to us and we have those shirts embroidered for the employees so they will have something that’s comfortable for them.
So again we do things. I think a little bit different from the status quo it’s not that I’m trying to grow a business. Have so many therapists that we can see X amount of kids. No I started out as a sole provider and then I slowly hired more people to meet the demands as people came into our office so I built it slowly. So again hiring speech pathologist and hiring occupational therapists and other professionals. I think if you’re always doing the right thing you’re going to attract those people. And when you do you take care of those people as an owner. As a business owner as a manager of a clinic you want to make sure that you are taking good care and paying people on time giving them good benefits time off. I can’t wait. This is the best part of fall in our clinic. We’re all going, I think I’m getting like 55 tickets there’s a place here in Tucson called Old Tucson studios and Old Tucson studios is a very old movie set located way out in the Tucson. I think it’s the Tucson Mountains. But if you do some research if you Google ‘old Tucson studios’ you’ll see that some of the John Wayne movies even some of the episodes of Little House On The Prairie, for those of you who are over what 35 years of age like me I’m about to hit 48, but you remember some of those old school western TV shows and it was a movie set.
And every year around Halloween they opened it up and they make it into a big multiple haunted house people with chainsaws chasing you and it’s just fun. It’s the fall we like that kind of stuff. I like that kind of stuff. I have a sign up list at the clinic and 55 people. Family members husbands spouses partners we’re all going to Old Tucson and having a big night out on therapy group of Tucson. We’re going to have a good time so I’m looking forward to that. We make relationships and we’re going to have a great time. So I hope that answers your question about hiring employees for Speech therapy private practice. Again it’s all about relationships and doing the right thing all the time.
Now I wanted to talk today about persistence and dedication and just not giving up because when I look back over at the episodes this is our 30th episode and when I first started this Speech therapy private practice a podcast uploaded episode number one back in July of 2015. When I look at these episodes as a timeline and it’s kind of what’s the most popular post. It’s really interesting. The most popular post the ones that really have the most listens are transitioning to Speech therapy practice tools that every speech therapy practice owner should have, your first office, six principles for business growth, also accepting insurances, the foundations of a Speech therapy private practice really kind of the basics the pillars the concrete what’s really strong and sturdy below the Private practice to make it successful.
And so when I make a podcast for you guys I don’t do it on every third Tuesday of the month. I mean I speak when I have something to say and last night for those of you who really know me I’ve got a son he’s almost 12. He’s playing games on the other side of this wall with his buddy online and so you might hear a scream or two that’s him having a good time. And Santa Claus brought him a four-wheeler a couple of years ago. And it’s kind of a story so I’m going to tell it to you. We wore those tires out on that four-wheeler so we live way up here in the Foothills in Tucson Arizona and we kind of do some back roads and we get off the beaten path. We get dirty and have a little bit of fun. And these tires that originally came on the four-wheeler they were starting to wear down and they were getting holes in them and we put this green slime in there and it would fill it up and it was holding here.
It is time for new tires so I’ve got these four tires on line and with the help of my son we took the wheels off of the four-wheeler and we brought these tires to discount tire. Now discount tire we love discount tire it’s a phoenix company and we use them all the time. And that’s my go to company for tires. I love these guys and so I said, “Hey can you guys swap these tires off the rim and put these on”. He goes ‘Yeah’ but next time you should buy from us because we can give you a great deal. “Mike thanks. I didn’t know what Just like E-Bay”. So I get those tires, they call me at the end of the day. I went back to the office got some work done. We had a television segment on KGUN (local ABC affiliate). We did some commercials. It was really cool. I went back to pick those tires up so I could go home and put them on my sons four-wheeler so he could play and have a good time. And well they actually bent one of the rims that it was no big deal its just part of the process. They got tire number one on, they got tire number two on, tire number three the rim was bent and tire number four they stopped because they didn’t want to bend that rim too.
So one of the ladies who work with us, her dad has been in the wheel business. He recommended that I go to this place in town that services go carts and golf carts here around town so I just didn’t want to do that. I wanted to do it myself so I got online did some research and let me tell you this is not easy I mean we’ve all changed tires right. But I’m talking about breaking a tire off of a rim and then putting a new tire. This big thick black circle on a steel rim and it’s not easy but there is a tool at Harbor Freight. Now Harbor Freight for those of you who don’t know I’m a kind of a handy guy I’ve got apartments and I’ve always fix things. My dad was a plumber. I’ve got very humble beginnings. I know how to work and my dad always said if you want something done do it yourself. So that’s what I did I got on line research went to Harbor Freight and got a mini tire tool changer. Why am I telling you this? I’m going to get to the mid of the story here folks. Well this was the biggest headache. Tried to take these tires off of a rim, breaking them down, pulling this this circle that doesn’t fit. I mean you got to stretch it to make it fit because when it pops over the rim it’s got to be snug and hold air it’s got to be perfect.
And so what I did was I researched it got the tools everything that I needed came home and I said I’m going to knock this out tonight and next thing I got one done and I was tired because I was frustrated and I got angry because it wasn’t happening fast enough. I started to get really frustrated and mad because all I wanted to do was put this tire on this rim, just be done put some add in and pop-in on the four-wheeler. But I still got three more right so the next night I did another one and it’s just frustrating because let’s face it as humans I think we want things to be easy. We want things to go the right way all the time. And it was a perfect example for a podcast because it’s just like speech therapy private practice.
I have talked to many owners who want to start that private practice when they start but they stop and then they go back and get a job or they just aren’t committed to the process. And I’ve always said if this were easy everybody and their mom would be doing it. So here I am trying my best to get these tires on the rim, getting frustrated, getting tired, getting agitated just like you will be when you’re dealing with insurance companies and trying to get paid and getting prior Auth. But you still have to get it done. And here it is it’s late. I want to get this stuff ready so my son can go ride his four-wheeler. But I have to finish it. So the next night I do the third tire. And it’s just I’m getting greasy; I got grit and grime all over me. I’m frustrated, again it’s hot you just start to cool off in Arizona but it’s still hot it’s uncomfortable. But I have to keep doing it. I want to get this done I have to get it done. I have no choice. It’s just like Private practice. You’ve got to have the right tools. You’ve got to ask for help. You’ve got to get credential with insurance companies if you’re going to take insurance plans. You’ve got to have all the necessary tools, procedures, help & assistance. Everything’s got to be in order and you can’t miss a beat. So that’s why I’m telling you this story. When you want to do something you just got to do it and you can’t stop. When you open a private practice you can’t just stop and say I think I’m just going to take off today and just tell these families that I would just see him next week. You can’t do that. That’s not how business works. Because again go back and listen to those first few episodes. If you’re flaky they’ll go somewhere else these patients and families will go somewhere else.
So you have to be dedicated more so than the average person. You have to be able to handle being told no, you have to be able to handle not getting paid, and you have to have enough money saved in the bank. So when you don’t get paid you can still float your business or your house payment or your expenses or your credit card payments or your car payments or whatever payments you have. That’s why I tell people all the time. Run lean before you open those doors that Private practice or before you start your private practice make sure your debt is down. Make sure you have a little bit of a line of credit if you need it has some cash in the bank so you can make that transition. I spoke to a private practice owner recently who didn’t have enough money in the bank and then they’re borrowing money from the bank to pay their employees and I even knew one guy who was doing payday loan so he can make payday. And it was just incredible when I heard that story I’m like wow this guy’s really struggling and it hurts financially and just hurts his ego and it’s just really hard business.
It doesn’t have to be that way. It has to be thought out. You have to ask for help, you have to have the right tools; you have to have that dedication and desire and be able to manage your visits, manage your schedule, manage your prior auth, manage your payments, getting your payments, getting your collection letters out if you’re not getting paid.
It’s a big process and that’s what I help with people when they ask me for help. We coach that online www.privateslp.com/coaching, if you want more information go there and I’ll help you. So I hope this has been a good episode. You guys have answered a couple of questions. Talked about a great topic. You know how to be persistent and just knock it out and get this done. But if you need anything just let me know, reach out to me firstname.lastname@example.org, or just go to www.privateslp.com/contact, and I’m here to help you. And as always thank you for listening.