Season 2 Episode 20 | Carla Titus | Strategies for Building a Practice you can Sell

HI there creatives. Thanks so much for listening to the Creative Psychotherapist podcast.

I'm excited to share this next conversation with you.

If money is not your thing and if yours overwhelming, um, I think my next guest could really be an asset and help with that.Her name is Carla Titus and she's a fractional CFO and founder and CEO of wealth and worth within.

And in this conversation today, she shares a little bit about what we need to be thinking about in terms of, um, you know, finances in our business and some things that we can do to help prepare for selling our business.

Should we choose to do so at any time and without further ado, have a listen.

I'm your host, Raina Lombardi and I'm very excited to welcome my next guest.

To the show, her name is Carla Titus and she is a finance expert with over 15 years of combined corporate financial planning analysis strategy and online business experience.

She provides fractional CFO services and financial consulting to business owners looking to grow their business profitably. Her priorities for clients are to grow profits, have cash in the bank and pay themselves well so they can build personal wealth.

Thank you so much for being here today, Carla. I'm really excited to talk to you.

Me too. Thanks for having me. I can't wait to share all the golden nuggets. Hopefully with your audience.

Yeah. So I think probably the first question would be what is a fractional CFO?

Yeah, so we get asked this a lot. I think a lot of people are not familiar with even what a CFO chief financial officer does or is as far as the role and responsibilities of that position.

And I always like to describe it by sharing, you know, in a corporation. There's always the CEO and the CFO. We hear this a lot. People are probably aware of familiar and what it is is a partnership between the owner or the person driving the company and the financial partner that brings in the perspective on how to make best financial decisions going forward. Not just today or in the past, but really forward looking, projecting out what are the goals, how are we going to reach them? What is the plan and also making sure they were executing a monitoring on those goals as we're going along.

The other thing that I compare it to is when business owners are having money questions and they look at their accounting team, other bookkeeper, other account and they're like, should I, can I afford to hire? Should I do this thing? Can I buy this other, you know, piece of equipment I need. And they're the account in our bookie for looking at them like what I don't know like why are you asking me or like I don't have time to take your call because I have 400 other plans to attend to.

And they're just not in a position where they either have the expertise experience or skill set or even the desire to sit down with you and say, well, let's analyze that decision. Do the financial, you know, analysis required and look at the data to understand can we afford to if we can now when can we afford to how much is it cost us and what are some of the alternative to our problem that we're trying to solve which is hiring.

That we can evaluate in order for us to make progress towards the goal, which is to maybe grow the company or be more profitable or bringing more revenue. Create a new revenue straight and that is the function, the forward looking planning that a CFO is in charge of as a leader in the company and coming in at that what we call fractional role because those companies don't need a full time.

CFO yet they will one day and but they still need the leadership and the guidance and direction that an expert, you know, in the field has and we make that accessible through that fractional CFO position where you still bringing all the goodness of the leadership, the high level expertise, the planning, the proactive approach to your finances to your business at a fraction of the cost.

That's awesome. So basically it's a contract position that allows you to go in, look at the finances of the business and help provide guidance based on what they want to do. But it's not they're not paying a salary, which if they were paying a CFO salary, that would probably break the bank is a small business owner. I would imagine it wouldn't be affordable for them to hire full times the FFO with all the requirements that it takes to have someone at that level and experience.

And that's why the fractional role is so popular and much more accessible to all the small businesses out there that are trying to grow, but it really need to tap into that financial knowledge and expertise to help guide what comes next for the business and be very proactive and intentional about the decision making around finances, which I know.

Kind of comes from your gut instinct or is an afterthought, but we really want to shift that conversation to more less intentionally control the path forward and decide what is our best alternatives to evaluate. And then before we make a decision, we put it all out on the table, all the scenarios and all the options.

And then we make a decision based on the information we gather for each of the scenarios and move on that path that hopefully is more profitable and also can you know put you in a better financial situation to have stability in the business long term. Yeah, so what are some just general things that small business owners really need to be doing to make sure that their finances are in order. I think a lot of us come in as technicians were proficient and whatever it is.

We studied and we're there to execute on that, but we're not necessarily so skilled in areas of things like accounting and budgets, let's say things of that nature.

Exactly. Like you said, nobody got into business to manage the finances already accounting side of the business let alone do bookkeeping right like let's be really clear that should be the first thing your answers, the moment you can afford to do so. And we want you out of QuickBooks and into doing your business and growing the business big picture that only you can do. So back to what are the basic things you should be doing is first the books need to be close every month. I know it's tedious. I don't know what he wants to do it. It's such an affordable position to outsource and delegate out early on in your business. You should really consider bringing in a bookkeeper.

It could be a contractor. You know, that's doing that for you and closing the books. Make sure they're reconciling categorizing and sending your report every month as part of their service.

And also looking at the balance sheet to make sure there's nothing there that shouldn't be there. And if they don't know what that is, maybe as in what they're accounting background or experiences before you hire them because I find that there's a lot of bookkeepers other that maybe don't have that expertise and they really can mess up your books and they can really make it tough at tax time to not get the right. You know tax deductions if the things are done incorrectly. So that's number one. Number two is you want to be looking at those financial statements every month.

And you know, I know that some people are not good with numbers or they're like, oh my god, I don't want to look at a spreadsheet full of things that I don't understand. The things we're looking at are four key things, right? You want to look at revenue has it gone up or down from the month before has it gone up or down from the year before.

And just start to get an idea of what's happening in your business from a revenue perspective. That could be your how you bring money into the business, right? Your sales, your income, revenue, all those things are the same thing.

Then you want to understand what are your costs of services. If you have clinicians and you're paying them wages to do the work to deliver the service, you need to understand what is that cost.

And then after that cost, what is left? What is left for me to operate on that is what we call a gross margin.

And now on your gross margin will start to give you some good idea of, are you at a healthy level or you need to make some progress stores getting back to a healthy level. I see that a lot of group practices are on commission base or other types of compensation structures that are not serving them. And when we really come down to the gross margin. It's just not healthy enough for the business to survive long term and they're starting to see cash flow issues or start to feel really strapped.

Because they can grow and sustain that while still paying the staff high wages that do not also yield high results for the company. So there's got to be an alignment there. I see it often on capacity management and weekly clinical hours not being managed correctly. That is really leaking the profits out of the business and not allowing to have healthy margins. And then from there you want to look at your expenses running and operating the business total expenses. Right. What is your subscriptions costing you? What is your rent costs new utilities.

You know, if you have cleaning services for the office anything that goes into just the overhead what we call right operating expenses of the business, your admin stuff, maybe even yourself because maybe you got out of clinical work at this point and you're just an expense of your business managing the business and running it.

So understanding what is that number and again has it gone up from the month before is it down from the month before year over year, you know, just try to see some patterns in that. And you don't see like look at that many numbers to know where know your business is healthy. Finally, there should be some profit left. And if there's not that we need to do something about changing that and that's where this proactive planning really comes into play to understand what is your path forward to fix that issue. What are your action steps to get you to profitability, even if it takes one or two months. And also do you have enough cash flow to get you to the one or two months mark before you run out of money. You run out of business and that's one thing that I think a lot of group practices are not managing, you know, if you're insurance based, you know, it's going to take 30 60 days to collect on those how healthier you're receivables are they growing are your builders doing the follow up job.

You know, and if you're private pay are your clients paying you on time or did taking like 120 days to pay their invoices and do you have a process to follow up with them. Again, we want to make sure all those pieces are integrated because they all impact those for numbers revenue cost of services or cost to go so all right.

Open expenses and at the end of the day profit is left for us the owner to hopefully not just pay yourself, but also take some draw so that you can build your own personal wealth. Yeah, I think that's really important.

And I do think that it is challenging for many of us in in this particular business, one, because all of us have our own money stories that we bring along to the work.

But to I think that there's a lot of pressure in terms of accessibility and what that means in terms of fee structure and how can we command a rate that's commensurate with our education training experience, etc.

But that also meets our rising financial needs, the cost of living has gone exponentially the past few years.

And you know, most insurance companies have not raised their rates, which means that we're kind of getting squeezed as practitioners and making it difficult to really have a healthy profitable business. What are some recommendations that you have for folks that maybe they are taking insurance, the insurance refuses to negotiate and increase rates. How can they make adjustments in their business to still be able to call in the finances that they need to take care of themselves personally, but also like you're saying, you need to have a nice cushion to be able to pay bills out as you're waiting for those receivables to come in.

What are some recommendations you might have for that. Yeah, so you mentioned fee schedule. That's when we always are looking and evaluating every six to 12 months with clients to understand, are we leaving money on the table. Sometimes you'd be surprised that if you build more actually the insurance will remiss you hire for the same CPT goes that in the past they may be where and you were not worth other fee schedule reimbursement rates have changed. And we found with a client in the process of doing that that we were leaving money on the table. And so we went ahead and raised it high enough that we knew that for a few years, we'll be okay, not to revisit that because we also didn't want to have to change the fee schedule or an over again every six months.

And so we intentionally did a boost just because of that. And I think I know that money stories do play a big role in this, but just remember you went to school for how long to be, you know, an expert in your field, people are seeking your advice because they really, because you have the experience. And expertise and you put in the time to learn it and people are benefiting, you know, there's even value on the other side of this. And I also say the more that you take in from payments and insurance and people who can afford it, the more you can afford to give back out to the community by giving some provol know or reduce rate. And that is not possible if you don't have a profitable business is putting your oxygen mask on first like they say on the plane before helping others.

And the more oxygen you take in the healthier you'll be able to help everyone else, right. And so it's no different here. We want to make sure that you're profitable first that your margins are not getting squeezed. And if they are, we need to step back and analyze what is happening with each insurance. What are the rates are getting squeezed or reduce how much are we paying our therapist and do we need to make a change going forward.

This is not about this meaning your workforce either by the way, by reducing everyone's salary and then making a max Exodus in your company, but it's really understanding for them. Thanks. Hires, do we need to change the way that we compensate that's still fair that's still, you know, beneficial to them as much as it is to us as a practice and making sure that that change aligns with the margins. We want to see going forward.

And I think that's a much easier shift than trying to get your current work first to buy into a peer reduction. So like don't try that, please. And also there's ways that we can get creative maybe, you know, someone practices have been on commission base and we're trying to get them away from that to like a set rate. And we'll offer, you know, extro vacation days in exchange to changing or we'll do a bonus structure instead and moving them away from commission. So those are some things that we try and test with. We don't do it all at once. We try with one person see how that goes the more the ones that we will be more willing to change that value their time off right that like they want more vacation and we want less commission. So we tried to offer them something that they see value in an exchange we're asking for something in return.

You know, they can always say no and that's okay. We just know that we'll have to eat the margin on those hires and then the next ones we do will do something different to make sure that we're bringing the right level of margin. But

if you're not looking at your margins, immersion rates from insurance, reassessing your fee schedule. All of this is interconnected and then last but not least your receivables. Do you have 200,000 of receivables is just sitting there waiting because your claims go rejected. There's no follow up. Your billers not on top of it. You know, are you having to be behind your billers say, hey, do you submit the you read some it that you call the they get denied again. What are we doing. And also like negotiating with insurance companies and rates is something that can be done. I'm not an expert on that. So don't ask me for help with it. But I know it has been done in the right way. 

There's people out there that teach you how to do that. And then something you can evaluate to to see if there's different, you know, codes that you should be building for. I don't code so you can maybe talk on again with appropriate and where the service is being delivered. Obviously we do everything with integrity and making sure that you're getting the most out of, you know, your insurance. And again, not every medical biller is, you know, as expert as they as others might be. So just making sure that you understand and our coaching and guiding to

And that's something we do for our clients is we do work with their medical billers to understand. Okay, why are you receivables. 

So, hi, what can we do about it. Is there something missing. Do we need more follow up and really help them kind of build that process because to us is also as much an accounting process that is a medical billing process. It's a huge accounting process. Yes. It's reconciliation. Yeah. And like that really is your cash runway right there. Right. If you think about if you were to collect that at the moment you submit the claim. We probably would not be talking a lot about cash flow because you would have piles of cash to rely on and runway and time to make changes things wouldn't feel so urgent. But unfortunately, because we're at the mercy of insurance care, submitting payment.

And then if an issue happens where your claims are completely rejected and you have a hundred claims rejected at once and you don't know what's going on. You have to get on the phone with them and try to resolve it. And next, but they're holding your payment hostage until you get that result.

So if you don't have a line of credit. If you don't have that cash runway of two, three months of expenses, you might not make payroll in two weeks, right. And we've never want to see you in the position where you're having to choose between paying your own personal bills and paying your staff. Like that is not fair to anyone.

And it's not your fault either. But it happens. Unfortunately, things happen, right. Being sometimes, you know, decide to close your account for no reason or put a hold on it. Weird things happen. And what I've learned from my years of being a CFO for small businesses that we have to be prepared for a lot of things. And then when nothing goes wrong, it's great because we just have a lot of cash and other Christian and a lot of runway. And I have to worry about anything. That's true. I knock on wood. I have not had that experience, but I could see how it could easily happen.

Things come up every day that are unexpected to that might eat at your cash flow that you were an expecting to have to do emergencies and repairs or whatever might have you. And if you haven't been actively like saving before you took on other people under your wing, I could I could see how just rapidly it could become a disaster.

Yeah. And and emotionally that must take a toll on people too when they're in that situation.

Yeah, what I find with working with a lot of group practice owners is that everybody's so giving so generous and so caring for their staff that they'll bend over backwards and do anything that they need to to make sure that they're taking care of even if it means financially personally taking ahead.

And I think that we can avoid a lot of that if we were just managing our cash for preparing for scenarios where again for no fault of your own. Maybe you were put in a situation, but you know you have two or three months of expenses.

So you don't have to rush and try to solve something like an emergency fire drill. And you really have two months to figure it out and make some changes and figure out if you want to apply for a land of credit or something else that can help you whether that particular situation. And now we have time and we can breathe and we can relax and handle the situation from a position of power and control versus from a position of despair. And you know when you're looking a little despair, the pink snow like to give you money so like that's the worst time to go get on.

I know I didn't ask for anything. So having that ahead of time is going to be very beneficial even if you don't use it or top into it. A lot of my clients we set them up with one we never touch it because obviously we're good at managing their finances.

But it's there for the unexpected as you scale the business is going to take more money and more resources to get that to do the hiring. You won't see those payments for 60 90 days the higher one get fully to capacity for you know 30 60 90 days sometimes till they have a full patient load so just knowing that and kind of working through the timing, especially when you're working through hiring knowing when that's going to be. It's just going to be a piece of mind so that you can better prepare and not freak out when you're not seeing those profitable months rolling because you're stealing and it's costing a lot of money. Yeah, I'm glad that you shared that part right that like sometimes people don't realize that as you're growing things become more expensive it shifts your profitability.

I think I was definitely had better profit margins when I was a solo practitioner because I didn't have all of these additional expenses that I needed to purchase in order to manage.

Having a group right thing your rent goes up because you're in a bigger space and then you're if you're doing direct deposit will that cost money to do run payroll right there's just an expense of that there's an expense of you know making sure everybody has access to a shared. Schedule or EHR system which the more people you add on there the more expensive that is you know so things just add up really quickly.

And it makes it much harder I think to be profitable as a larger group practice and it did as a solo practice.

But there's probably things that I could learn to be more effective in this department to I would say.

Yeah, I think as you shift to group practice what happens is your profits do get tighter, but you also are you know taking out of a larger number right your revenue is growing and you might still have 10% profit but not a larger number that's 10% of and what you want to be comparing is those percentage of because as your company grows now you compare apples, apples by looking at those percentage of revenue rather than absolute dollars which we also want to look at to see you know are we making more. But ideally you have a bigger base that you're taking 10% of or 5% of and that if that continues to stick you know over a year over a year as you add more clinicians and to the practice and the bigger that 10% of profit is going to be for you as a you know net number.

And so there's benefits to scaling the practice is not easy it is expensive, but I think that on the flip side you should see more profit. The percentage again won't maybe won't change, but you should be able to see more absolute dollars as a profit total that you get to take home and you know also need to reinvest back in the business so there's a healthy balance there.And this is around the time where you know having our services or someone that's guiding the way because you finance is just called really complex there's a lot of moving pieces and as an owner maybe you don't even have the time. Let alone the energy or really like wanting to even look at it like I know that you know a lot of practice owners are just like I don't even want to look at my numbers and we don't really know what's happening so they want someone to guide the way or show the highlight real on what's happening so they still have the ownership of it, but they don't have to do all the work.

And we find that that complexity levels when we are best suited to work with a practice to come in help delegate that out you're not advocating your responsibility to know your numbers, but you at least have a guide to help you understand what's happening. Yeah, I think that's I think that's important and really helpful because like I said earlier, you know we're probably really skilled at providing the therapy, but. Most of us don't have a background in accounting or bookkeeping or business management, I some people will go back to school and get those kinds of degrees, which is awesome. But for other people, I think it's it's almost an overwhelmed thing to like it's overwhelming, I don't feel confident, I don't feel a sense of mastery here.

And therefore I'll avoid looking at it, which is, you know, not helpful, it's not a healthy relationship with the money if you're avoiding looking at it. So having somebody that has that expertise to be able to create the systems and structures in order to get the money managed in an effective way and help you interpret, okay, you do have enough money to be able to go and do this. X Y and Z thing that you want to add in your business or you don't and here's why that's really helpful. Yeah, we like to say not yet and then how can we make it possible because we don't like to tell people know they don't like it. And so what will we say is if you do this three things now is say, heck yes, let's go do it versus say, I'm concerned if you go down that route now, right.

It's like maybe three months here's what I want to see shift before we go make that decision and I think that really helps this and so on as P at ease knowing that okay, I need to go around 20% before I go higher than next person.

Right now I feel you know better about my decision. I know we're going to be a little bit healthy financially and we're not having to stress and have the sleepless nights. But also, you know, something you said around, oh, some people go back to school and get like their MBA or whatever degree to learn, well, you don't have to do that.

You can also just partner with someone who knows that they can bring that partnership and expertise to you just like you wouldn't go get a lot degree and an HR degree.

You also don't want to get a business degree. There's a lot of degrees. I know you guys love and have all the degrees probably already, but like being in that partner that also is kind of that second brain in the business that you can console with. Because I think ownership business ownership is lonely and you can't talk to your employees about your issues because you can make parallel into a week's right that's not an appropriate conversation to be having.

So who do you turn to your spouse's tire of listening to you. They probably don't really have good advice either.

Unless they have a business degree and then your friends might not understand the state of business. Your Adam might give you like advice for a different stage. Right.

And so unless you have a good support system, then who are you turning to for those questions to give you a really sound advice from a financial perspective to really make sure the business is operating in a healthy financial way.

Yeah, that's really sound advice and grounded in the reality of the situation, right. Like, yeah, we don't want to burden our employees or staff or team members with those things. And then of course, you know, we need that we need some expert information and those times. And we're probably not going to get them from our friends either.

Because they probably are an expert in our type of business. Maybe they're an expert in business, but they might not be an expert in what it means to run a private practice, which I think is a little bit different.

We have different constraints because of our ethical codes legal stuff like that. So having somebody that has a foundational understanding of what we need as as it pertains to clinical practice. And then we have this plus that expertise in the accounting area and financial area, I think is a win, win. It just I think it sets you up for better success in the future than if you're trying to just figure it all out on your own. That's for sure.

Exactly. We want to make sure you feel supportive and that you feel like you have the right information to make the right decisions in your business. And unless you love analyzing data and being spreadsheets, which we do, but might have some of you might not, then it's going to be really hard to get those insights.

Unless you're looking at your numbers, which is why we're such a big reporter enough star by looking at your number.

You know, they might be scary. They might not be perfect, but think of it as a starting point that you're going to make progress towards right. Just like when you give a patient a plan to improve on, you're starting for where they're at, right. It's not bad. It's not wrong. It's just what it is. And then you're helping them improve on that with your support. So it's no different than that is we're going to give your plan action steps problem solved with you and make sure that you have the right perspective from a financial lens to really get you to the next space of growth.

And you want to see improve for your already have. And that's really when I see a book on coming really handy. If everything's going great and you know your numbers and your cash was healthy, like you might not need us right.

So you're on a good path. We want you to be there already. But if you feel hesitant and you know that you can turn to your current team to ask the questions and nobody's really helping you with that.

Then it might be time to explore, you know, getting some support and see how back could work best for your practice, especially if you're looking to grow. That's where I see a full really.

Thrive is and really comes into help you accelerate that growth and also boy mistakes that are expensive and keep you on track. Yeah. And how can or how can and or how do you help people who not only want to grow but are looking at their business as as an asset as a financial asset, not for what it produces each week or month that it pays you. But as an asset for sale in the future, if you build your business up, it could have some valuation, which would allow you to sell and retire. How do you help people with that process?

Yeah. And what it's the right thing to me is that people think about selling when they actually want to sell.

This to be a little too late because if unless you had the right financial metrics that you were already hitting for the last two years, they're going to go pull tax returns to see what your business was doing. And if it wasn't looking very good, you're not going to get the highest value for your business and your retirement, you know, that was dropped up and maybe selling the business and making hitting that big valuation might not be there. It might just be discouraging this appointed at that point and that you have to put in maybe a couple more years to fix it.

And we don't want to see any practice owner, you know, be caught up with maybe it is even like a health situation where they can no longer run their practice or it could be a life situation where they just have to sell the practice for whatever reason. We want to get you the maximum value we can for it. So what we want to do is start a process a few years before you're ready to sell also. I just think every business owner should have the option to sell their business when they want to if a good opportunity or offer presents itself. So why wait till you're ready to sell what if someone came to you and said I'm going to give you this much and you're like wow, I never thought I could get that much for my practice. And maybe you're like sure I can go for that or like that feels great. I can go retired now and it's early than you expect there. Right. So always being ready with the right set of numbers and financially being strong is going to say you're not position of power to take on those opportunities.

But if you're just even not wanting to sell right now and you just want to have a good profitable business with a high valuation that one day down the road you want to sell in the meantime is just a cash flow machine for you printing them money printing those profits for you to create your own personal wealth in maybe buying a building or buying personal assets. And so now you leverage the profits of the business to get you the assets you need for an early retirement or even not even retired. So I think a lot of you like to work and so do I but it's a work option or more flexible work hours or maybe you peel yourself off your business as much as you possibly can because you hired a right health instructor to run the day day and you only get to do the things that are fun for you or the things that you really enjoy. 

And to me the definition of you know personal wealth is really like the owners right is it freedom is it time is it money what is it like it's it buying a bunch of real estate properties what is it and we always work with that end goal in mind and walk backwards to an action plan today that will help you map out how to achieve those goals long term and it might not happen into years it might be five years 10 years. Whatever it is maybe putting your kids to college you know whatever your goals are your business should provide the lifestyle and the results financially that you need for your life to be what you want it to be and we're really big on.

You know mapping that out together because we know that as business owners you're not just a business owner you're also a person with life goals in mind and if you have a map does how we're going to you know fairly get you started a little bit on what is the end goal for this whole thing and how do we make sure that you know that you know you're not just a business owner you're also a person with life goals in mind and if you have a map does out we're going to you know fairly get you started a little bit on what is the end goal for this whole thing and how do we make sure that you know you're not going to be a lot of money.

And how do we make sure that the profits are powering all of those dreams and goals that you have for your life and then created a plan to make sure that you're ready for it so it's much more than just adding values your company of course we're all you know about the results here too but it's also what can the business do for you.

Yeah, I think that that part is really important right like we invest so much of ourselves into this business that the business really should be working for us we shouldn't be working for the business but sometimes it gets flipped around what are some things that people like need to be need to be doing if they do want to sell their business is there.

And things that you would recommend that they start to do to prepare for that.

Yeah so a lot of what we talked about at the beginning is really some of the key financial metrics you're going to want to head and start to work towards improving that is gross margin right knowing what is left after your play your clinicians for delivering services that needs to be healthy we like to see that you know again and it's going to vary depending on this is not financial advice but you know we're happy to help you with your particular situation.

We tend to see that between like 50% gross margins maybe even higher than that on average we want to see like that healthy level you know profits if you're scaling your company between 5 and 15% on a yearly basis is what we like to see because we want to also reinvest back into what you know the growth needs to be.

And it's going to vary depending on the size of your practice right if you just going from solo to group that might look a little different because you're investing a lot and then once you have you know 10 20 clinicians under you the profitability starts to shift and it starts to get a little bit better and then then from there on you know the more you add you'll see those profits continue to stay but again it's from a much higher base so really controlling that controlling your overhead costs I see a lot of practices are just adding a lot of admin support right like.

So many people and maybe you can streamline some of that you know what another opportunity that I see people are missing is automating a lot of their workflows right so what tech tools can we pay for to help reduce that amount of hours that employees are spending doing tasks especially recurring tasks and maybe we can automate behind the scenes and then obviously we want the human touch on the front end to make sure we're converting you know increase to paid first appointments and then we can't do that.

First appointments that you know where can you introduce something to help your team say sometime in streamline and help reduce the amount of workload and also just another right processes I think sometimes we are doing things that maybe are not streamlined and there's opportunities your staff might have some ideas ask them have you seen you know where we can improve what are some things that you're noticing that we're continuing to repeat over and over again that could just be. So we're going to be able to do a automated process and they you'll be surprised how many ideas they might bring to the table.

They're really keeping those overhead expenses to the right level right for the practice as you grow and scale you'll find that you'll add more to that but really being intentional and evaluating every year are we putting the dollars to the right places like what is the allocation being very intentional about that with some of our clients we do what we call like salary cops we say the size of the team is going to cost us this much per year. And then we find a way of how we're going to fit everyone's salaries and compensation structure under that so that we know what we can afford to hire what we can afford to hire yet and maybe what's a higher for you know the future versus the now.

And a good healthy mix of like interns associates and you know so pervac is that you can have can really help your profit margin also increase so like not overlook some of those junior level positions that a lot of people need to get license on and really are looking for the hours and being able to get the supervision hours needed to get their license sure is really you know helping with that margin conversation as well so I think having like a good mix of experienced people and then more junior are really going to help you drive those margins.

But at the end of the day really think about you know that profitability is that improving over time is a stain study how our micro margins doing and then you know it's the practice growing right is the revenue increasing or we see more patients how many appointments we have how many clinical hours per week and start to evaluate those numbers that are really going to give you an insight into what else you need to be doing to continue to grow and increase the value of your practice over time.

Those are the things we evaluate and look out with our clients to make sure the things are healthy and are going in the right direction and again everything is intentional we don't do anything by you know like just because surprise like this happen now we're like we have a plan we're working towards it and we're intentionally trying to move the needle in those areas. I love that and I agree I feel like it's really important to have a system for tracking your metrics. I know a lot of people will talk about that in terms of like social media and things but I think it's more important to be looking at that in terms of what's happening in your actual business right like our how how are the calls being converted what is that look like are you losing clients.

Because the person on the phone is in saying the right thing right that alone could be a way of automation teaching people how to have those conversations that convert and encourage that client to book that first appointment even if they're a little bit hesitant.Yeah, that makes a big difference. Yeah, I find this sometimes owners really benefit from  getting on the front end of their process and getting on those calls to hear what patients have to say and like the feedback they get that gives them an opportunity to improve the process like don't overlook that right in my I know you don't probably have a lot of time but if occasionally you can jump on in a few calls and just listen to what you know patients are saying that gives you an idea of how to improve on things.

And making sure that you're definitely going to change your stuff on it and you know improving on those commercial metrics and also understand where your clients coming from like where your patients finding you because I think sometimes we invest time and money and effort on things that do not move the needle. I always say likes and comments on pay the bills we got to get calls but right we want paid patients that are in need of our services and that we're matching with our services and providing that value and solving the problem for them.

Where are they coming from are they coming from your website they're coming from your speaking engagements are they coming from local newspaper magazine ads whatever you're doing online or offline that really could yield those patients to come finding you and sometimes it is social media but just understanding which platform and where we're going to put our person how are we going to track that conversion to really understand that we have that return on investment. And I will notice activities that we're putting time towards to bring in the right patients to our practice.

Yeah, I think that that's really important for people to hear sometimes people think oh well I have to be through social media but that might not be the best way to get clients in the door.

It depends on who your population is who are you who are you serving and and then what are you doing on the social media because that part is really important what's the messaging that you're using to get people to come in the door.

I kind of look at it like it's another opportunity for visibility it's like another sign road sign out in front of the office just to let people know that work here I don't invest a ton in that to convert I'm more of a I would say in person.

Networker connecting with other people other therapists in the community and building that community network.

It's difficult sometimes because you might meet with somebody several times before you get a converted referral but I feel like it's a much more worthwhile investment of time and it's something that typically isn't going to change in the same way as like social media.

The way they change their algorithms to actually get you out in front of your potential client that's constantly changing and so that's time energy money that you're having to invest to educate yourself to figure out what that is or to pay somebody to do that for you. I don't know it feels like a lot of output for a minimal return sometimes.

Yeah, and I think this is where your data and your results are going to speak loudly on what is actually working on where you should invest more time maybe it is going to those referral doctor offices to send you all your patients and send them you know a little gift or don't answer coffee or something like you know making that connection you know that is bringing the leads that you really need to understand where are they coming from first if you're not asking that on your intake form and in your process that might be something you want incorporate right away.

And then I don't like your data how many people say you they found you on social media which social media platform you know are they giving you back what you're saying in your message are they repeating the words that you're using in your messaging that said oh I said this and then they're saying exactly those words back to me that means the message is hitting and that's why they're calling and sending up the appointment right maybe they're finding young psychology today like where are they looking for you and then how are they coming to you and that's data you have available in your business today.

And if you're not tracking it start now and then start to analyze and look at what are the trends how many people is that 80% of our people finding us through Google well, should we sing Google act right like what is it and how does it work for your specific practice and then what do you need to be doing more of that's working and then let's settle down on that let's allocate more money to it too and then see if the results increase because we put some focus or emphasis in the allocation of budget towards those activities. That's great advice.

Is there any other kind of quick win tips that you might be able to offer listeners who are trying to work on this aspect of their business to overcome some of the hesitancy and resistance to actually investing money and hiring an expert to help them with finances.Any kind of tips or guidance for that process.

Yeah, so I think that the best thing I can say is that we have been supporting your practices for a while so we do know what are like some of the pockets of areas of opportunity that we immediately can come in and make a big impact.

Our goal is to have not only our cost cover but then have you get more out of your business because you brought us in as your team to create more value that is the job of the CF was to create more value for the company and really steer that strategic plan forward looking and help you execute and stay on track on that.

So if you're having trouble doing that on your own if you're not reading your financial statements or you read them and you have no idea what they say and you need someone to interpret that I speak both therapists and accounting so I can help also be the liaison between you and your accountant and really get what we need out of that support role. You know, if you bookkeeping team as well to make sure we have the right structure to make the right decisions because that's what it comes down to with the data is your reports maybe are not being done correctly there for you don't know what they say or mean and you know something categories and things that get you know mislabeled and you're like I have no idea what was into this and then we start to explore some of those opportunities to streamline and really tell have the statement.

So that's what we need to know to make decisions and again if you're just not you know into spreadsheets or numbers and you just want a guiding light and someone who is going to come and not judge your business right you are where you are we're just here excited to make progress with you and being that partner and understanding that it might be hard for you to take that first step and we're just going to make sure that you feel taking care of along the way with compassion and care. So that's why you're business and we want to see you succeed and if you're going to bring us on or hire us to support you we want you to also have the financial results of bringing the team like this on to your business.

There's no fluff here the numbers online they will be results we will measure against them trust me I'll be the first one to put them in front of you right and say think that there's a lot of people are there offering services that maybe are not tied to the numbers of the results. So I'm very much tied to the bottom line and understand are we making a difference or not so if you're you know hoping to hire a CFO now or in the future something I want you to look out for is also what is their experience what is their expertise do they have a finance degree what is their background because I think all of that is going to help you in front to make a better decision on who you bring on to your team and trust that they know what they're talking about and do they specialize in group practices or health care are they the right CFO for you.

Because there's so many options out there and then there's a lot of people that are not qualified to give advice and don't have the education or background that are calling themselves CFO so I just always want to make sure that people are careful of that even your bookkeeper right do they have the right accounting background.

All these roles that involve money like are they the right person to you advice are they qualified do they have the expertise and then are they going to help you improve and help you through a process that they have to get you the results that you're looking for because it's really easy to spot in the first three to six months if nothing has changed because the results won't be any different right again the numbers online so you can always go back to your PNL and say they might see a folder or job.

If I had to hide from that that's great. No, that's true and that is really helpful to know that within three or six months there should be some movement to point towards the evidence of like this is effective or this is not effective and maybe we need to make an additional change or tweak to whatever it is that we're doing. That's really helpful and there've been a situation that could be as long as one year but you know you've got to be seeing some progress that's always my thought is like if you can see any progress and something might something else is happening and maybe they're you don't have the right person guiding you but if you can move the needle in six to 12 months and I'll be asking a little questions.

No, that makes sense because then you're like wasting more of your finances that you're wanting to be a better steward over and nobody wants to do that like flesh it down the toilet you know we work so hard to bring in what we do bring in that we want to make sure that when we're bringing on some money into our business that they are able to support our growth plan and and help us you know with the bottom line. Yeah and that's for every role in function right not just a CFO or finance but really like what are you getting out of your marketing team what are you in an of age or support legal team like you know we can just go and measure what is the impact on every single dollar we spend for every activity in the business and really if you don't understand that that might be

a place of opportunity that you can go evaluate what have I gone in from this teams lately and then what value are they bringing to me and my business. 

Are they we just maybe I'll grow them or we don't no longer need their support that's another way to save some money and evaluate I always say go look at what you can stop pause delay or cancel and those are the areas where you could be surprised how much of the savings we can yell our clients right away by just looking at those things you know and it could be temporary delay or pause it could be we cancel and then we realized three months later we really needed that and we put it back on maybe at the wrong level maybe we had the whole team subscribe to really need two people you know like those are the things that I want you to start looking at and really be discerning with your money because you are working hard for your money so I want you to keep as much as you can of that and I'll be just giving it away.

Because only for the right things.Yeah, definitely we don't want to give it away and I love that idea of going through each thing line by line and can I stop this do I even need this service anymore can I pause it temporarily because I'm not using it consistently or can I just you know cancel it terminated I try to do that at least once a year I have not done

that this year something that I need to do I have a few things that I want to tweak in terms of subscriptions where I know I have a subscription to one program and a subscription to another there's some duplication overlap but before I can make the switch I have to do some adjusting but doing so will save me and it's not a lot but over the course of the year that's a few hundred dollars or five years that you probably ignore the four or whatever you know however long.

 I always say maybe it's like you need to double that investment to get rid of some three other pieces of software you know I you know we're not all see if I'm not all about cutting we're just about allocating to the right places for the right amount to accelerate growth of the business right and to see the value we're always looking for ROI like I mentioned before and then making sure that you're doing that once a month this is your or once a year this is your reminder right to go through and do that and it's really about thinking strategically about your business and working on the business still instead of in the business which we do a lot day to day we know we're busy we all doing 20 different things but really come up for air look you know from the top down view.

 What I hear a lot of our clients tell us is if it wasn't for our time together I probably would never look at my numbers so if functions like a great accountability to the work clients to have the meeting to go through the numbers answer the questions and really take away whatever tasks or things we need to go work on so that what next time we meet we've actually made some progress so if that helps your audience kind of get an idea of what is like to work with us as well on why they might or you know one that consider our support in their business too Yeah, no, I think that's great and probably extraordinarily accurate having that accountability to to somebody else particularly if it's something that one's been avoiding for a long time that's that support through the process is important.

Yeah, where can people learn more about you learn more about your business and and find out more of how they could work with you and you could come on and assist them and their financial goals for their business.

Yeah, if you're looking for a fractional CFO or you're ready to outsource your finances but still we're going to hold your responsible for the results because we both do the work we take most of it away but there's still the decision making the stage for you you can check out our website at wealthworthwithin.com on the contact page you're welcome to book a free call we can have a conversation about whether or not now is the right time if we are the right support for you and can we meet your needs we're really big on what are your needs and how can we meet them from through our service.

And if we are not the right person we have a huge network of other CFOs and professionals that can help you as well if you're in a different stage than maybe we think you can benefit from a different service we do a lot of our services with integrity and honesty we just want to make sure that you all have the right support that you need not just that you buy our services right if they're not right we're going to tell you and say go somewhere else is what you need now not as yet and then come back when you're ready. So if you're ready for that go ahead and book a call on our website if you want to follow along to what we're up to as we're growing our firm as well and helping other business owners you can subscribe for our newsletter on our website again wealthworthwithin.com and if nothing else we love to put educational content and free resources on our social media at wealthworthwithin and you'll see a lot of videos where I explain a lot of this thing that I talked about go more in depth and they're sure videos because I want to make sure you get the key take away.

And then if you have follow questions you know make sure you contact us we're happy to provide you as much of the free resources as we can we just want to see businesses thriving and you know employ more people and being profitable and being here for the long term and we always want business owners to enter their business and have the business to what they need for them. I love that Carla thank you so much I'm definitely going to sign up for your newsletter for sure. I feel like I've learned I feel like I've learned so much just from listening to you share about what you do today and and how the services that you provide are really valuable.

If we're serious about growing our business getting it to its optimal healthy state profitable state and so that it can best take care of everyone ourselves but also the other folks that we have in the practice and the clients that we're serving.

So thank you so much for coming on and talking about this really important topic today.Of course things for having  me and I know I want to see more group practices how they're supporting all the mental health needs of all the patients are there that all need you so much in their life so that's what we do what we do so that we can help more through the work we do to support you all. Yeah it takes a village right like we might be doing the work of therapy but I do think that there's so many other people out there that are supporting the work of therapists through their unique lens and expertise area that you know it's a ripple effect of caring for the community so thank you so much.

Yeah thanks so much for having me.

Thanks so much for listening to this episode 20 of season two with Carla Titus I hope you enjoyed this conversation again if money is not your thing. Her services might be something to look into early love to that she will give a look at your situation and really provide some guidance on whether or not she's the right person to support you at this time like maybe first you need to do some other things before she can come in and and really help get your finances in order. Anyway I hope you enjoyed listening to this episode and we'll talk with you next week stay creative everyone.