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Lessons from Building a Multidisciplinary Practice- Webinar Transcript

Ali: That’s our official marker that we’re getting started. Good morning, everybody. Or, yes, I guess it’s morning for everybody. Maybe not if you’re in the UK. But most people we’re gonna be in the morning. This is called “Coffee with a Clinic Owner” and I still haven’t had coffee yet today, which I think is a disaster. Have you, Kendall, had coffee?

Kendall: I have my tea. I’ve got my Jane mug.

Ali: Oh. Look at you! So cute.

Kendall: I’ve got my tea.

Ali: That’s so great. Welcome to “Coffee with a Clinic Owner”. We’re gonna be talking with Kendall this morning. I’m gonna let a few more people filter in here. While you’re joining, we would love to know a little bit about you. It’s one of my favorite parts of these sessions. If you wanna, in the chat, if you see a little chat icon at the bottom of your screen, you can click it. You’ll get a chat panel. Everybody is automatically muted, yep, so you don’t have to worry about speaking, but we would love to hear a little bit about where you’re from, what discipline-

Kendall: Can we get a Jane mug?

Ali: I know, people want your Jane mug already. They’re jealous. Where you are, what discipline you are, and if you’re a solo practitioner or already part of a group? Good morning. You can switch the two to say panelists and attendees if you wanna speak to everybody that’s here. I think it’s defaulting just to panelists. So it’s a flip down in that two area. You can flip it to panelists and attendees. Oh, perfect. So people are starting to add their names, where they’re from, and whether they’re part of a solo or group practice currently. And yeah, what discipline you are is also lovely. Great. Welcome, everybody. Hi, Vanessa. Great. Kendall’s gonna kinda scroll through and read these as they come in. We’ll have to scroll back as well. Good morning. Hi, Kristy from Ottawa. Michael and a massage therapist, part of a group. Great. Welcome, everybody. There is also the Q&A area at the bottom that you’re welcome to use. We’ll do some Q&As at the end. But we’ll also take questions from the chat. If you have questions as we’re going through, feel free to add them if you have questions about anything Kendall says and you’d like to have a little bit more of an explanation about anything, add them in. Good morning, Rose from Wellington. Hello, Alison. Good morning. Okay, perfect. Hi, everybody. Nice to see you, nice to see you. Okay, I think that we, I’m sure we’ll have more people filtering in. I was gonna mention, oh, I’m Ali. I always forget to introduce myself, co-founder of Jane. We’re here with Kendall, who is the founder of Vancouver Wellness Center, which we’re both in Vancouver, but different Vancouvers.

Kendall: Yeah, very different.

Ali: I’m in Vancouver, Canada and Kendall’s in Vancouver, US. Do you say US?

Kendall: Washington state.

Ali: Yeah, you would just say Washington state. You don’t need to specify the country.

Kendall: Yeah, in this environment I would clarify US.

Ali: US, in the US of A.

Kendall: I’m sure most people were thinking Vancouver, Canada. So yes, Washington state.

Ali: Two different Vancouvers. And I think lots of great people filtering in still. So this is gonna be more of, like, just a verbal conversation. So I did wanna mention that if you wanna put in headphones, do laundry, you don’t really need to watch our faces, although you can if you want to. And I’m a big fan of doing laundry when I am listening to podcasts, ‘cause it’s the only time with three children I can get through, I never get through, who am I kidding? There is always more laundry to do. So feel free to do some of you menial tasks if you want while you’re listening. Okay, let’s get started. So Kendall, did you wanna start by just introducing yourself maybe a little bit and telling us a bit of your story and where you come from?

Kendall: Yeah. So I’m Kendall Hagensen. Like Ali said, I am the owner, I created Vancouver Wellness Studio in Vancouver, Washington, in the US. First, I really wanna thank Ali for having me. But also for creating Jane, because we are so grateful that we found Jane. We have been looking for a system like this for years. We are Jane’s biggest fan. And I’m just so appreciative to you for-

Ali: Oh, thank you. Okay. You’re making me uncomfortable. Let’s move on.

Kendall: Okay, so I’m Kendall. So I’m a somatic psychotherapist and trauma therapist. I work mostly with clients who have chronic pain and medical issues, medical illnesses and medical trauma. So our team here at Vancouver Wellness Studio, we’re a multi-disciplinary team, so we have everything from mental health, to nutrition, and fitness training, massage therapy, Chinese medicine, acupuncture, naturopathic medicine. We have a movement studio here. So before COVID, we had a lot of classes. Meditation, dance, yoga, all the things.

Ali: You were a dancer, weren’t you? You were a dancer?

Kendall: Yes. So I’m a dance movement therapist as well, but I grew up as a dancer, and danced in college.

Ali: I love it.

Kendall: Yes. The reason we’re actually called Vancouver Wellness Studio and we have studio in our name is because I felt it was so important to have movement, and creativity, and community as part of the collaborative holistic wellness offering. And so we do have an actual studio space here and movement is very important to us. And then I also provide business coaching to wellness professionals and those who are creating and expanding wellness centers. So that’s what I do in my day-to-day right now.

Ali: How did you get onto this collaborative care sort of style? Why is this something that’s so important to you?

Kendall: Yeah. So I’ll take it way back. Ali’s heard my story. Some of you might have heard my story, but I’ll take it back to the beginning and why it’s so important for me to have this collaborative approach and for our community. So way back when I was in high school age, my mom had been living with MS for several years. Multiple sclerosis, if you haven’t heard of it. Most people just say MS. And so at that point, when I was graduating from high school, there was, like, a graduation project to graduate out of high school. And so I wanted to do something to help my mom, basically. And so I decided for my project that we were gonna do a dance production. And I was a dancer at the time. And so we put on this production and raised money. And then there’s a paper that goes along with it. And so at the time, I had been dancing a lot and I just felt like movement was very healing to me, so I decided, okay, I’m gonna research the healing properties of movement for this paper. And through that, I discovered that there is an actual field of dance movement therapy. And I was just blown away by this option of, like, what I could be as a professional to blend movement, and psychology, and helping people. So I really set on this path. Like, okay, I wanna be a dance movement therapist. I wanna help people with chronic illnesses. So fast forward to college and then I started having my own issues with MS, actually, and was diagnosed as a junior is college. So at that point, I was really hit in the face with the dysfunction of our medical system in the US. And I don’t know how it is in Canada. I don’t know the true experience there of the medical system, but here in the US, it’s built for emergencies, which I’m so grateful for. But it’s not built for preventative care and it’s not built for chronic illness. So I started to really explore alternative medicine at that point. And I built my own little care team around myself. And that was the first time I ever tried acupuncture, and massage, and those sorts of things. And I received great care. And it was a good experience. But I realized that those providers still weren’t communicating with each other and they weren’t in the same location. So it was still a very exhausting experience for me to go-

Ali: To advocate for yourself.

Kendall: It’s just continuous, right?

Ali: Yeah, yeah.

Kendall: So at that point, I started envisioning a place where people could come where if they’re seeing one person on our team, or the whole team, that they just feel that wrap around support. They feel the collaborative care and that we are really working together on their behalf and that we’re all in the same location. So I started really envisioning that. And I took that with me as I went to graduate school and put my focus there. And I have two daughters. When my older daughter was one, I decided, like, okay, it’s time to go for it and try to bring this vision to life. And so in January of 2016, I started looking for the team, and spaces, and we opened in September of 2016.

Ali: I love it. I love that you come from that patient perspective, that client perspective. So you are your own customer, which is best way to start a business. Same as Jane, that’s how Jane started. I was my own customer, solving my own problem. And it’s really interesting the perspective that that gives you because you know. You know what it’s like to advocate for yourself through the system and what it’s like to have a team of people caring for you. So I like talking about that so much. I love that we’re talking about the hiring part, too. That’s super fascinating, especially for people that are maybe thinking about adding disciplines for the first time, or even that are maybe thinking of expanding their discipline base. How do you decide what disciplines you wanna bring in? And then, where do you find them? How do you make that decision on who should be part of your team?

Kendall: Yeah. So as far as deciding the disciplines, I think that comes back to your own vision. So my encouragement with anyone I work with in this realm is like, we have to get so clear on the vision first and your why. Why are you even doing this? Because it’s a lot of work to be a business owner, it’s a lot of work to be in this field. And it’s a lot of relationships, right? What we do is all about relationships. It’s all about relationships. And people. So we have to know why we’re doing it and what makes most sense in our vision. So as far as choosing providers, you wanna make sure that’s in line with what you picture. So if you really want to serve families and young kids, those are gonna be, maybe different providers. Obviously they need to have a pediatric specialty. But for that part of center, you can bring in modalities like speech therapy, physical therapy, occupational therapy, naturopaths who are also pediatricians. There are tons of chiropractors who specialize in perinatal and working with babies. So there’s that whole realm. For us, I had experienced enough of the modalities myself to know, like, okay, this is what makes a lot of sense for people with chronic illnesses and autoimmune diseases and things like that. And then over time it has shifted. And I’ve learned that it’s more about the people and less about the modality. So there was a point where I felt like, okay, it has to be exactly balanced with one person from each modality, or we can’t be too heavy on mental health, or too heavy on naturopathic medicine. And then I realized, we still try to keep the balance as much as possible, but it’s more about the practitioner. When I come across a practitioner who comes to me, like, this’ll happen pretty often where someone will reach out to me, we’re not even hiring, someone will reach out to me and say, like, oh my gosh, like, this is it. This is where I wanna work. This is the place that I’ve imagined being. Like, this is how I wanna work, this is how I wanna serve people. And I typically give them a chance and then I end up hiring them because they’re so passionate about what we’re doing. And that’s what makes it work. So there’s other things to consider, like, logistically, like noise, for example. So in our space, like chiropractic with the drop table doesn’t work because it’s loud. And so we’ve tried it in the past and it’s like, it just doesn’t work because we’re trying to do massage therapy in the next room or whatever it is. So there’s certain things like that, over time, that you’ll learn, like, don’t go well together. Yeah.

Ali: Yeah. I’ve had that experience, too, with massage therapists working in a physical therapy clinic. And we’re like, they have to be massage therapists that are doing sports massage or that are comfortable with it. Their clientele are not gonna get, like, a relaxing, quiet environment, because the physical, like, they’re not quiet. So yeah, it’s interesting. I was thinking about that with writing even job postings. I have to do that a lot for Jane for hiring. I’ve had to do that for the practices. And I was actually just writing one for my clinic, Canopy, which I didn’t mention at the beginning. I also have an integrated healthcare clinic called Canopy. And one of the things that I’ve learned by running clinics and by visiting clinics, and talking to clinic owners is that every clinic is very, very unique. And so when you’re writing your job posting, so many people just write, like, I need a physiotherapist. But that describes what the person does. It doesn’t describe anything about you and your heart and what kind of person is gonna fit well into your practice. And so I’ve actually really recommend people think about more flipping job descriptions to describe really the heart of their practice. So that’s kind of what you were saying. Like, they have to align with the heart of your clinic. So what do you offer at your practice? So you have to be a team player, obviously, if you’re gonna work with you. We work in collaborative care. And so really describing the practice environment even more than what it is you’re looking for. I mean, most of our practitioners will be in regulated professions. So, like, you have to have a degree, or you have to have a qualification. But beyond that-

Kendall: Well, that’s what I tell coaching clients, because they’ll say, like, big hot topic question all the time, how do I find people to hire? And it’s like, we have to weave in your company values into your job posting. We put our mission, we put our values. And I am very, over time, I’ve gotten much more specific and detailed in the job posting to say, like, this is really what we’re looking for. And you have to be so passionate about collaborative healthcare, because we do things a bit differently. We meet every single week as a whole team. We discuss cases with permission, of course. We support each other personally and professionally. Our team, we are all very, very good friends. We have a lot of dual relationships, we see each other for services, not for psychotherapy, but for other services, and we do that well. We’ve practiced that a lot. But it’s a learning curve for new providers who come in because oftentimes we’re not used to spending sort of that extra time with your work family, really, on behalf of patients. And so it’s something that’s very important to us when we’re looking, that that person values that time.

Ali: Well, let’s talk about that. I’ve had a few experiences with that where I’ve attempted to organize, as a younger manager of a practice, years ago, trying to organize social events for the team, and people are just too busy, or they can’t, they have young families, and it can be really challenging to get people, in their off work time, get together. So how do you onboard a new person into your team and how does that change things? And how do you get your team members to kind of have that relationship of working together in that way?

Kendall: Yeah. The biggest recommendation that I have, like, when you’re trying to create something collaborative is to put as many systems and structures in place at the beginning as you can. So this, like, the weekly team meeting that we have, we’ve been doing that since the day we opened. And it was, in the very beginning, it was a whole team of brand-new providers that we didn’t know each other, and it was a challenge to have them understand the value. ‘Cause I had experienced that. Like, I did an internship at a wellness center and they were doing the collaborative thing. And I felt like I sort of knew the value of it. And so trying to teach that to other people was difficult in the beginning. So that’s just a foundational piece of what we do. So when we onboard someone new, they come, even as part of the interview process, they’ve already been to that meeting, they’ve met everyone. They’ve really heard, so a lot of times when we do interviews, like, that’ll be, like, their second or third interview when they come to the group meeting. And what we’ll do is we’ll have the current VWS team members go around and share, of course, who they are and what they do, but also, like, how they ended up coming to the VWS and how long they’ve been here. And those stories really shine a light on, like, who we are what we’re doing.

Ali: I love that.

Kendall: And so the new providers will often say, like, whoa, I didn’t even know what I realized, like, what I signed up for. And this is pretty amazing. And it creates that sort of safe, vulnerable experience.

Ali: I love that you bring your other practitioners into the hiring process, so it’s not you, as a practice owner, doing interviewing, hiring someone, and saying, here’s your new team member. So they feel more committed from the very beginning to bringing this person in and doing the work to getting them, like, up and running as a team, because they’ve been part of that choice. So do you then get their feedback after that meeting and say, what do you think? Like, would this person be-

Kendall: Oh, totally.

Ali: Yeah, that’s very cool. There’s a couple of questions here. A lot of questions about the job postings. And people are wondering if we can post examples. We also post Jane’s values with every job posting. I like that you do as well. I can send around one of our, it’s obviously not the same discipline, but I can send around one of our values job posting combos, and if you have any examples, I could do one.

Kendall: I’m happy to share an example, oh yeah.

Ali: Yeah, we could send some around with the recording of this call. And then some questions about limits of that. Another question is whether your staff members are contractors or employees?

Kendall: So we don’t have any independent contractors on our team. We have mostly W-2 employees. And then we have a few core team members who are with us from almost the beginning. When we started, we were a collective. So everyone was their own business. And then we had an agreement of working collaboratively. And it was just rental agreements. It was not independent contracts. Now, we’re mostly W-2 employees, but we still have these core team members who are technically renting space, but they are fully part of our collaborative team. But we don’t have any independent contractors.

Ali: And the reason for the transitioning was just that it didn’t create the same level of commitment to the, kind of, central? What was the reason for the transition? I’m just guessing.

Kendall: Yeah. So originally, it was pretty organic. We got to a point where we were having an issue, I think it was with massage therapy, where we weren’t finding a massage therapist to rent space, and be committed, and stay long-term. And so we decided, like, okay, I’m gonna try to hire a massage therapist. And it took months, and months, and months to find the right person. But once we did, it’s been amazing. And she’s been here ever since. She’s been here for four years. And then from there, it was just an organic growth of the business that it felt like, okay, it is easier when you’re doing something collaborative to have W-2 employees, because it’s easier to make, sort of, those group decisions.

Ali: Sure.

Kendall: So we have gone in that direction. And also for financially, for growth of the business, there’s definitely more opportunity with employees that way.

Ali: Yeah. And I mean, I don’t know how detailed we wanna get in this, there are people are wondering about if they’re paid hourly, or by treatment? Contract versus employees and pay type is always, like, a really hot topic for people owning businesses, ‘cause there’s not a lot of, like, you can’t really ask other clinic owners who, like, are down the street from you. It’s kind of a hard place to find examples.

Kendall: I’ve had that experience, too. And it’s like, we get, I don’t know what that is, why we can’t share that information. I’m happy to share it.

Ali: Okay, great.

Kendall: I feel confident. Like, we pay our employees well. It’s important to me that people can make a living, and enjoy where they work, and not be overworked and underpaid, all those things. But we pay per session right now. So if they see a client, they get paid. If they don’t see a client, they don’t get paid for that. And then we also have an administrative rate. So they get paid for everything that they do for us in their job. So the administrative rate is lower. They do their notes, they get paid to come to meetings, that sort of thing. They get paid to go to marketing or networking, and then they get paid their practitioner rate for the session. And it just depends on the modality. And it’s really about what you’re charging a client to come to that service. So I always give a general rule of, like, how much is a lower admin rate? It’s $15 an hour for the admin rate. Someone’s asking what our admin rate is.

Ali: And they get the flat admin rate no matter what discipline you are?

Kendall: No matter what discipline.

Ali: So you have one plan rate and then the rest is based on what your, sort of, the market rate is for your discipline out there?

Kendall: Yeah, the practitioner rates vary because we are able to charge clients differently for different modalities. So like, the mental health counselors, the clients pay a bit more for that than they do for massage, for example. But generally, like if you’re trying to hire someone in a different modality, you would look at your area, your local area and say, okay, what are people charging for massages around here, and what do we wanna charge for massage? And then you can start that person at, like, 35 to 40% of what you’re charging the client of what their flat admin rate, or flat practitioner rate would be. And the way we do it is that wage increases are built in depending on case load. So it’s incentive to grow together and it gives everyone that motivation to build the case load. So it’s like, okay, so if they start at $40 per client hour, if they are now, okay, now they’re up to 15 clients a week, so now they can make $45 per client hour, or now they’re up to 20.

Ali: You’re just super transparent with how this works. Everyone at the practice understands it. There’s no confusion.

Kendall: Yep.

Ali: No one has to be concerned that other people are getting paid a different amount than them. If they do, they’re understanding why that is.

Kendall: Yeah.

Ali: I love that.

Kendall: There’s always opportunity, too. Like, we can make a decision as a group, like, you know what? It feels like time to raise the massage therapy rate for clients, right? And then it gives the practitioner an opportunity to make more.

Ali: Yeah. And you, as well, as the clinic owner, are covering your costs, you’re getting paid fairly. Well, I mean, this is another question that I had for you is, how do you mix your clinical work with your practice management work? Because clearly you’re doing a lot of practice management. You’re spending a lot of time thinking about this, you’re being very thoughtful, very intentional about it. And I think a lot of people are just crunched for time. And so they’re like, well, this sounds great, but how am I gonna do this?

Kendall: It’s such a big question.

Ali: Yeah, it is a big question.

Kendall: It changes all the time. So I think something that I do fairly often is I sit down and I write my current schedule and I write down my ideal schedule. Like, the entire day and the whole week. Like, if this is not working, if I feel burnt out, if I feel like I’m working too much, things are not balanced enough, then what does it need to be? And then I make drastic changes in my schedule and what I’m doing. And I think over time I’ve just learned, like, it’s okay. Everything’s gonna be fine, it will all work out. And I think sometimes we get stuck in, like, okay, I have to see this many clients a week to make enough money. And there’s just no other option. And I would encourage you to sit down and think about, like, there has to be another option. If this is not working for you, what can you change in your own system of being the owner, and the way that you’re working, so that you can still make enough money, still make a living, but be able to spend more time on the business? We have to have those chunks of time set out to work on the business in addition to working in the business. And even if I was a solo provider, with my own health stuff going on, I can’t work full-time. I would never be able to do, like, a nine to five, Monday through Friday thing. And I knew that going into this adventure. So I try to set systems in place that would allow for me to not see too many clients. And I continue to kind of shift to a lower and lower caseload of clients as we bring on more therapists here, so that we can still serve those clients that we need to serve and spend more time working on the business and supporting employees.

Ali: Sure. Yeah, and I think this is an interesting question in the chat panel because I’ve experienced this as a clinic owner many times that people do a lot of mental math with the percentage that you’re keeping for the clinic. So much mental math. And most people who haven’t owned a practice haven’t seen the expense side of things. And so when they do their napkin math, they kind of have four or five main expenses and then they assume that the rest is just being pocketed by the clinic owner. And I would say most clinic owners have had this experience from practitioners. So it’s a hard conversation because I know that the average clinic margin is very, very small. Like, this is just a reality. It’s not a hugely profitable business in geneal. And so obviously for you, the difference, so you have to pay that admin fee. So part of that percentage that you’re keeping back is paying everyone for that admin time. It’s also paying, obviously, for all your admin staff that are not bringing in money. It’s paying for your rent. And then I would assume it’s paying for some of you time that you’re doing actually managing, running, growing your business, which is completely appropriate that the work that you do is paid for. Would you say that that’s kind of the main things that are being covered by that fee?

Kendall: Yeah.

Ali: How do you respond if practitioners are, like, that seems like a lot? Or doesn’t that not come up ‘cause it’s just so transparent?

Kendall: It’s pretty transparent here. I think I’ve always been very open with my team about money. And I think we started as, like, people think you need a ton of money to invest and open a clinic. And it’s like, I’m always very open. And this is what people are saying about, okay, the clinic owner down the street won’t tell me about this. I’ve always been open, even with colleagues around our community. It’s like, I started VWS with $5,000 of our own savings. That’s it. And we started very organically, and slowly, and we had that collective model. And it worked. We grew slowly into what we are. But I’ve never had, like, these huge amounts of money to put into this. And over the years, I’ve just been clear with my team, like, whenever we have been profiting, I usually go them and say, okay, we are gonna be putting this back into the business and we’re gonna be investing in, okay, now we can have an office manager, now they can have more hours, or whatever it is. Like, sort of growing organically that way. And that’s been a choice with, also, the privilege of I’m a married person, my husband works full-time, and we’ve had that luxury for me to choose sometimes to say, okay, do I take this profit as a salary or do I put this back into the business and help it grow? And so we’re getting to a point as a business now, where we’re able to bring on an additional role. We’re hiring a clinic coordinator soon. And it’s like, that’s someone who’s not bringing in direct revenue from clients.

Ali: No, just supporting. Yeah.

Kendall: So just to give you an idea, we’re five years in and we’re to that point now where we can do that. And COVID put a wrench in everything for everyone. But I do like to be open about that. Because when we think about your why, if your main reason of opening a wellness center is to make a bunch of money, then this is not the business for you.

Ali: I don’t think any healthcare practice. If your main goal is to make a ton of money. I’m, like, you make a good wage as a practitioner for sure in most disciplines, but yeah, even, so Canopy is this, I have a rent, I had the original same model you did, which is the room rental model. So people pay a set rent, I rent out the rooms in two chunks. So there’s one shift in the morning, one shift in the afternoon. But you’re really capped. Like, once your rooms are all rented, and you’re never gonna be at 100% capacity, that’s as much as you can grow.

Kendall: As much as you grow.

Ali: That’s as much as you can grow. And so I was actually considering franchising Canopy before Jane started, because I had the software, I had the brand, I had admin staff, I knew how to set up a practice. And so I was gonna go and open more of them, but then Jane started and now I don’t have time to do that. But you are capped by your physical space. You can only grow and you can only grow so big. So yeah, that’s funny, I had a similar experience. I’m wondering about if we should move to clients and how do you educate your clients on your model of care, and how do you find clients? I was really interested to hear you say that you admin fee covers marketing, like, your practitioners are responsible for doing some marketing. Do they have a set amount of time that they have to spend doing that? Or how do you encourage that?

Kendall: Yeah. So we collaborate on everything. Our employees, when they come on, they understand that they will be doing the team meeting every week and that they will be responsible for one to two hours of networking or marketing every week, especially when they’re just starting. And it goes in line with the model of like, you’re paid per session. And I will mention, like a long-term goal for me is to be able to pay everyone on salary. But this is where we are right now as a clinic. So when employees come on, they understand, like, okay, your caseload grows one client at a time, one patient at a time. So how are we gonna work together to get you as many patients as soon as possible? And so they have to go out and let the community know that they are here. We are well-known in our community now after five years, but when we add a new provider, like, people get very used, like, they find a provider and they’re like, okay, that’s my acupuncturist, right?

Ali: Sure. Yeah.

Kendall: So we have to let them know, now we have two acupuncturists on our team, so we have to let the community know, hey, we have this additional person you can now come see. She has a different specialty. And she has to be out there meeting people, meeting other providers. So we all work together in that way. But like, for mental health, for example, the need is so high right now that those employees end up not having to do as much.

Kendall: Anything.

Ali: Or anything.

Ali: I couldn’t even tell you right now, I was just joking ‘cause I was talking to some of the moms that work at Jane. I’m like, do you ever feel like you’re emotionally supporting a lot of people but you’re not really getting a lot of emotional support? And every mom was, like, yeah. Like, the stories that just, like, came into this, I was just like, is everybody feeling this way right now? It is not just me. So I was like, let’s go find a psychologist. Do you know, like, the wait times are like six months, eight months, like, no one can get care right now. It’s really shocking.

Kendall: And it’s stressful as a business owner, too. And I’m a mental health counselor, and so my heart, when clients call in and they’re in tears and they have called 10 therapists and they can’t get in, it’s just like, it’s so heartbreaking. And we do the best we can. It’s the reason our mental health team has grown so much in the past year because we’re trying to support more people.

Ali: What are you gonna do when you run out of space?

Kendall: Well.

Ali: Kendall? I didn’t tell you I was gonna ask you that. Excuse me.

Kendall: It’s interesting. We are the telehealth word. Like, pros and cons. So we are very much an in-person, like, let’s hug type of team. And our clients feel that. And part of their experience that they get from being put in this collaborative environment is that they come to our physical environment and they feel that. So telehealth is great. It’s a wonderful tool, and we have that option with mental health. But I’ve decided it doesn’t work with our vision to just, like, hire 10 therapists to meet the need but keep everyone on telehealth, because those clients are not, then, getting the collaborative-

Ali: Collaborative.

Kendall: Experience. So for us, it’s like, we try to maximize space. We have eight treatment rooms here. We have the movement studio, a lobby, a bathroom, and then we have a full-size gym, a 2,800-square foot gym that is connected to our space that the fitness trainer on our team, he owns his own business and he developed out the gym on that space. So we just maximize as best we can. And I try to remind people, like, I don’t want people to work weekends if they don’t wanna work weekends, but we can also search for providers who would love to work weekends.

Ali: Oh, my goodness, that is just, like, the hardest thing ever, though. Nobody ever wants to work weekends. Or evenings. But I’m like, that’s when, especially if you’re a new provider, that’s when you’re gonna build your caseload, evening and weekends is when people are off, they can come and see a new provider, and it’s such a struggle to get people to work those hours. I understand.

Kendall: And that’s where it comes down to the job postings and being clear. Like, we need a second massage therapist on our team really bad. We have a wait list every week for massage therapy. We need another provider. Hey, if anyone who’s listening-

Ali: I know. I was, like, same. Anyone in Vancouver wanna come, I need a massage therapist.

Kendall: We need a massage therapist but we need someone who wants to work Saturday, Sunday, Monday, because that’s the space we have in our massage room.

Ali: Yeah. So what are you gonna do now to try and find that person? So you’re gonna write an amazing job posting, you’re gonna explain what you have. Where are you gonna post it? How are you gonna-

Kendall: So we’ll, yeah. We always post it on a site like Indeed, like just to have it stationary there. But we usually end up finding our providers thorough word of mouth mostly or on a Facebook group.

Ali: Or now on a webinar. On a Jane webinar.

Kendall: Yeah, or a Jane webinar. Please email me. But we always have it, like, on Indeed so that they can go there and see it. And we always have the posting on our website. But mostly I go to my team and I say, all right, we need to find this new person. Who do you know? Who can you ask? Tell everyone you know who are looking for. And that gets easier as you have more modalities on your team, because then they, that’s how we found our second acupuncturist. Our first acupuncturist is a friend of a friend. And she’s amazing.

Ali: Because then they also understand the heart of the collective already, and so they know that they’re not gonna recommend someone that’s not gonna be a good fit for the practice or that they’re not gonna work with well. And it’s amazing to me that the same discipline is even recommending one another because sometimes people can feel a bit possessive over their caseload and not want another one of the same discipline to come in. So it speaks very highly of the way that you created a team that feels so secure that they will bring in, they’ll recommend someone of the same discipline. That’s amazing.

Kendall: And that’s the difference of a truly collaborative approach. Because sometimes, like, when people think of the benefit of having a wellness center and a multidisciplinary team, they think, okay, well, the benefit is referring to each other, right?

Ali: Exactly. Exactly. I’ll be the only one at this, you’ll be the only at that, and we’ll all get the benefit of that.

Kendall: And you can help build each other’s caseload. Right, which is true. We think of that as a side effect of it, right? Yes, we all can build our caseloads faster because we are collaborating. But it’s not about, like, I’m the only person who can do this. And we are very clear when people join our team, like, this is not a competitive environment at all. And so we are here to support our fellow team members. And even if we have, let’s say we hired two mental health counsellors at the same time, which we’ve done in the past, and it’s like they both have, okay, they start with zero clients.

Ali: Nothing, yeah.

Kendall: But we were very clear, there are the specialties of each person, our office manager knows them. If we’re talking about a new client in the meeting and it’s like, okay, you know what? They’re actually really looking for this, then everyone says they should work with this practitioner.

Ali: Right. It’s so obvious that it doesn’t feel competitive.

Kendall: Yeah, yeah.

Ali: And so we only have, like, five more minutes before we’re gonna go to Q&A and I have, I’m like going through my question list, like, we’ve missed so many. It’s fine, this was so good. So how do you educate your clients on your model of care? Obviously, you’re doing a lot of educating of your team and getting the right people involved. But it seems like your clients would also need to be educated. And what does that look like when they come in for a massage, for example? Yeah, how do you even get started with clients?

Kendall: Yeah, so there’s a few different ways that clients find us. They start with one provider, and then they come in and they’re like, oh, I didn’t know you had these other things here. We also have an option where it’s a, we call it the holistic care plan and clients can actually, before they see anyone, they can fill out a comprehensive intake form. So it’s questions from like, the intake form’s all the modalities, there’s all the legal information you need in it from everyone, and all the consents and everything. And they fill that out and then we review it as a team before the client sees anyone. And we make a recommendation of, like, these are people who have chronic illnesses, they’ve been told they’re fine, or they’ve been dealing with it for 20 years, they don’t know what to do. They have all these symptoms but they don’t actually know which provider to start with. So we review it and then we give them a recommendation of, okay, here’s who we think your primary practitioner should be, and secondary, and so on, and this is the plan. As far as educating the community, I think people are really hungry for this type of care. In the US, it’s like, everything is so disjointed. And so when they happen upon a place that is going to, like, wrap them in support in this way and really help them get better and stay well, they tell all their friends about it.

Ali: Right. So word of mouth would probably be your primary.

Kendall: Word of our mouth in our field is always the best. But we do a lot of education as far as like community talks, or free talks, corporate wellness stuff, like a lot of our education right now is about trauma and how it affects our health, how it affects our body, and teaching, just putting out, like, free content about that, but also doing trainings for corporate teams and things so that the community is getting that greater awareness of, like, this is specific to COVID especially. This has been the impact and this is why we feel this way.

Ali: So there’s kind of two entry points for a client. They might come directly referred to one practitioner. And in that case, they get that one service. And while they’re there, they maybe are educated about everything that’s available.

Kendall: Sure.

Ali: Or they’re coming to you as a wellness center, they understand the wellness center idea and they’re just saying, I’m just gonna give you all my information and I want you to tell me what the best treatment plan would be for my needs. Is that how it works?

Kendall: Yeah.

Ali: So there’s kind of two entry points.

Kendall: We have two main entry points. And then sometimes people will start with one provider and then they’ll be like, actually, can I do the holistic care plan? I really wanna do the whole thing-

Ali: Once they get there. And then they’ll do the intake assessment even though they’ve already come in for one service. Yeah, that’s super fascinating. So even just your practitioners, I’m sure, talk about it and then you’ll probably have information in your waiting area that kind of explains some of the different services. Is that how it-

Kendall: Yeah. So we have, behind the front desk we have, like, a menu of services. So they can see the different individual options, and then our website has all the information and the holistic care plan is there as an option, too.

Ali: Cool. Okay, there’s lots of questions. I think we should go start looking upon them, ‘cause some of them are really good. I really like this one, how do you structure your team meetings and your one-on-ones?

Kendall: Mm-hmm.

Ali: And I just lost it, that’s from Madison. So how do you structure your team meetings, one-on-ones with providers?

Kendall: Yeah, so the team meetings, let’s say sometimes there’s five Wednesdays in a month, but let’s say there’s four. We have a different structure for each week of the month and we rotate that. So our meetings are 90 minutes. We eat lunch while we’re there, that sort of thing. First meeting of the month we dedicate to shared clients. So if they’ve given permission to coordinate their care, that meeting is fully dedicated to clients. We try to check in on clients every week, but that one in particular is like the whole time. Second meeting of the month is marketing, networking, anything involving that. Third meeting of the month is focused on one provider from a team. So they’re in charge of doing an in-service for the group on a topic, like, our massage therapist just did one on fascia and craniosacral therapy. And those are super interesting. Like, that’s one of the biggest benefits of the collaborative multidisciplinary team, because you’re learning. Like, as a therapist, to learn about that from a massage therapist, the whole time I’m thinking, like, how does this impact any of my clients? And it helps them get better faster. So that’s the third meeting of the month. So they can present or they can, like, ask, if they have a complex case they can ask about it or just get personal support. And then the last meeting of the month is really dedicated to personal and professional support of each other. So we’ll do, like, longer check-ins, we’ll share wins, we’ll share challenges, we’ll share appreciations with each other. And we try to do those check-ins every week, too, just sort of briefly. One-to-one meetings with employees, it just depends on what we’re doing. I try to take a mindset of instead of managing employees that I am coaching them and I am guiding them. I’m there alongside with them and that we keep it positive and also realistic.

Ali: That’s amazing, ‘cause 90 minutes a week is a lot of scheduled time when you put all those people together. And it’s amazing that you prioritize that because you, obviously, like you said, you have to prioritize things and schedule it in to make them happen. But even as you’re talking about what you do in those sessions, they just are so clearly beneficial. Like, you can see what the benefit of that would be to the rest of the week, to the rest of the month, and to your practice in general. But when you just think, like, 90 minutes of meeting time, it just feels like so long. But as you’re going through what they are-

Kendall: We run out of time every week.

Ali: Yeah, that’s amazing. And that you pay the staff to be there so that everyone shows up, obviously, not just ‘cause they’re paid, but because you’re providing value in those. And so did they work right away or did it take a bit of time to find a rhythm? Yeah, I was gonna say, ‘cause a lot-

Kendall: Meetings did not work .

Ali: No, and I don’t want people to feel discouraged if they try to start something, well, like, this is awful.

Kendall: Oh my gosh, no.

Ali: Yeah, so .

Kendall: If you have a group practice already, like, say, a mental health group practice and you’re not doing this, and then you add modalities and you try to do this, it will be rocky.

Ali: It’ll be hard.

Kendall: People will protest, absolutely, they will be so confused why they’re there and why it’s valuable. And you so you just stick it out, stick it out. It was very rocky in the beginning. And we also had a bunch of people on our team that were new providers and had new practices. And so we were all trying to build our caseloads at the same time and I’m trying to make them do these meetings. And it was rocky for sure. But now, everyone loves it. And we could not operate without them.

Ali: Without it. That’s interesting. And even you could start with like, ‘cause like you said, you run out of time every week. You could start with a 30-minute meeting weekly and then just and like get the value, and then maybe be like, okay, well, clearly this is going great. Let’s make it a 60-minute. I wonder if there would be, and I always think it’s interesting, ‘cause this happens in our company, too, like, as you grow and change, you have to change your processes and add things. And there’s things called standups and huddles in the kind of the tech world. And so we do a huddle. Actually, we had one today. We do a huddle every week at 10, every Wednesday, and then we have an all-hands, every month we do a longer one. And we tried to do it when we were smaller and it just didn’t work. Everyone was like, what’s the point of this? We wanna get back to work. And then we had to add them again later when we’re like, oh now we need them ‘cause communication is harder with a bigger group of people.

Kendall: Yeah, well, a centralized place to have communication. Because we have a lot of shared clients now. And so people actually really wait for that meeting, because then they can have that communication with their teammate rather than doing it, trying to find time outside of that during the week.

Ali: Okay, we have another question. How do you assess or screen potential clinicians to make sure they really wanna join a group practice and not just start their own or build a caseload and leave? So I guess this is part of that values conversation we were having, and your really, like, deep interview process.

Kendall: Yeah. I’m just super clear. I’ve certainly had people join that ended up leaving a year later because they thought they wanted to do the collaborative thing and then they realized they didn’t. But I’m very clear. I’m like, look, we’re a family. Like, we’re in these meetings every week. This is a long-term thing. I’m not looking for providers who want to be here for six months, build up their caseload, and leave. On the same vein, though, I love helping providers get to where they wanna go in their life. So if organically, they’ve been with us for a few years and organically they’re like, you know what? This is just in my heart, like, I wanna go do this other thing. I fully support them to that.

Ali: Totally. Yeah. And you never know if someone’s gonna come back. I always say-

Kendall: Yeah, oh yeah.

Ali: Have good endings. You should always have a good ending. And so often in the healthcare world, a practitioner will leave a practice and people will feel so hurt by that that their response is just, like, a very, very emotional negative ending. And I find that if you don’t leave, I’ve had practitioners come back to work for me again. Same with, like, even our staff-

Kendall: Admin.

Ali: Or even our customers. If someone’s leaving Jane I’m always like, we really want the best system for you, but maybe you’ll come back one day. Maybe Jane will be a good fit in the future for you. And so yeah, I find that it’s a weird thing people do as humans, we get so hurt and then we end up with this very negative final moment. But leaving the door open is always a good plan.

Kendall: Leaving the door open is good. And I think part of, like, the collaborative process makes it harder for people to want to do that, to want to go do their own thing in isolation because once they really get the full value of being on a collaborative team, it’s like, why would I actually wanna do anything else? Because we have this community of support and it’s different than, it’s a different type of support than even from your spouse, or your partner, your friend, right?

Ali: Sure.

Kendall: Like, we, as healthcare providers, we understand what we’re going through. And especially during COVID it was like, this is it. These are the people who actually get how hard this is for us.

Ali: It’s interesting, because I often say being a clinic owner is quite a lonely place to be because clinic owners have a very specific, they have specific wins, and specific losses, as well as being a practitioner. And so it seems like you’ve also created a little bit of support for yourself as a clinic owner, through your team. Bringing a little bit more transparency kind of brought them into your support circle. And usually when I say that to a clinic owner, I’m like, being a clinic owner’s pretty lonely. They’re all like, yeah, it totally is. How come we never talk about that?

Kendall: It is, it is.

Ali: lonely.

Kendall: Yeah. And my team is an amazing support, but like you said earlier, like, they will never actually know what it is to be the clinic owner. And so something I really appreciate, actually, about coaching when I do, like, my coaching groups is it’s a group of us, all clinic owners, and it becomes this different community of support. And I really appreciate that, too.

Ali: We have six minutes left and the kind of questions people are asking are all very practical. Like, who does the billing? What’s the max payment you go to? How do you stop people from cannibalizing one another? And these are all questions. I wanna talk about what you do offer, because I really appreciate you sharing so much great wisdom with them, with the Jane community. So you do offer help with this if people want to learn more. And obviously, there’s so many questions. So I’m like, let’s just make sure that they know that you are available if people wanna continue the conversation. Tell me about that. What are you doing? You’re out there sharing this with other people.

Kendall: Definitely. So first, like, definitely join our Facebook community. So there’s a private Facebook group we have called, Wellness Center Creators. So jump on Facebook and request to join that. I’ll let you in. And then ask these questions there, because there’s already a great community there of clinic owners or people starting clinics. And they will help answer questions. I’ll pop in and answer your questions there, too. And then I do offer coaching. So, individual, group coaching, and then also through workshops and things. So the next thing I have coming up is my business planning workshop intensive. So this is a really great way to begin. If you’re at the very beginning stages, solo provider getting ready to do this, or if you already have a group and you’re expanding, or you’re just trying to make a change to your clinic, this workshop is three hours, it’s live, and it’s a great way to connect with other wellness center creators. There’s a chunk of time in there where I do live Q&A with everyone who attends. And it’s very experiential. There’ll be meditation, there’ll be time to really dedicate to working through each part of your business plan. I share general business structure education. So if you can come live, I would definitely recommend it. So it’s July 27th on Tuesday. It starts at 1:30 Pacific Time. And it’s three hours. So you’ll see, I think Erica put the link to register, maybe, in the chat, but also, you’ll receive it in a follow-up email.

Ali: Yeah, we’ll send the Facebook group and that information in the follow-up along with the recording of this session, yeah.

Kendall: So if you can’t come to the live business planning workshop, there will be an option in the email to grab the recorded version. And it’s pre-recorded. It’s not of the three hours. It’s a condensed version that lets you go through at your own pace. So you can grab that if you can’t come to the live one. And you’ll get a discount code, too, for being at the webinar today. And then, yeah, if you’re interested in the group coaching or the individual coaching, just email me, kendall@vancouverwellnessstudio.com. I can put it in the chat, but you’ll get it in the follow-up as well.

Ali: Okay, I love it. I loved this conversation. Thank you for spending the hour with us. There was a lot of questions we didn’t get covered, but hopefully people will reach out. And it was really nice to spend some time with all of you out there as well who attended live, and to all of you who are gonna be listening to this as a recording. It was great to share this hour together. And we will definitely be sending out the recording, which always gets asked a million times at the end. Nice to see everybody. And hopefully everyone enjoys the rest of their Wednesday.

Kendall: Have a great day, everybody.

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