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[00:00:00] Hello, everyone. Welcome to The Testing Psychologist podcast, the podcast where we talk all about the business and practice of psychological and neuropsychological assessment. I’m your host, Dr. Jeremy Sharp, licensed psychologist, group practice owner, and private practice coach.

This episode is brought to you in part by TherapyNotes.

TherapyNotes is in my opinion, the best EHR for testing psychologists. If you’re on the hunt for an EHR and you want to give them a shot, you can get two free months by going to thetestingpsychologist.com/therapynotes.

This episode is brought to you by PAR.

The new PAR training platform is now available and is the new home for PARtalks webinars, as well as on-demand learning and product training. Learn more at parinc.com\resources\par-training.

Hey everyone. [00:01:00] Welcome back.

For those of you who own your practices, I’m guessing this is most of you, you may know that part of the job as the practice owner or visionary for the practice is to dive deep into trends that could influence your practice, generate ideas for improvement and keep your finger on the pulse of the industry. That’s what today’s episode is all about. These are business topics that I’m thinking about for 2024.

As I mentioned before, I am the visionary for our practice. Even if you’re in solo practice, you are the visionary. There is no one else doing the job that I just described. There is no one else who is out there thinking about the future of your practice and where it might be headed, trends you need to be aware of, changes you might want to implement, or directions to go.

So today I’m sharing some of the topics that I’m thinking about [00:02:00] for 2024 for our practice. Now, not all of these ideas will directly impact our practice, of course, but I think it’s valuable to brainstorm and identify potential areas for growth and monitoring as we continue to level up the practice.

Speaking of leveling up your practice, I didn’t plan that, this is your formal invitation to consider consulting if you would like some support and help with growing your practice. We’re in no man’s land for the mastermind groups. The recent cohort started in January. The next cohort will start in July, but there’s always a chance that I have some individual spots open. I also offer a la carte strategy sessions if you just want to meet for an hour here or there and hammer out some questions. You can go to thetestingpsychologist.com/consulting and schedule a [00:03:00] pre-consulting call to see if any of those options fit for you.

In the meantime, let’s talk about business topics that I’m thinking about for 2024.

This is a really fun episode to put together. This is, I think one of the… The favorite part of my job in running our practice is doing the visionary work. I greatly enjoy diving deep into trends, topics, and directions for the industry and thinking about how to apply some of those ideas to our practice. And so this was fun to put together.

I’m just going to dive right into it: Things that I’m going to be thinking about in [00:04:00] 2024.

Let’s start with technology.

This is always a big heading, but I feel like this year it’s even more salient because of the introduction of AI or the mass introduction of AI. Mass market appeal. AI, Artificial Intelligence, there’s so much to say here. There are so many ways that AI is likely going to become involved in our work. We’re in the beginning stages of rolling out AI and its use in mental health.

You have likely heard, some folks are using AI to help with report writing, note-taking, and generating content. I think the possibilities are endless and I’m going to be thinking a lot about how to leverage AI in our practice. So, creating social media content, blogging, graphic [00:05:00] design. For instance, the software Canva now has AI built in to help generate images. That’s how my assistant generated our new podcast cover art using AI. I’m going to also try to leverage it to help develop standard operating procedures and document our systems and processes.

I think that the software that we use is only going to accelerate. I think it’s only a matter of time before AI is integrated into most of the major EHRs at the least to help with note-taking.

We’re piloting an AI software right now called Upheal in our practice. This is a software that essentially listens in to your therapy sessions and at the end of the session, it takes about 30 to 60 seconds to generate the progress note and you [00:06:00] copy and paste what it generates into the note template. Two of our therapists are piloting it. They have found it very helpful. I know that there are going to be increasing applications for that kind of thing.

Some of you may have heard of the Notes app, which some folks are using to record intake interviews and to produce a written document summarizing that information. So there are all sorts of applications for AI in the work that we do.

I think there is a big gap in leveraging AI to solve staffing problems. Admin staff is notoriously hard to find, train and retain. So, looking to things like chatbots, AI scheduling software, that sort of thing. Anything that will reduce the need for admin staff could be coming into play [00:07:00] with following up on insurance denials. So there are so many applications.

If you’re not looking into AI or moderately familiar with it, I think you have to at least do some research and figure out if there are some possibilities to use it in your practice, because this is the direction that everything is heading. It’s only a matter of time before everything is going to have an AI assistant built in, including Microsoft Office. They’re on the leading edge of integrating AI in Word, PowerPoint, and Excel and pretty much any other major software platform is going in that direction as well.

Now, also under the heading of technology, I put TikTok. TikTok is growing. There are a lot of leading thinkers out there who believe that TikTok is going to be one of the most valuable media companies in the world. At the current growth rate,[00:08:00] I don’t want to butcher this statistic, but at the current growth rate, I think TikTok is set to overtake Facebook or Meta in terms of just revenue and valuation as a company in the next 2 to 3 years if they continue to grow at the same rate. So TikTok is not going anywhere as far as I can tell. There is only going to be more info on TikTok as time goes on. 

I, personally, have resisted TikTok simply because I, in all honesty, struggle to regulate social media sometimes. I love researching things and I could easily see getting lost on TikTok. But if you’re not on, you don’t know what it is, and you don’t know how it works, I think it is worth downloading and messing with it for a week or two weeks or a month just to figure it out, see what’s trending, see how the algorithm [00:09:00] works, search some hashtags, figure out what is coming up in the world of mental health, neuropsychology, testing, and diagnosis. It is huge.

One trend that continues to grow is self-diagnosis or it’s called undiagnosis, or you might think of it as decolonizing of diagnosis. This is still popular. It’s something that is spreading on TikTok that we should know about. It influences our work significantly when folks are self-identifying or self-diagnosing any number of mental health disorders. That influences how we approach it and how we work with our clients. So my second topic under technology is TikTok.

Moving on to another topic, I of [00:10:00] course will be thinking about hiring, growth, and company culture. The overarching theme here for me is it seems clear that we are done with the COVID boom. From 2020 to maybe early 2023, we had a really good run in those three years. You could just hire a million people and count on everyone being full. The referrals came without any effort or marketing because everybody needs mental health. A lot of practices grew very quickly and are now finding themselves underbooked or over-leveraged either financially or psychologically.

What does that mean?

It means that practices grew too fast for their own good. They grew too fast for their own leadership capabilities. I certainly identify with this. I think it happens to [00:11:00] everyone. They grew too fast for their ability to develop standard operating procedures, systems, and so forth. So it goes back to that idea for me that growing is easy, but scaling is not.

So that’s one theme that I’m thinking about as a lot of practices coming out of the COVID boom are now finding themselves in a place where they have to market for the first time ever, either using Google ads or getting out in the community and whatnot, and referrals are slowing down. I started to hear in probably September 2023, pretty widespread opinion that referrals are slowing down and folks are having to get out there and hustle a little bit more for referrals.

So I think the COVID boom is done. Now we’re growing more deliberately, putting more systems in place and being choosy with who we hire based on [00:12:00] need and whose schedules we can fill the fastest based on our referrals. We’ve also invested in Google ads for the first time ever. Again, started that back in the fall and have enjoyed some success with Google ads.

Now, other expansion thoughts, I will be thinking a lot about expanding into auxiliary businesses. So looking at businesses around town who are a little more progressive and willing to invest in maybe in-house mental health. You may have some of these businesses in your area. I encourage you to check them out and see if you can establish contracts of some sort to provide in-house mental health services for these companies.

I’m thinking about further embedding in medical practices. We currently have a second location that is embedded in a pediatric primary care practice, and I would love to continue that model with other medical practices in the area.

Primary [00:13:00] care behavioral health is a huge growing area, both financially and practically. I think there’s something to take advantage of there. The same goes for schools. Mental health in schools is suffering and schools for the most part just do not have enough resources. I think there’s a big market there for mental health private practice owners to capitalize on that and establish some contracts with schools and provide either therapy or evaluation services.

Let’s take a break to hear from a featured partner.

Y’all, there are so many EHRs out there to choose from. That’s why I am happy to endorse TherapyNotes as what I consider to be the best EHR for testing psychologists. The note templates that are embedded are usable right out of the box for testing folks. We don’t have to do any customization and that is so valuable.

Beyond that, TherapyNotes is [00:14:00] a full-featured EHR. It handles scheduling, billing, insurance claims submission, notes, documentation, and everything. They also recently rolled out custom forms, which means that you can create your own intake paperwork to send to clients through their client portal. If you’d like to consider TherapyNotes, which I would highly encourage you to do, you can get two free months by going to thetestingpsychologist.com/therapynotes.

Let’s take a break to hear from our featured partner.

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All right, let’s get back to the podcast.

I’m also thinking a lot about additional service lines in our practice. Now, a lot of these are therapeutically oriented, but if you are in a practice where you are doing some therapy, paired with your testing, this could be helpful.

I’m thinking a lot about financial coaching. So people are getting hit hard by the return of student loan payments recently, inflation, of course, and COVID stimulus money just running out. There’s some pretty good data that folks across the country average savings is down. A lot of people attribute that to COVID stimulus money just running out. So I [00:16:00] think there’s a big market to incorporate financial coaching or couples therapy that centers around financial coaching into your practice to capitalize on those trends.

Another trend that is emerging is the sober curious group. This is paired with addiction, of course, but there is a huge rise in “sober” curious folks and what that might look like. What does it look like to stop drinking? What does it look like to establish a different relationship with substances?

So going back to TikTok and social media, this is a really interesting trend to research and see what’s out there, but it’s gaining a lot of traction. So if you have any ability to work in the addiction realm or sober curious folks, I think there’s a big need right now and a lot of interest.

Sadly, another population that [00:17:00] continues to need support is teenagers. The mental health of teenagers keeps declining, especially among girls and marginalized groups like ethnic and racial minority teenagers. Suicide rates are going up. It’s sad and terrible. And this is starting to hit home for me right now because my kids are right on the cusp of becoming teenagers and I do have a girl who is going to be a teenager soon and getting into social media and all the things that brings. I’m guessing many of you are the same. So personal and professional interest in teenage mental health or adolescent mental health.

What else? Getting back to in-person work. I guess you would call this a service line. I think the telehealth boom is done. [00:18:00] The vast majority of our calls are clients who want to be seen in person. I still think there’s room to do telehealth for intakes, feedback, and testing. But as far as ongoing psychotherapy, in person seems to be the trend. Folks are zoomed out and they want to be in person. So if you have the capacity to get back to in person work, I think there is something to be said there.

And then the last thing I’m thinking about as far as additional service lines is reaching underserved populations and ironically, utilizing telehealth for rural areas. PSYPACT is one facet of this. If you are not PSYPACT-approved or credentialed, something to look into. It’s a lengthy process and pretty cumbersome, to be honest, but once it’s done, it gives you a lot of flexibility to help folks, but I’m thinking more locally. Even in the state of Colorado, we have so many rural areas and there [00:19:00] are lots of opportunities to provide telehealth services to folks who are out in those rural areas and underserved areas.

Another facet of reaching underserved populations is groups. We are leaning in hard to our group therapy services because it hits 2, maybe 3 high points for your practice. It increases social connection, which I think everyone needs. Research is really clear that social connection is a protective factor and what we’re wired for. It hits the revenue high point because the per-hour collections for groups tend to be higher than for individual therapy. It also helps to service your waitlist if you have a waitlist for counseling because you can get more folks into groups than individuals.

If you are interested in [00:20:00] groups at all and looking for resources to help build your group program, my wife, full disclosure, is a consultant around group therapy. She is a group therapy expert. She runs The Art of Groups. I’ll include a link in the show notes, but it’s artofgroups.com. She has plenty of knowledge to share around building groups in your practice if you are interested in going that route. She consulted with our practice. We have a thriving group program now where we’re running 10 to 15 groups at any point in time.

I think groups are going to be a huge service line that we’re going to continue to lean into just to serve as many people as possible at a lower price point for them because it’s a lower copay, typically are out of pocket rate, but a higher revenue point for us because the hourly rate and collections is higher than individual therapy.

Okay. Two other topics that I am thinking about. Always thinking about revising the [00:21:00] testing battery is always on the radar. I’m particularly interested in updated executive functioning measures and anything utilizing technology or digital assessment. So I’m going to be going hard on that in the coming year.

And then the last thing related to that is simply the rising costs for testing. The materials fees keep going up, which I get, see previous inflation. That leaves, especially the insurance-based practices, in a really precarious situation. We got to figure out how we’re going to handle this.

In our practice specifically, we are implementing a materials fee for 2024 for the first time ever. We landed on 40 per evaluation just to try to cover some of the cost of materials because we are an insurance heavy practice and we’re not [00:22:00] getting raises from insurance at nearly the rate that materials fees are going up.

So, think about a materials fee. We’re doing a close survey of our testing materials and what we’re doing for each of our batteries. Are we being judicious in using the measures we’re using? How many questionnaires we’re distributing and that sort of thing? So thinking a lot about rising costs for testing and trying to find ways to mitigate those costs.

If you’re private pay, raising rates makes a lot of sense right now, if nothing else than to just cover the rising costs for testing materials. And if you haven’t done the calculations to figure out how much it’s going to cost to do an evaluation, I would absolutely do that. We are finding that it is running between $100 and $200 [00:23:00] per evaluation. We’re a larger practice of course, but we’re spending easily $6000- $8000 a month in testing materials fees. And that is a lot. So going to be paying close attention to that.

All right, folks. That is my summary of business topics for 2024. Hopefully, some of these things are resonating with you. If not, at least this exercise might resonate with you, where you get to sit down, and think a little bit more deeply about the direction and vision for your practice and what sort of things you want to keep on your radar over the next 12 months or so as you try to grow or improve your practice.

All right, y’all. Thank you so much for tuning into this episode. Always grateful to have you here. I hope that you take away some information that you can implement in your practice and in your life. [00:24:00] Any resources that we mentioned during the episode will be listed in the show notes, so make sure to check those out.

If you like what you hear on the podcast, I would be so grateful if you left a review on iTunes, Spotify, or wherever you listen to your podcast.

If you’re a practice owner or aspiring practice owner, I’d invite you to check out The Testing Psychologist Mastermind Groups. I have mastermind groups at every stage of practice development, beginner, intermediate, and advanced. We have homework, we have accountability, we have support, we have resources. These groups are amazing. We do a lot of work and a lot of connecting. If that sounds interesting to you, you can check out the details at thetestingpsychologist.com/consulting. You can sign up for a pre-group phone call and we will chat and figure out if a group could be a good fit for you. Thanks so much.

The information contained in this podcast and on The Testing Psychologist website is intended for informational and educational purposes only. Nothing in this podcast or on the website is intended to be a substitute for professional, psychological, psychiatric, or medical advice, diagnosis, or treatment.

Please note that no doctor-patient relationship is formed here, and similarly, no supervisory or consultative relationship is formed between the host or guests of this podcast and listeners of this podcast. If you need the qualified advice of any mental health practitioner or medical provider, please seek one in your area. Similarly, if you need [00:26:00] supervision on clinical matters, please find a supervisor with expertise that fits your needs.

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