WEBVTT 00:00:00.000 --> 00:00:01.780 A lot of new grads feel like they need to work 00:00:01.780 --> 00:00:05.019 for someone else or... a couple of years before 00:00:05.019 --> 00:00:06.879 going independent. It's, you know, one of those 00:00:06.879 --> 00:00:09.179 debated topics, right? What gave you the confidence 00:00:09.179 --> 00:00:12.060 to jump in, would you say? I would say, I mean, 00:00:12.080 --> 00:00:15.160 a lot of it is, it's just never comparing ourselves 00:00:15.160 --> 00:00:17.199 to others because I always do it. But it's like, 00:00:17.219 --> 00:00:18.539 you don't know, you know, obviously the whole 00:00:18.539 --> 00:00:20.760 story. Some people seem like they take off and 00:00:20.760 --> 00:00:22.460 they have a lot of success, but we don't know 00:00:22.460 --> 00:00:25.120 what's kind of under the hood and stuff. I just 00:00:25.120 --> 00:00:27.980 use Headway and now we've become a group practice 00:00:27.980 --> 00:00:30.519 and I use Headway still. I have independently 00:00:30.519 --> 00:00:33.320 credentialed for myself as kind of a backup. 00:00:33.549 --> 00:00:35.570 and kind of working on the rest of the providers. 00:00:35.810 --> 00:00:39.469 What is your view on like in -person versus like 00:00:39.469 --> 00:00:42.770 virtual versus like hybrid psychiatric care? 00:00:43.009 --> 00:00:45.710 I think probably the hybrid's the best option. 00:00:45.850 --> 00:00:48.969 After COVID, people just want to do online. I 00:00:48.969 --> 00:00:50.829 always tell people, you know, prior practice 00:00:50.829 --> 00:00:53.630 is half clinical and half business. And business 00:00:53.630 --> 00:00:55.990 does not care anything about clinical. So you 00:00:55.990 --> 00:00:57.509 can be the best clinician, but if you don't know 00:00:57.509 --> 00:00:59.670 how to market and get the business stuff going, 00:00:59.829 --> 00:01:02.109 then you're going to struggle. Hi, everyone. 00:01:02.189 --> 00:01:05.469 Welcome to No Priora, the podcast where we celebrate 00:01:05.469 --> 00:01:07.750 psychiatric NPs who didn't wait for permission 00:01:07.750 --> 00:01:10.659 to build something extraordinary. I'm Lindsay 00:01:10.659 --> 00:01:12.879 Hill, and today's guest has one of the most incredible 00:01:12.879 --> 00:01:15.739 timelines I've come across. He grew up on a family 00:01:15.739 --> 00:01:18.840 farm in Washington's Yakima Valley, went to Texas 00:01:18.840 --> 00:01:20.859 to earn his doctorate in psychiatric nursing, 00:01:20.939 --> 00:01:23.099 and then came home to Washington and built a 00:01:23.099 --> 00:01:26.379 multi -location practice with five offices across 00:01:26.379 --> 00:01:29.900 the state in under two years. Dr. Miguel de la 00:01:29.900 --> 00:01:32.620 Mora is a board -certified psychiatric mental 00:01:32.620 --> 00:01:35.000 health nurse practitioner, a Jonas Scholar, and 00:01:35.000 --> 00:01:37.599 the owner of Bellevue Psychiatry, with locations 00:01:37.599 --> 00:01:40.739 in Bellevue, Kirkland, Kennewick, Vancouver, 00:01:40.980 --> 00:01:44.140 and Moses Lake. He's bilingual. He treats everything 00:01:44.140 --> 00:01:47.140 from ADHD and depression to substance use disorders. 00:01:47.260 --> 00:01:49.680 And his approach to care is all about treating 00:01:49.680 --> 00:01:52.340 the whole person, not just the symptoms. And 00:01:52.340 --> 00:01:54.879 here's what I love about his story. He didn't 00:01:54.879 --> 00:01:58.239 do the safe thing. He didn't work for someone 00:01:58.239 --> 00:02:01.079 else for 10 years first. He saw a need in his 00:02:01.079 --> 00:02:04.000 home state and he went and built it. That's what 00:02:04.000 --> 00:02:07.319 No Prior Off is all about. Today, Miguel's going 00:02:07.319 --> 00:02:09.659 to walk us through how a kid from Yakima Valley 00:02:09.659 --> 00:02:12.020 Farm ended up running a psychiatric practice 00:02:12.020 --> 00:02:14.960 across five cities, what it takes to scale that 00:02:14.960 --> 00:02:17.460 fast, and why he believes real healing requires 00:02:17.460 --> 00:02:20.719 way more than just medication. Let's get into 00:02:20.719 --> 00:02:23.960 it. All right. Well, thank you for having me. 00:02:23.979 --> 00:02:27.300 What an intro. Now I got a lot to bring with 00:02:27.300 --> 00:02:30.460 that kind of intro. So thank you, Lindsay. Thanks 00:02:30.460 --> 00:02:32.060 for being here, Miguel. Thanks for being here. 00:02:32.439 --> 00:02:34.379 Yeah, I think it's really cool that you were... 00:02:34.729 --> 00:02:37.250 raised in Washington. I probably have told you, 00:02:37.270 --> 00:02:39.110 but I'm also from Washington. So that's kind 00:02:39.110 --> 00:02:43.289 of a cool commonality that we have. So you grew 00:02:43.289 --> 00:02:47.129 up on a family farm in Yakima Valley. Paint me 00:02:47.129 --> 00:02:49.150 a little bit of a picture as far as what that 00:02:49.150 --> 00:02:53.090 was like and how does a farm kid end up in psychiatry? 00:02:53.969 --> 00:02:57.669 Yeah, so that is an interesting kind of result 00:02:57.669 --> 00:02:59.969 from there. So, I mean, both of my parents are 00:02:59.969 --> 00:03:03.189 from Mexico, so I came to the U .S. to better 00:03:03.189 --> 00:03:05.169 their life and hopefully the kids that they were 00:03:05.169 --> 00:03:07.310 going to have. And my dad kind of worked as a 00:03:07.310 --> 00:03:10.710 foreman for a lot of the big apple orchards back 00:03:10.710 --> 00:03:14.069 in the 80s. That was a big moneymaker. It was 00:03:14.069 --> 00:03:17.090 just apples and all the fruit. And then he just 00:03:17.090 --> 00:03:20.050 decided to have his own business while he still 00:03:20.050 --> 00:03:22.870 worked for someone, so got a farm there in the 00:03:22.870 --> 00:03:25.169 Yakima Valley. That's where I grew up, me and 00:03:25.169 --> 00:03:28.669 my siblings. And it was, we weren't the kids 00:03:28.669 --> 00:03:30.909 that had the video games or stuff. We were just, 00:03:30.930 --> 00:03:32.889 you know, working on the farm, going to school, 00:03:32.990 --> 00:03:35.689 playing sports and stuff like that. So I think 00:03:35.689 --> 00:03:39.909 when I look back, it was a great segue to learn 00:03:39.909 --> 00:03:43.530 about hard work, determination, and just what's 00:03:43.530 --> 00:03:45.490 possible just because I would see it in my dad. 00:03:45.710 --> 00:03:47.610 Even though to him, it was always kind of a side 00:03:47.610 --> 00:03:50.729 thing to do. It was something that we saw the 00:03:50.729 --> 00:03:53.580 end result once we had Cherry. orchards so either 00:03:53.580 --> 00:03:56.259 the harvest happened or cattle so whenever the 00:03:56.259 --> 00:03:59.620 cattle was sold or whatever you know that happened 00:03:59.620 --> 00:04:02.979 but yeah i mean i think that it was uh one is 00:04:02.979 --> 00:04:06.699 i i think i was 25 i got diagnosed with adhd 00:04:06.699 --> 00:04:09.699 so it kind of covered up my symptoms because 00:04:09.699 --> 00:04:12.199 um some of the literature shows that people that 00:04:12.199 --> 00:04:14.400 grow up on farms or a lot around a lot of labor 00:04:14.400 --> 00:04:17.240 apart from sports they can manage their symptoms 00:04:17.240 --> 00:04:19.860 sometimes without medication so i think even 00:04:19.860 --> 00:04:22.920 my own struggles it was way to help because i 00:04:22.920 --> 00:04:26.300 was always working it was like uh i get told 00:04:26.300 --> 00:04:28.980 like uh even now from people just like you eat 00:04:28.980 --> 00:04:31.540 fast and it's like that's kind of how i was raised 00:04:31.540 --> 00:04:33.220 like it was like hurry up and eats because we 00:04:33.220 --> 00:04:34.839 got to go back to the farm and work and stuff 00:04:34.839 --> 00:04:37.720 like that so i think it was a great foundation 00:04:37.720 --> 00:04:41.420 and then from there um just the idea of i always 00:04:41.420 --> 00:04:43.560 wanted to be a doctor wanted to go to med school 00:04:43.560 --> 00:04:45.620 elementary middle school and high school very 00:04:45.620 --> 00:04:48.139 typical for an immigrant family one of the kids 00:04:48.139 --> 00:04:50.779 be either a doctor or lawyer it's kind of what 00:04:50.779 --> 00:04:53.319 it's a common theme. And then my first year in 00:04:53.319 --> 00:04:57.100 college, I pivoted to business because I had 00:04:57.100 --> 00:04:59.240 had a little entrepreneur spirit and had, you 00:04:59.240 --> 00:05:01.939 know, interest in that. Did that for about six, 00:05:02.079 --> 00:05:05.980 seven years. Did like finance and sales and lending 00:05:05.980 --> 00:05:08.899 and stuff like that. And then I kind of got burnt 00:05:08.899 --> 00:05:11.360 out. At the time, it was the last few years of 00:05:11.360 --> 00:05:12.899 those seven. I was in Los Angeles, California. 00:05:13.740 --> 00:05:16.519 So I was working there and then my best friend 00:05:16.519 --> 00:05:19.660 was living in Houston and he had been looking 00:05:19.660 --> 00:05:23.120 at getting into medicine. He was kind of doing 00:05:23.120 --> 00:05:25.600 similar sales. So I ended up kind of packing 00:05:25.600 --> 00:05:28.360 my bags and then went to Houston. I worked probably 00:05:28.360 --> 00:05:31.399 one more year and then started the prereqs. I 00:05:31.399 --> 00:05:33.600 got into the University of Texas there in Houston, 00:05:33.759 --> 00:05:36.519 the BSN program, and then I worked for a year 00:05:36.519 --> 00:05:39.579 and then did the DMP. And psychiatry, I think 00:05:39.579 --> 00:05:42.579 for me, it was just that was what interests me 00:05:42.579 --> 00:05:45.060 just from struggles I've had or just stuff that 00:05:45.060 --> 00:05:47.860 I would see. A lot of times you have that uncle 00:05:47.860 --> 00:05:50.040 that drinks and that's how he's coping with stuff 00:05:50.040 --> 00:05:52.160 or just people you see that you're like, well, 00:05:52.319 --> 00:05:54.899 it's not the substance or the activity. It's 00:05:54.899 --> 00:05:57.139 what's the pain from that and stuff. And then 00:05:57.139 --> 00:06:00.019 as soon as I got done, just came back to my home 00:06:00.019 --> 00:06:02.839 roots of Washington and where I'm at here today 00:06:02.839 --> 00:06:05.319 in Bellevue, Washington. So that's really cool. 00:06:05.709 --> 00:06:08.589 Yeah, thanks for sharing that. It's also ironic 00:06:08.589 --> 00:06:11.790 because my dad always worked in Bellevue as I 00:06:11.790 --> 00:06:13.709 was growing up. So again, another thing we have 00:06:13.709 --> 00:06:15.649 in common, but that's a really cool story. Very 00:06:15.649 --> 00:06:20.569 inspiring. I'm also curious because a lot of 00:06:20.569 --> 00:06:24.550 psych NPs who are in Texas struggle as far as 00:06:24.550 --> 00:06:28.670 the laws there and opportunities. And I find 00:06:28.670 --> 00:06:30.889 it interesting that you kind of when you finished 00:06:30.889 --> 00:06:35.100 your ENP at UT that you were like. I'm going 00:06:35.100 --> 00:06:37.600 back to Washington. Tell me about that. Like, 00:06:37.639 --> 00:06:39.980 was there, did you look for opportunities in 00:06:39.980 --> 00:06:42.740 Texas and it wasn't quite what you were hoping? 00:06:44.139 --> 00:06:46.620 Yeah, I did. So we had to do like a thousand 00:06:46.620 --> 00:06:49.100 hours of clinical hours for the DMP. So I did 00:06:49.100 --> 00:06:53.819 my first two rotations were inpatient and the 00:06:53.819 --> 00:06:58.240 last two were outpatient. So I'm a talker, networker. 00:06:58.240 --> 00:07:00.660 And with some of the preceptors I had, one of 00:07:00.660 --> 00:07:03.920 them owned a kind of a med spa set up there in 00:07:03.920 --> 00:07:07.560 the suburbs of Houston. Really nice office. She 00:07:07.560 --> 00:07:10.959 had three other providers and she had staff and 00:07:10.959 --> 00:07:13.740 everything. and kind of taught me a lot and just 00:07:13.740 --> 00:07:15.879 kind of mentioned like well you know if you do 00:07:15.879 --> 00:07:17.699 have interest of going back home she's like i 00:07:17.699 --> 00:07:19.740 think that washington's probably one of the best 00:07:19.740 --> 00:07:22.000 if not the best states i would for sure do that 00:07:22.000 --> 00:07:26.660 her thing was There in Texas, psychiatrists, 00:07:26.699 --> 00:07:28.639 they got kind of smart and they were charging, 00:07:28.680 --> 00:07:32.980 I think, $1 ,500 to $2 ,000 a month to be collaborative 00:07:32.980 --> 00:07:37.839 with PsychMP. So for her, it was her, three other 00:07:37.839 --> 00:07:40.879 providers she had. So she was paying, I think 00:07:40.879 --> 00:07:42.800 she was paying maybe the $2 ,000. So she was 00:07:42.800 --> 00:07:45.279 paying $8 ,000 a month just to be able to practice 00:07:45.279 --> 00:07:47.600 medicine and stuff for her and the other people 00:07:47.600 --> 00:07:50.769 that she had. so she would tell me Miguel she's 00:07:50.769 --> 00:07:53.629 like I sometimes struggle with that when I'm 00:07:53.629 --> 00:07:56.610 sleeping because one of these days this you know 00:07:56.610 --> 00:07:59.170 psychiatrist can say hey I'm retiring or I don't 00:07:59.170 --> 00:08:00.949 want to do this and then what the heck am I supposed 00:08:00.949 --> 00:08:03.569 to do with me and the other providers that I 00:08:03.569 --> 00:08:05.810 have and kind of my whole operation and stuff 00:08:05.810 --> 00:08:09.610 so I think that was a little bit of of just hearing 00:08:09.610 --> 00:08:11.610 that and hearing that like it's just a lot of 00:08:11.610 --> 00:08:15.949 uncertainty there also with my director for the 00:08:15.949 --> 00:08:19.209 dmp program she had mentioned that like the previous 00:08:19.209 --> 00:08:21.310 cohort i think they had had a small class like 00:08:21.310 --> 00:08:24.329 four people um none of them had been not licensed 00:08:24.329 --> 00:08:26.550 in texas they all lived there but they had been 00:08:26.550 --> 00:08:29.370 licensed in other states so she was mentioning 00:08:29.370 --> 00:08:31.569 that that was because of the environment and 00:08:31.569 --> 00:08:35.470 atmosphere for the practice uh availability and 00:08:35.470 --> 00:08:37.250 what you can and can't do there in texas for 00:08:37.250 --> 00:08:40.389 nurse practitioner so i think both of those and 00:08:40.389 --> 00:08:44.039 just the fact that I was from Washington, was 00:08:44.039 --> 00:08:47.559 a driving force to finish school in 2023 and 00:08:47.559 --> 00:08:51.139 then move back. Yeah, absolutely. I can definitely 00:08:51.139 --> 00:08:53.919 understand why you would do that because Washington 00:08:53.919 --> 00:08:57.139 is a great state to practice in and not to hate 00:08:57.139 --> 00:09:00.080 on Texas, but it seems like it's possibly one 00:09:00.080 --> 00:09:03.419 of the worst to practice in. So that makes a 00:09:03.419 --> 00:09:08.870 lot of sense. So you're bilingual. In Washington, 00:09:08.950 --> 00:09:12.090 especially in the areas that you're in, how important 00:09:12.090 --> 00:09:14.669 is it to have Spanish speaking psychiatric providers, 00:09:14.789 --> 00:09:17.470 would you say? I mean, it's big. I think central 00:09:17.470 --> 00:09:20.250 Washington for sure. And more eastern Washington, 00:09:20.370 --> 00:09:23.850 it's even bigger. I think my clinic manager and 00:09:23.850 --> 00:09:26.990 the rest of my staff is bilingual. And then right 00:09:26.990 --> 00:09:29.690 now, I guess I'm the only provider that is, but 00:09:29.690 --> 00:09:31.570 we're always looking. And that would for sure 00:09:31.570 --> 00:09:33.169 be a plus. It's just finding someone that speaks 00:09:33.169 --> 00:09:38.509 Spanish. So it's just it's a big part. With the 00:09:38.509 --> 00:09:40.570 availability of speaking Spanish, I mean, when 00:09:40.570 --> 00:09:43.429 I have those patients, it's good because it gets 00:09:43.429 --> 00:09:46.009 me to practice my medical Spanish and how do 00:09:46.009 --> 00:09:47.889 you ask them this and ask them that and stuff. 00:09:48.070 --> 00:09:52.409 But yeah, no, it's a huge thing. How is it there, 00:09:52.450 --> 00:09:54.909 I guess, in Arizona with you? It's definitely 00:09:54.909 --> 00:09:57.970 helpful to be bilingual. I wish that I was bilingual 00:09:57.970 --> 00:10:01.289 and I'm not, but definitely makes you much more 00:10:01.289 --> 00:10:03.809 marketable as a psych NP and a lot more opportunities 00:10:03.809 --> 00:10:07.559 for sure. Yeah. A lot of new grads feel like 00:10:07.559 --> 00:10:10.899 they need to work for someone else for a couple 00:10:10.899 --> 00:10:12.860 of years before going independent. It's, you 00:10:12.860 --> 00:10:15.159 know, one of those debated topics, right? You 00:10:15.159 --> 00:10:17.559 clearly didn't subscribe to that belief. What 00:10:17.559 --> 00:10:19.659 gave you the confidence to jump in, would you 00:10:19.659 --> 00:10:23.220 say? I would say, I mean, a lot of it is it's 00:10:23.220 --> 00:10:25.440 just never comparing ourselves to others because 00:10:25.440 --> 00:10:27.059 I always do it. But it's like you don't know, 00:10:27.059 --> 00:10:28.899 you know, obviously the whole story. Some people 00:10:28.899 --> 00:10:30.700 seem like they take off and they have a lot of 00:10:30.700 --> 00:10:33.000 success, but we don't know what's kind of under 00:10:33.000 --> 00:10:36.590 the hood and stuff. I'm more of the hybrid, like 00:10:36.590 --> 00:10:40.049 I always tell other students, like MP students 00:10:40.049 --> 00:10:43.429 or new providers, if you can go work for someone 00:10:43.429 --> 00:10:47.509 for a year. More like a 4 -10 schedule than that 00:10:47.509 --> 00:10:50.990 fifth day look at doing your own practice and 00:10:50.990 --> 00:10:53.070 kind of building. I think that that's probably 00:10:53.070 --> 00:10:55.070 like a healthier way to do it. That's what I 00:10:55.070 --> 00:10:57.389 did. I worked for about a year at a community 00:10:57.389 --> 00:11:00.669 mental health, learned a ton. We took their everything, 00:11:00.870 --> 00:11:03.450 which was great because I would see from five 00:11:03.450 --> 00:11:06.009 years old up to 90 years old. And it was just 00:11:06.009 --> 00:11:08.950 not a niche, but it got me to see a little bit 00:11:08.950 --> 00:11:11.289 of everything. And then just kind of when I went 00:11:11.289 --> 00:11:13.940 on my own, be in a position where I was. least 00:11:13.940 --> 00:11:16.899 a little bit comfortable, but I would say you 00:11:16.899 --> 00:11:18.860 worked in community health there in Washington 00:11:18.860 --> 00:11:22.059 first. Yeah. But I, I mean, I was pretty much 00:11:22.059 --> 00:11:24.019 since day one, I had my own practice. It was 00:11:24.019 --> 00:11:26.419 just a matter of, um, just doing it on, on the 00:11:26.419 --> 00:11:29.419 side or one Saturday a month or that's right. 00:11:29.500 --> 00:11:33.100 And stuff. So, yeah. Um, how much was your salary 00:11:33.100 --> 00:11:35.120 at that community health position? If you don't 00:11:35.120 --> 00:11:38.059 mind me asking, uh, I think it was around 160 00:11:38.059 --> 00:11:42.870 ,000. So, yeah, which was for it was in central 00:11:42.870 --> 00:11:45.490 Washington. So it was not like the cost up here 00:11:45.490 --> 00:11:47.750 in Seattle. So it was pretty fair. It also just 00:11:47.750 --> 00:11:50.009 came with a lot of good benefits. So I think 00:11:50.009 --> 00:11:52.269 you can go either way. I mean, I get usually 00:11:52.269 --> 00:11:54.950 week to week people send me Facebook messages 00:11:54.950 --> 00:11:57.570 or different chats about like mentorship or like, 00:11:57.590 --> 00:11:59.070 you know, I have a question about this or that. 00:11:59.649 --> 00:12:02.840 I think if. If you want to be successful from 00:12:02.840 --> 00:12:05.639 day one without going to work for someone, then 00:12:05.639 --> 00:12:07.679 you just, one, you better have a good chunk of 00:12:07.679 --> 00:12:09.620 money for investment for like everything that 00:12:09.620 --> 00:12:12.600 needs to be put in there. And then two, just 00:12:12.600 --> 00:12:15.220 be someone that you can learn quick and just, 00:12:15.240 --> 00:12:18.740 you know, go with change. Because if you're a 00:12:18.740 --> 00:12:21.000 brand new clinician and then also trying to start 00:12:21.000 --> 00:12:23.480 a business, it's doable. It's just going to be 00:12:23.480 --> 00:12:27.250 a lot. Yeah, for sure. How long did you stay 00:12:27.250 --> 00:12:31.389 at that community health clinic on the side? 00:12:31.809 --> 00:12:34.470 Yeah, I stayed about a year. So I think it was 00:12:34.470 --> 00:12:39.710 like 12, 13 or 14 months. So, OK, were you getting 00:12:39.710 --> 00:12:41.570 student loan repayment at the community health? 00:12:42.660 --> 00:12:46.039 Yeah, that that job was just unicorn. They were 00:12:46.039 --> 00:12:49.559 giving me 1500 bucks a month with no commitment. 00:12:49.740 --> 00:12:53.440 So and that was just a check to me. So which 00:12:53.440 --> 00:12:55.779 every year, which was the one year I would give 00:12:55.779 --> 00:12:59.460 them like the statements that it was applied, 00:12:59.659 --> 00:13:02.600 obviously, to the loans. But yeah, it was there 00:13:02.600 --> 00:13:04.899 was no contingency on you have to work here for 00:13:04.899 --> 00:13:07.299 this long or this or that. It was just a flat 00:13:07.299 --> 00:13:13.220 1500 bucks. Gotcha. Wow. That is cool. Okay. 00:13:13.279 --> 00:13:16.820 So people are very curious about kind of how 00:13:16.820 --> 00:13:20.740 to open a practice. So I just have a couple of 00:13:20.740 --> 00:13:23.919 questions for context as far as like how much 00:13:23.919 --> 00:13:26.700 money you spent kind of getting started with 00:13:26.700 --> 00:13:29.340 your practice, I think is a good place to start. 00:13:29.419 --> 00:13:32.679 And did you get credentialed independently off 00:13:32.679 --> 00:13:35.779 the bat or a little bit more about kind of taking 00:13:35.779 --> 00:13:39.990 insurance or referral sources and whatnot? yeah 00:13:39.990 --> 00:13:43.669 so i think doing it kind of hybrid start like 00:13:43.669 --> 00:13:45.710 i had mentioned it gives you a lot of avenues 00:13:45.710 --> 00:13:50.210 to um have that set income um if you're someone 00:13:50.210 --> 00:13:52.049 that has a spouse that makes more enough income 00:13:52.049 --> 00:13:54.250 well then even even more you can maybe do it 00:13:54.250 --> 00:13:58.559 but um initially when i started um I probably 00:13:58.559 --> 00:14:01.399 started with like $5 ,000 as far as just startup 00:14:01.399 --> 00:14:06.440 for just general stuff. But once I had that, 00:14:06.500 --> 00:14:08.700 I had Fridays off. So it was a Friday. Once I 00:14:08.700 --> 00:14:11.620 had that Friday, pretty much booked up to, I 00:14:11.620 --> 00:14:14.840 don't know, 9, 10, 11 patients. And that was 00:14:14.840 --> 00:14:16.919 like a consistent, you know, volume coming in. 00:14:17.559 --> 00:14:20.720 Then that's when I decided to spend more money 00:14:20.720 --> 00:14:24.419 and get help. Because the thing is, once you 00:14:24.419 --> 00:14:26.460 start getting help is when your practice will 00:14:26.460 --> 00:14:30.039 grow even more. So a lot of providers I've seen, 00:14:30.059 --> 00:14:32.039 they like to champion themselves of like doing 00:14:32.039 --> 00:14:34.779 everything. But that's going to be only for so 00:14:34.779 --> 00:14:36.159 long because you're either going to get burnt 00:14:36.159 --> 00:14:38.700 out or there's going to be a bottleneck of how 00:14:38.700 --> 00:14:41.179 much you can grow based on you doing admin plus 00:14:41.179 --> 00:14:45.399 doing the clinical side of it. OK, so you hired 00:14:45.399 --> 00:14:50.889 a virtual assistant. Yeah, so mine. Yeah, because 00:14:50.889 --> 00:14:56.669 maybe my ADHD or who knows why, I just hired 00:14:56.669 --> 00:14:58.950 someone full time that was in person because 00:14:58.950 --> 00:15:02.269 I had the I guess the more traditional would 00:15:02.269 --> 00:15:05.350 be hire a virtual assistant. People want 20 hours, 00:15:05.429 --> 00:15:07.070 but you really have to hire them for 40 hours 00:15:07.070 --> 00:15:08.950 because they don't really like do anything with 00:15:08.950 --> 00:15:13.049 the part time. The way I did was when I was full 00:15:13.049 --> 00:15:16.879 on Fridays. I was probably bringing around 10 00:15:16.879 --> 00:15:19.899 ,000 revenue just from Fridays. So I was like, 00:15:20.000 --> 00:15:22.500 well, I can hire someone for four or 5 ,000. 00:15:22.519 --> 00:15:25.299 If it's someone that is going to be full -time 00:15:25.299 --> 00:15:28.620 in person where we can meet up and also someone 00:15:28.620 --> 00:15:31.019 that I can invest for the rest of the time. I 00:15:31.019 --> 00:15:33.379 found someone that was a clinic manager at a 00:15:33.379 --> 00:15:35.759 family doctor's office, which is a little different, 00:15:35.840 --> 00:15:37.360 but they knew a little bit about everything. 00:15:37.799 --> 00:15:40.700 And then just basically offered them a full -time 00:15:40.700 --> 00:15:43.440 position. We waited a little bit on the benefits 00:15:43.440 --> 00:15:45.379 just because like, okay, give me some runway, 00:15:45.539 --> 00:15:47.399 you know, four or five months. And then we'll 00:15:47.399 --> 00:15:49.460 look at that. But I, you know, mentioned like 00:15:49.460 --> 00:15:51.779 my goal is for you to grow, for us to get you 00:15:51.779 --> 00:15:54.320 to a much higher position. Eventually get over 00:15:54.320 --> 00:15:56.360 a hundred thousand salary, like something where 00:15:56.360 --> 00:15:58.970 it's worth, you know, your time and stuff. it 00:15:58.970 --> 00:16:02.330 offered me the ability to train them in the time 00:16:02.330 --> 00:16:04.970 that i could but also they already knew how to 00:16:04.970 --> 00:16:06.929 be a manager so a lot of these roles they were 00:16:06.929 --> 00:16:09.110 able to like really run with the reception role 00:16:09.110 --> 00:16:11.850 the kind of medical assistant role the prior 00:16:11.850 --> 00:16:14.610 auths all that kind of stuff and then i knew 00:16:14.610 --> 00:16:16.309 that this person was the person i was going to 00:16:16.309 --> 00:16:18.570 use for any virtual assistant that i hired to 00:16:18.570 --> 00:16:22.230 train them yeah so in that case um you know for 00:16:22.230 --> 00:16:23.750 most people that's like well that's way too much 00:16:23.750 --> 00:16:26.710 to pay for someone but I knew it was a value 00:16:26.710 --> 00:16:28.490 that I was going to get down the road versus 00:16:28.490 --> 00:16:31.590 just thinking of it short term. And thus far, 00:16:31.690 --> 00:16:34.889 it's panned out really good. Yeah, I think kind 00:16:34.889 --> 00:16:37.970 of reinvesting strategically is really smart. 00:16:38.090 --> 00:16:41.190 And I think that's a unique kind of approach 00:16:41.190 --> 00:16:43.169 and model. And you're right. I think a lot of 00:16:43.169 --> 00:16:46.029 providers wait to hire support. But I think that's 00:16:46.029 --> 00:16:48.269 really interesting and cool. So does that person 00:16:48.269 --> 00:16:51.169 still work with you? And how has that role kind 00:16:51.169 --> 00:16:54.379 of... expanded and, you know, what kinds of things 00:16:54.379 --> 00:16:56.659 did she start out doing versus maybe what she 00:16:56.659 --> 00:16:59.759 does now? Yeah. So, um, yeah, I mean, they're, 00:16:59.759 --> 00:17:01.600 from what I know, kind of in the long haul of 00:17:01.600 --> 00:17:04.319 it, she started out with intake Q, which is what 00:17:04.319 --> 00:17:06.440 we use for EHR. She started out with headway 00:17:06.440 --> 00:17:09.579 who we use for billing, got those down and then 00:17:09.579 --> 00:17:11.380 did a little bit of the medical assistant work 00:17:11.380 --> 00:17:13.660 of like Q and me meds or like, you know, doing 00:17:13.660 --> 00:17:15.970 the prior odds or stuff like that. And then I 00:17:15.970 --> 00:17:17.869 was because she was in person, I was able to 00:17:17.869 --> 00:17:21.369 have her go to all the therapy offices in person, 00:17:21.650 --> 00:17:24.309 shake hands, give flyers and stuff like that. 00:17:24.410 --> 00:17:26.730 So she was kind of a little bit of everything 00:17:26.730 --> 00:17:30.609 in the beginning. And then after I decided to 00:17:30.609 --> 00:17:33.730 go full time in the in the practice, then we 00:17:33.730 --> 00:17:38.690 hired our first two assistants. And they did 00:17:38.690 --> 00:17:40.769 one did like patient care coordinator, which 00:17:40.769 --> 00:17:42.630 was like the reception work and the insurance 00:17:42.630 --> 00:17:45.829 stuff. And then the other one was a medical assistant 00:17:45.829 --> 00:17:49.650 work. So she was able to train them and kind 00:17:49.650 --> 00:17:51.670 of get them going. And then we just kind of grown 00:17:51.670 --> 00:17:54.549 from there. So that's cool. And were the two 00:17:54.549 --> 00:18:00.809 that you brought on, were they? Yeah. One was 00:18:00.809 --> 00:18:05.049 from Costa Rica and the other one's from Nicaragua. 00:18:05.470 --> 00:18:09.210 So. And how did you find them? So I used a company, 00:18:09.369 --> 00:18:13.190 you know, I did my research and I see that there 00:18:13.190 --> 00:18:16.009 was, you know, the Asia's where a lot of the 00:18:16.009 --> 00:18:19.069 companies are at, like the Philippines and stuff 00:18:19.069 --> 00:18:21.329 like that. I know Hello Reach is kind of big 00:18:21.329 --> 00:18:23.990 in that area. And then there's Latin America 00:18:23.990 --> 00:18:27.710 and there's the Middle East. because of having 00:18:27.710 --> 00:18:30.009 some patients that speak Spanish and because 00:18:30.009 --> 00:18:32.309 I wanted them to be in the same time zone for 00:18:32.309 --> 00:18:34.950 the most part. We use Remote Leverage, which 00:18:34.950 --> 00:18:37.130 is a company that I think they do everywhere, 00:18:37.250 --> 00:18:39.190 but they really concentrate on Latin America. 00:18:39.630 --> 00:18:42.829 So that's how we interviewed them, went through 00:18:42.829 --> 00:18:44.910 the panel and then landed on. I was going to 00:18:44.910 --> 00:18:47.549 hire one, but then just with my mind of like, 00:18:47.670 --> 00:18:50.190 OK, I'm growing, I need more. I ended up hiring 00:18:50.190 --> 00:18:53.990 initially two because at some point it's like, 00:18:54.109 --> 00:18:55.789 well, if you're going to train one, you might 00:18:55.789 --> 00:18:57.849 as well train two. If you can see if you can 00:18:57.849 --> 00:19:01.089 forecast growth there. So, yeah. OK. And for 00:19:01.089 --> 00:19:03.210 those positions, do you pay them like an affordable 00:19:03.210 --> 00:19:05.049 kind of hourly rate? Is that how that works? 00:19:05.630 --> 00:19:09.089 Yeah, so it's anywhere between, what do I pay 00:19:09.089 --> 00:19:12.009 them? Like 10 to, I think thus far we're up to 00:19:12.009 --> 00:19:15.269 11 bucks an hour. I mean, just trying to really 00:19:15.269 --> 00:19:17.809 keep people long -term. We probably do a lot 00:19:17.809 --> 00:19:19.690 of stuff that's kind of outside the box, but 00:19:19.690 --> 00:19:23.869 I think it'll pay in return. So we do the quarterly 00:19:23.869 --> 00:19:28.009 bonuses up to $300 a quarter. So that's based 00:19:28.009 --> 00:19:31.289 on performance. And then we do, so that's every 00:19:31.289 --> 00:19:34.009 quarter, just based on how you perform. We do 00:19:34.009 --> 00:19:38.130 five. days uh i think it's five days of major 00:19:38.130 --> 00:19:40.630 holidays off so they get those days for free 00:19:40.940 --> 00:19:43.180 They get up to five days off of vacation so they 00:19:43.180 --> 00:19:44.859 can pick whatever five days to use them however 00:19:44.859 --> 00:19:49.019 they want. And then we do summer break and winter 00:19:49.019 --> 00:19:51.579 break off. So what that looks like is the last 00:19:51.579 --> 00:19:54.619 week of June we'll have off. The whole clinic 00:19:54.619 --> 00:19:56.779 will have off and they get paid for that. And 00:19:56.779 --> 00:20:00.339 then winter we do December 24th till January 00:20:00.339 --> 00:20:02.440 1st of nine days. They'll have off and they get 00:20:02.440 --> 00:20:05.500 paid for. So the recruiters like those are just 00:20:05.500 --> 00:20:07.839 benefits I've never heard people doing. But like 00:20:07.839 --> 00:20:09.900 that's going to pay in return on investment down 00:20:09.900 --> 00:20:11.349 the road. because you're going to keep people 00:20:11.349 --> 00:20:14.990 there and stuff. And it's worked well. I think 00:20:14.990 --> 00:20:17.950 most people are very happy with working for us 00:20:17.950 --> 00:20:22.430 because we treat them like humans and just treat 00:20:22.430 --> 00:20:25.490 them well as best as we can. Yeah, it sounds 00:20:25.490 --> 00:20:27.809 like it's really important for you to reinvest 00:20:27.809 --> 00:20:30.230 in your business and your people and treat them 00:20:30.230 --> 00:20:32.490 right so that you retain them and they want to 00:20:32.490 --> 00:20:34.490 continue to work for you, which is, I think, 00:20:34.529 --> 00:20:40.099 really smart. Okay, so headway initially. So 00:20:40.099 --> 00:20:44.740 at what point did you start getting credentialed 00:20:44.740 --> 00:20:48.279 outside of Headway? And yeah, what did that look 00:20:48.279 --> 00:20:50.180 like? Or did you use any other platforms additionally? 00:20:50.809 --> 00:20:53.710 I just use Headway and now we've become a group 00:20:53.710 --> 00:20:57.150 practice and I use Headway still. I have independently 00:20:57.150 --> 00:21:00.490 credentialed for myself as kind of a backup and 00:21:00.490 --> 00:21:02.230 kind of working on the rest of the providers. 00:21:02.470 --> 00:21:04.970 I just from networking and talking to people, 00:21:05.029 --> 00:21:08.150 I had these two mentors that I met. One was in 00:21:08.150 --> 00:21:10.329 New York City and one was in Orange County, California. 00:21:10.730 --> 00:21:13.470 They both had like 10 plus provider group practice. 00:21:13.549 --> 00:21:15.430 So obviously knew what they were doing and got 00:21:15.430 --> 00:21:17.589 to that stage. And both of them use Headway. 00:21:18.200 --> 00:21:20.319 yeah they both use headway group practice billing 00:21:20.319 --> 00:21:22.460 so to me i'm like wait a minute if these people 00:21:22.460 --> 00:21:24.559 have these huge practices and they're using headway 00:21:24.559 --> 00:21:26.200 and they're fine with it and they've been using 00:21:26.200 --> 00:21:29.220 it for three or four years then i'm gonna guess 00:21:29.220 --> 00:21:32.220 that it probably should be okay so there's you 00:21:32.220 --> 00:21:35.710 know pros and cons to everything um I'm actually 00:21:35.710 --> 00:21:38.710 on, we'll probably can put in your links this 00:21:38.710 --> 00:21:41.890 Thursday at 515 Pacific Time. I'm going to do 00:21:41.890 --> 00:21:44.869 like a free like webinar kind of on Zoom as far 00:21:44.869 --> 00:21:46.930 as group practice on Headway because some people 00:21:46.930 --> 00:21:49.309 have asked me some like might as well just do 00:21:49.309 --> 00:21:53.750 some webinar. But with that, we just find that, 00:21:53.809 --> 00:21:56.509 you know, we get paid no matter what. I know 00:21:56.509 --> 00:21:59.150 there's like some code you can't use, but for 00:21:59.150 --> 00:22:01.309 us, it's mostly, you know, three or four billing 00:22:01.309 --> 00:22:04.779 codes and we just stick to that. So that's. who 00:22:04.779 --> 00:22:07.500 we use for any of the providers, including myself. 00:22:07.680 --> 00:22:10.880 I'll look later at maybe doing independent billing 00:22:10.880 --> 00:22:13.859 and stuff. It's just that opens a whole can of 00:22:13.859 --> 00:22:16.579 worms of like, do I hire a biller? And like, 00:22:16.700 --> 00:22:19.400 how good are they about chasing claims? Should 00:22:19.400 --> 00:22:22.559 we hire someone in -house to do them? So I think 00:22:22.559 --> 00:22:24.759 it's just a lot of stuff to think about there. 00:22:25.390 --> 00:22:27.829 Okay. So you run all your billing no matter where 00:22:27.829 --> 00:22:30.650 the referrals come from through Headway. Okay. 00:22:30.869 --> 00:22:33.049 Okay. That makes sense. It's interesting because 00:22:33.049 --> 00:22:36.390 I remember seeing a guy in, I believe it was 00:22:36.390 --> 00:22:39.289 Oregon, who same thing, he had scaled a group 00:22:39.289 --> 00:22:43.009 practice using Headway. And I reached out to 00:22:43.009 --> 00:22:45.609 him because I was considering at the time doing 00:22:45.609 --> 00:22:48.910 something similar. But I don't know. It was weird. 00:22:48.970 --> 00:22:51.190 I met with Headway and it seemed like they were 00:22:51.190 --> 00:22:55.569 like, we're not doing group. practice support 00:22:55.569 --> 00:22:57.650 or maybe they were like in the middle of a transition 00:22:57.650 --> 00:23:01.049 um but it was like kind of vague at the time 00:23:01.049 --> 00:23:03.769 so i just think it's interesting that like it 00:23:03.769 --> 00:23:06.730 sounds like for you it's worked great and it's 00:23:06.730 --> 00:23:09.549 possible and in what what's what month is it 00:23:09.549 --> 00:23:14.349 april 20 26 it's possible to build a group practice 00:23:14.349 --> 00:23:18.630 with using headway as kind of um your billing 00:23:18.630 --> 00:23:20.670 what percentage of your referrals would you say 00:23:20.670 --> 00:23:23.059 have come through headway i mean it peaks in 00:23:23.059 --> 00:23:25.720 you know highs and lows but i think on average 00:23:26.559 --> 00:23:29.519 i don't know probably maybe 20 of them come from 00:23:29.519 --> 00:23:32.279 there so i think a lot of it is just our availability 00:23:32.279 --> 00:23:35.279 having different uh providers um i hear from 00:23:35.279 --> 00:23:36.759 other providers who like i don't get anything 00:23:36.759 --> 00:23:39.059 from headway it's just for billing which is 100 00:23:39.059 --> 00:23:41.420 it's for billing but i don't know if it's the 00:23:41.420 --> 00:23:44.059 way our profiles are on there or what we do but 00:23:44.059 --> 00:23:45.779 we've actually had some pretty good success from 00:23:45.779 --> 00:23:48.700 just getting people to go on headway and stuff 00:23:48.700 --> 00:23:50.880 i think the i mean the biggest thing is just 00:23:50.880 --> 00:23:53.079 availability so people want to be seen today 00:23:53.079 --> 00:23:56.339 not tomorrow so it's part of it is the more providers 00:23:56.339 --> 00:23:57.839 you have the more availability someone could 00:23:57.839 --> 00:24:01.200 see someone today so yeah what's the main drawback 00:24:01.200 --> 00:24:04.259 would you say to using headway probably that 00:24:04.259 --> 00:24:06.759 sometimes when they verify benefits it might 00:24:06.759 --> 00:24:10.299 not be 100 what it is and then six months down 00:24:10.299 --> 00:24:12.720 the road the person can the patient can get like 00:24:12.720 --> 00:24:14.579 information that's different and now they've 00:24:14.579 --> 00:24:16.140 already established a relationship and now they 00:24:16.140 --> 00:24:19.220 have to decide what they want to do or if they 00:24:19.220 --> 00:24:21.279 you know been charged this different amounts 00:24:21.279 --> 00:24:23.500 on their credit card from the deductible So, 00:24:23.500 --> 00:24:26.039 yeah, I mean, that's probably the biggest drawback 00:24:26.039 --> 00:24:27.599 that there's no way around it. It's going to 00:24:27.599 --> 00:24:30.680 be what it's going to be. Yeah. How many providers 00:24:30.680 --> 00:24:33.220 do you have working for you now, Miguel? Four 00:24:33.220 --> 00:24:36.680 or five of us, including myself. So they're all 00:24:36.680 --> 00:24:40.500 1099. So most of them are full time, but some 00:24:40.500 --> 00:24:44.059 have more of a part time. And then the full time, 00:24:44.079 --> 00:24:47.539 they some of them work. I mean, the amount of 00:24:47.539 --> 00:24:49.319 patients I see or not, I'm probably the one that 00:24:49.319 --> 00:24:51.339 sees the most patients still just because I'm 00:24:51.339 --> 00:24:54.759 using the income to grow the practice. But we 00:24:54.759 --> 00:24:57.519 haven't set up a 1099. So with 1099, you can't 00:24:57.519 --> 00:25:00.059 control our schedule. So you can tell them like, 00:25:00.160 --> 00:25:02.079 you know, our full time goal is to get you four 00:25:02.079 --> 00:25:04.279 days a week and have, you know, one day off for 00:25:04.279 --> 00:25:06.720 admin or to do whatever. But they can dictate 00:25:06.720 --> 00:25:08.880 how many patients they see that the days that 00:25:08.880 --> 00:25:12.140 they do, they do work and stuff. So. So, yeah, 00:25:12.200 --> 00:25:15.549 right now it's five of us. Okay. And how does 00:25:15.549 --> 00:25:18.529 the pay work for them, if you don't mind me asking? 00:25:19.230 --> 00:25:22.769 Yeah. So with the 1099, we just have a flat 70 00:25:22.769 --> 00:25:25.430 -30 split. So they get 70 % of what we collect, 00:25:25.549 --> 00:25:28.190 and then we get 30%. We're pretty good about 00:25:28.190 --> 00:25:32.289 even cancellation. So our cancellation are pretty 00:25:32.289 --> 00:25:34.910 much the full appointment visit. So most of the 00:25:34.910 --> 00:25:36.890 time, we don't have any cancellations from patients. 00:25:37.430 --> 00:25:40.210 But if we do, they even get from that split as 00:25:40.210 --> 00:25:46.190 well. Okay. Okay. That's cool. And what is your 00:25:46.190 --> 00:25:50.630 view on like in -person versus like virtual versus 00:25:50.630 --> 00:25:55.869 like hybrid psychiatric care? Yeah, I think, 00:25:55.950 --> 00:25:59.849 I mean, I've seen it both ways. I think probably 00:25:59.849 --> 00:26:02.390 the hybrid's the best option, but it's hard. 00:26:02.490 --> 00:26:04.470 I mean, you, you know, from seeing patients still 00:26:04.470 --> 00:26:09.019 after COVID people just want to do online. for 00:26:09.019 --> 00:26:11.519 many reasons and stuff. So many of the providers 00:26:11.519 --> 00:26:12.980 that I've networked or talked with, I always 00:26:12.980 --> 00:26:14.839 ask them that question like, hey, how many people 00:26:14.839 --> 00:26:17.759 do you see in person versus virtual? And most 00:26:17.759 --> 00:26:19.700 of the time it's 80 to 90 % is still virtual. 00:26:19.960 --> 00:26:23.849 So I think that. For us, it's, I mean, I see 00:26:23.849 --> 00:26:25.789 patients in person on Fridays if they want to 00:26:25.789 --> 00:26:27.690 be seen in person, but if not, the rest of the 00:26:27.690 --> 00:26:30.789 time it's all virtual and stuff. So I've seen 00:26:30.789 --> 00:26:33.309 people scale completely virtual and I've seen 00:26:33.309 --> 00:26:36.730 other ones that do a mix of both. So I think 00:26:36.730 --> 00:26:39.869 for us, it's a little bit more possible. I would 00:26:39.869 --> 00:26:42.329 say like if I open up a therapy practice and 00:26:42.329 --> 00:26:45.680 have therapists. For that, I would say I could 00:26:45.680 --> 00:26:47.960 see where more patients want for an hour to see 00:26:47.960 --> 00:26:50.240 someone in person. But there's people that do 00:26:50.240 --> 00:26:53.500 also just virtual for therapy. So but I think 00:26:53.500 --> 00:26:55.940 I think hybrid is probably the best option if 00:26:55.940 --> 00:26:58.500 you can. But I've seen it done both ways. So 00:26:58.500 --> 00:27:01.539 your in -person locations, because now I'm curious, 00:27:01.700 --> 00:27:03.859 like, are your providers all in Washington? And 00:27:03.859 --> 00:27:06.539 then also, like, do you have a lot of overhead 00:27:06.539 --> 00:27:08.940 with these in -person locations or is it like 00:27:08.940 --> 00:27:11.460 space you rent from a therapist? Does it help 00:27:11.460 --> 00:27:15.470 with like the marketing? yeah so we have out 00:27:15.470 --> 00:27:19.029 of the five we have um three that are like offices 00:27:19.029 --> 00:27:21.430 and then the other two are more satellite offices 00:27:21.430 --> 00:27:23.730 they're offices but they're ones that we rent 00:27:23.730 --> 00:27:27.910 space from so um the providers we have they're 00:27:27.910 --> 00:27:30.670 all from washington um i've kind of made that 00:27:30.670 --> 00:27:33.089 as a rule i don't know if it's good or bad but 00:27:33.089 --> 00:27:35.569 just um i need to be able to shake your hand 00:27:35.569 --> 00:27:37.369 i need to be able to like go to lunch or else 00:27:37.369 --> 00:27:39.450 have conversations about how stuff's going how 00:27:39.450 --> 00:27:42.430 stuff's growing so i know i mean i can get a 00:27:42.430 --> 00:27:44.269 provider in maine i can get a provider anywhere 00:27:44.269 --> 00:27:47.309 to work here but i think since we only focus 00:27:47.309 --> 00:27:49.410 on washington i want to have providers from here 00:27:49.410 --> 00:27:51.329 and stuff and i mean there's enough providers 00:27:51.329 --> 00:27:54.049 to hire so thus far that's where it's at but 00:27:54.049 --> 00:27:56.630 i've been approached by um different providers 00:27:56.630 --> 00:27:58.970 like hey are you hiring i'm in texas i'm in these 00:27:58.970 --> 00:28:00.930 other places but as of right now we've been just 00:28:00.930 --> 00:28:04.339 hiring local Okay. And are these people you like, 00:28:04.339 --> 00:28:09.220 like word of mouth or Facebook groups or how 00:28:09.220 --> 00:28:10.839 do you usually hear about the providers you hire? 00:28:11.380 --> 00:28:15.400 Yeah. So they've been surprisingly, cause I haven't 00:28:15.400 --> 00:28:19.279 too, too much of pre -settling or affiliate before 00:28:19.279 --> 00:28:21.059 the last couple of months with the universities. 00:28:21.220 --> 00:28:23.359 They've been, I think all the ones that I have 00:28:23.359 --> 00:28:26.279 are from LinkedIn. Interesting. Yeah, I posted 00:28:26.279 --> 00:28:29.960 a job and then they applied and they liked what 00:28:29.960 --> 00:28:31.599 they heard and they decided to come on board. 00:28:31.880 --> 00:28:37.400 I love that. I love that. So a lot of your referrals 00:28:37.400 --> 00:28:42.299 come from therapists, right? Mm -hmm. And have 00:28:42.299 --> 00:28:44.559 you done a lot of the boots on the ground marketing 00:28:44.559 --> 00:28:48.640 or primarily has it been like your office manager? 00:28:49.420 --> 00:28:54.180 So initially I did, I did a lot of like lunch 00:28:54.180 --> 00:28:56.119 meets, even though it was like a virtual kind 00:28:56.119 --> 00:28:59.920 of resume meets. And then I had the clinic manager 00:28:59.920 --> 00:29:04.720 do some in -person marketing. And then when we 00:29:04.720 --> 00:29:07.940 went from the referral coordinator and the medical 00:29:07.940 --> 00:29:10.140 assistant, patient care coordinator, then came 00:29:10.140 --> 00:29:12.319 a referral coordinator, aka our marketing person. 00:29:12.480 --> 00:29:16.140 So we hired her and she was the one that's really 00:29:16.140 --> 00:29:19.319 helped us to grow even more. Her main, role is 00:29:19.319 --> 00:29:22.539 to talk to every therapist in washington state 00:29:22.539 --> 00:29:26.059 so find a way to get to that level so she does 00:29:26.059 --> 00:29:29.660 zoom chat she does phone calls and she's on the 00:29:29.660 --> 00:29:32.359 in most states you have facebook groups per county 00:29:32.359 --> 00:29:34.460 or per area for facebook therapists where they 00:29:34.460 --> 00:29:37.740 like hey i you know in search of a prescriber 00:29:37.740 --> 00:29:40.480 or psychiatrist that can help this patient so 00:29:40.480 --> 00:29:43.180 she's on there she's commenting and then she's 00:29:43.180 --> 00:29:45.839 also connecting with them and trying to set up 00:29:46.799 --> 00:29:48.700 chat so she can get they can get to know her 00:29:48.700 --> 00:29:50.839 and get to know our practice and that's worked 00:29:50.839 --> 00:29:53.740 wonders i think that that's um something that 00:29:53.740 --> 00:29:56.599 i'm looking at maybe rolling out later with hiring 00:29:56.599 --> 00:30:01.109 more staff that people can like hire subcontract 00:30:01.109 --> 00:30:03.269 from me, someone that can do that for them. Because 00:30:03.269 --> 00:30:06.109 when you look at all different people and referrals, 00:30:06.430 --> 00:30:10.049 nothing beats a therapist referral because they're 00:30:10.049 --> 00:30:11.849 more committed patients. They're more serious 00:30:11.849 --> 00:30:14.390 about getting better. And you can refer back 00:30:14.390 --> 00:30:16.109 to the therapist after the initial appointment 00:30:16.109 --> 00:30:18.210 and say, Hey, how are they doing? Give me some 00:30:18.210 --> 00:30:19.849 insight. And then they give you all this insight. 00:30:20.150 --> 00:30:22.950 So compared to headway or ZocTalk or any of the 00:30:22.950 --> 00:30:25.650 referral source, I always tell any provider therapist 00:30:25.650 --> 00:30:28.950 referrals are the best referral sources. Okay. 00:30:29.660 --> 00:30:31.799 And so basically you're saying you hired somebody 00:30:31.799 --> 00:30:35.299 to full -time be like marketing for you, right? 00:30:35.500 --> 00:30:39.680 Yeah. That's cool. That's really cool. compared 00:30:39.680 --> 00:30:42.259 to the google ads or compared to everything else 00:30:42.259 --> 00:30:45.279 um i think it's just the best way to go it's 00:30:45.279 --> 00:30:46.839 just you gotta know how to train them you gotta 00:30:46.839 --> 00:30:48.599 get someone that's you know good personality 00:30:48.599 --> 00:30:51.180 kind of bubbly someone that's gonna not be afraid 00:30:51.180 --> 00:30:54.019 to get on the phone or do zoom stuff i mean she's 00:30:54.019 --> 00:30:57.160 she's been able to have uh like group owners 00:30:57.160 --> 00:31:00.819 of therapy clinic or uh offices with like i don't 00:31:00.819 --> 00:31:03.519 know 10 15 therapists to chat with herself so 00:31:03.519 --> 00:31:06.059 when you get someone to that caliber like you're 00:31:06.059 --> 00:31:09.420 they're doing just fine so uh some of these they'll 00:31:09.420 --> 00:31:11.859 talk to me and we'll have that conversation after 00:31:11.859 --> 00:31:14.240 or some she's doing fine with and networking 00:31:14.240 --> 00:31:18.000 with them so yeah i think yeah that's smart she's 00:31:18.000 --> 00:31:20.279 a little bit of a unicorn i don't know how i 00:31:20.279 --> 00:31:21.779 would say you're gonna find a bunch of times 00:31:21.779 --> 00:31:24.500 this situation but she's been working well for 00:31:24.500 --> 00:31:27.339 us and stuff and i think with a lot of providers 00:31:27.339 --> 00:31:29.039 that's where they struggle is like i don't know 00:31:29.039 --> 00:31:31.619 how to do marketing which I always tell people, 00:31:31.700 --> 00:31:34.660 you know, prior practice is half clinical and 00:31:34.660 --> 00:31:37.619 half business and business does not care anything 00:31:37.619 --> 00:31:39.759 about clinical. So you can be the best clinician, 00:31:39.759 --> 00:31:41.839 but if you don't know how to market and get the 00:31:41.839 --> 00:31:44.220 business stuff going, then you're going to struggle. 00:31:44.880 --> 00:31:48.619 Yeah. Have you put a lot of money into like Google 00:31:48.619 --> 00:31:51.119 ads? I don't think we put any dollars into Google 00:31:51.119 --> 00:31:54.200 ads. So we've been able to just from our referral 00:31:54.200 --> 00:31:56.869 sources, get patients to keep growing. Okay. 00:31:56.930 --> 00:31:59.789 And how did you find this marketing? I don't 00:31:59.789 --> 00:32:01.230 know what her title is, but how did you find 00:32:01.230 --> 00:32:04.109 her? Through remote leverage, through like the 00:32:04.109 --> 00:32:06.390 virtual assistant setup too. Oh, so she's not 00:32:06.390 --> 00:32:10.329 in Washington. Nope. That's incredible. Yeah. 00:32:10.470 --> 00:32:15.539 She is in Nicaragua too. so um i've actually 00:32:15.539 --> 00:32:17.900 i'm it might be even some people that hear this 00:32:17.900 --> 00:32:21.460 but i've had two psychiatrists and three psych 00:32:21.460 --> 00:32:23.839 mps try to poach her for me and she sends me 00:32:23.839 --> 00:32:25.740 like the little screenshots what they send her 00:32:25.740 --> 00:32:27.559 and i'm like here's 100 bucks for doing that 00:32:27.559 --> 00:32:29.119 like i appreciate you letting me know because 00:32:29.119 --> 00:32:31.440 they're basically like oh i'll pay you more you 00:32:31.440 --> 00:32:34.160 know it's like okay but Because she, you know, 00:32:34.160 --> 00:32:36.200 likes the culture we have here with all the other 00:32:36.200 --> 00:32:38.140 staff and everything, I'm sure, you know, and 00:32:38.140 --> 00:32:39.799 the pay and different things, she's not going 00:32:39.799 --> 00:32:41.680 to just go somewhere else. So, and I, and I've 00:32:41.680 --> 00:32:44.779 told her if we keep growing and you can, if I 00:32:44.779 --> 00:32:47.579 get venture this idea of training someone to 00:32:47.579 --> 00:32:49.779 kind of have another provider want to use the 00:32:49.779 --> 00:32:52.319 services, you know, we'll increase pay or we'll 00:32:52.319 --> 00:32:53.900 do some other stuff. So I'm always going to, 00:32:53.900 --> 00:32:55.900 I'm going to expect a lot from you, but I'm also 00:32:55.900 --> 00:32:58.559 going to pay you for that added value you're 00:32:58.559 --> 00:33:00.559 bringing. So that's intriguing though, because 00:33:00.559 --> 00:33:04.119 it's like, I feel like it is. harder to form 00:33:04.119 --> 00:33:08.460 those relationships virtually? You know, is it 00:33:08.460 --> 00:33:10.579 just like she's doing the Zoom coffee chats or 00:33:10.579 --> 00:33:12.759 is she providing value to these practice to the 00:33:12.759 --> 00:33:16.400 therapy therapists? Yeah. So one of the things 00:33:16.400 --> 00:33:17.980 that I started initially that she kind of took 00:33:17.980 --> 00:33:21.839 over was I started a therapist referral network. 00:33:22.039 --> 00:33:24.200 And what that looks like, it's an outlook email 00:33:24.200 --> 00:33:28.599 group. And every so often, like not every so 00:33:28.599 --> 00:33:31.630 often, every few days in a week. they're like 00:33:31.630 --> 00:33:33.750 blind carbon copy they'll get an email saying 00:33:33.750 --> 00:33:38.829 hey we have two patients the 21 female this is 00:33:38.829 --> 00:33:41.309 their issue this is their insurance you know 00:33:41.309 --> 00:33:44.930 30 year old uh male this is their insurance this 00:33:44.930 --> 00:33:46.990 is their issue please reply if you have availability 00:33:46.990 --> 00:33:49.089 in the next two weeks if you take their insurance 00:33:49.089 --> 00:33:52.230 and if you want to help them and uh we've grown 00:33:52.230 --> 00:33:54.809 that network to about almost 200 therapists in 00:33:54.809 --> 00:33:57.630 washington state so with this is another way 00:33:57.630 --> 00:34:00.029 for her to stay in touch with the therapist so 00:34:00.769 --> 00:34:03.009 And we've been we've been able to get a lot of 00:34:03.009 --> 00:34:06.910 referrals from there, too. So. OK. OK. Those 00:34:06.910 --> 00:34:09.849 patients are like your guys's patients that you're 00:34:09.849 --> 00:34:15.079 referring to therapists. OK. So in a way, she 00:34:15.079 --> 00:34:17.500 acts almost like a social worker of all finding 00:34:17.500 --> 00:34:19.920 resources, which is huge because no one, no one 00:34:19.920 --> 00:34:22.159 that I know from the practice here in Washington 00:34:22.159 --> 00:34:24.500 is doing stuff like that. Unless you're in community 00:34:24.500 --> 00:34:26.780 mental health and you have just the funds to 00:34:26.780 --> 00:34:29.219 hire someone to do that. So let's say I get a 00:34:29.219 --> 00:34:31.599 patient and they seem like they need a therapist 00:34:31.599 --> 00:34:33.860 from their ACE score, from the like stuff they 00:34:33.860 --> 00:34:36.699 mentioned. I'll ask them if they want one. If 00:34:36.699 --> 00:34:39.239 they say, yeah, then on Spruce, I'll page JC. 00:34:39.699 --> 00:34:42.250 She'll call them, get a little bit of info. and 00:34:42.250 --> 00:34:45.809 then she'll blast this email group with the patient. 00:34:46.210 --> 00:34:52.769 And then usually within 48 hours, they'll have 00:34:52.769 --> 00:34:55.989 an email with who replied and who the patient 00:34:55.989 --> 00:34:58.309 has to just call. So I always tell the patients, 00:34:58.369 --> 00:35:00.050 we literally do all the heavy lifting. Instead 00:35:00.050 --> 00:35:02.489 of telling you, go on psychology today and call 00:35:02.489 --> 00:35:04.469 these 10 people that maybe two will call back 00:35:04.469 --> 00:35:06.070 and then they'll tell you they don't have availability 00:35:06.070 --> 00:35:08.130 for a month. We're pretty much doing all the 00:35:08.130 --> 00:35:10.949 heavy lifting. So that gets us good with a therapist. 00:35:11.309 --> 00:35:12.409 Because they're like, well, crap, they're giving 00:35:12.409 --> 00:35:14.809 me free referrals. But that also gets them to 00:35:14.809 --> 00:35:17.110 be friendly with us to send us referrals. So 00:35:17.110 --> 00:35:19.949 it's a win -win. Very smart. So these kind of 00:35:19.949 --> 00:35:22.829 strategies, did you like come up with these yourself 00:35:22.829 --> 00:35:26.550 or was it from these business mentors? And then 00:35:26.550 --> 00:35:28.449 also, did you like pay these business mentors 00:35:28.449 --> 00:35:31.110 or do you pay for coaching or business mentorship? 00:35:31.809 --> 00:35:36.190 Yeah, the that idea with a therapist, that's 00:35:36.190 --> 00:35:38.550 just out of my own brain as far as just like 00:35:38.550 --> 00:35:40.510 being in cells before and just saying, OK, like 00:35:40.510 --> 00:35:43.250 what can be something that could work? And just 00:35:43.250 --> 00:35:45.389 knowing that I wanted to focus on therapists 00:35:45.389 --> 00:35:48.289 and stuff. So that was just organically just 00:35:48.289 --> 00:35:51.409 like other ideas that kind of came up. But yeah, 00:35:51.550 --> 00:35:54.030 I mean, I have two kind of business mentors that 00:35:54.030 --> 00:35:57.170 I see. I pay them every month. And then I have 00:35:57.170 --> 00:36:00.050 also Dr. Hecox, who's a psychiatrist there in 00:36:00.050 --> 00:36:02.059 Colorado, and he does. case consults monthly 00:36:02.059 --> 00:36:05.400 so with him we just talked shop about like the 00:36:05.400 --> 00:36:07.980 the cases i mean he's been a psychiatrist for 00:36:07.980 --> 00:36:10.340 25 years so he's pretty much seen it all and 00:36:10.340 --> 00:36:13.869 stuff um and that's probably a thing that i'm 00:36:13.869 --> 00:36:15.969 always trying to tell anybody that i talk to 00:36:15.969 --> 00:36:19.150 is just like we need to focus on mentors and 00:36:19.150 --> 00:36:22.230 we need to focus on just stop being the silo 00:36:22.230 --> 00:36:24.309 at this profession is which a lot of it once 00:36:24.309 --> 00:36:26.050 you get into especially telehealth it's like 00:36:26.050 --> 00:36:27.650 you're by yourself all the time and that's not 00:36:27.650 --> 00:36:30.130 healthy for us so getting mentors for clinical 00:36:30.130 --> 00:36:32.809 stuff as well as for business i think is like 00:36:32.809 --> 00:36:35.110 there's no reason to reinvent the wheel so just 00:36:35.110 --> 00:36:38.050 pay someone that's done it get you know all the 00:36:38.050 --> 00:36:39.750 stuff they're going to save you and i'm sure 00:36:39.750 --> 00:36:41.170 they'll save you way more than what you're paying 00:36:41.170 --> 00:36:44.500 them so Yeah. I always see you on the Facebook 00:36:44.500 --> 00:36:48.139 groups. Are you just like trying to provide free 00:36:48.139 --> 00:36:55.059 value to kind of build? Yeah, I. but right now 00:36:55.059 --> 00:36:59.239 yeah i mean um some of it is i feel like with 00:36:59.239 --> 00:37:00.840 some of the clinicians that are coming out from 00:37:00.840 --> 00:37:03.940 the stuff that i see um i think the schools need 00:37:03.940 --> 00:37:07.500 to like the schools are in their own uh disaster 00:37:07.500 --> 00:37:09.639 because of the funding cuts and different things 00:37:09.639 --> 00:37:11.039 with a lot of the nursing schools and they're 00:37:11.039 --> 00:37:12.980 just you know teaching to whatever the boards 00:37:12.980 --> 00:37:15.639 are but there's a lot of like what i call common 00:37:15.639 --> 00:37:18.619 sense which is a lot of like your mentorship 00:37:18.619 --> 00:37:20.980 programs or stuff like that um or some of the 00:37:20.980 --> 00:37:22.420 other ones but there's a lot of stuff that they 00:37:22.420 --> 00:37:24.960 just don't learn So some of the stuff I'll post 00:37:24.960 --> 00:37:27.880 on there is for that last week. And then this 00:37:27.880 --> 00:37:31.239 week I did these webinars and those are just 00:37:31.239 --> 00:37:33.380 one -offs. Like I'm not asking for any money 00:37:33.380 --> 00:37:35.280 or anything. It's just like, here's some information 00:37:35.280 --> 00:37:37.780 from my experience. And then just cause I keep 00:37:37.780 --> 00:37:40.219 seeing people fail and just struggle. And it's 00:37:40.219 --> 00:37:42.380 like, they need to understand that the reason 00:37:42.380 --> 00:37:44.280 that they're struggling is because of this reason. 00:37:44.360 --> 00:37:47.900 So, yeah, but some of the stuff, I guess in the 00:37:47.900 --> 00:37:49.840 beginning I was on it a lot more than you see 00:37:49.840 --> 00:37:51.440 it kind of burnt out sometimes I'm being on this 00:37:51.440 --> 00:37:54.530 group. So, yeah. Some of your comments make me 00:37:54.530 --> 00:37:59.289 laugh sometimes. Well, I just I'm like the worst 00:37:59.289 --> 00:38:01.849 about the anonymous ones. Like we should have 00:38:01.849 --> 00:38:03.610 something where like you don't post anonymous 00:38:03.610 --> 00:38:07.030 because I understand so many reasons why. But 00:38:07.030 --> 00:38:10.510 at the same time, it can provide like you don't 00:38:10.510 --> 00:38:11.989 know who's asking the question and what's their 00:38:11.989 --> 00:38:14.030 intent and stuff like that. So I think some of 00:38:14.030 --> 00:38:18.090 the times it's been some of that. Yeah. You have 00:38:18.090 --> 00:38:20.150 been such a wealth of information. I'm not quite 00:38:20.150 --> 00:38:21.969 done yet. I have a few more questions if you 00:38:21.969 --> 00:38:26.239 have the time for it. Yeah. What does a personal 00:38:26.239 --> 00:38:29.840 brand kind of mean to you as a psych NP? Like, 00:38:29.900 --> 00:38:31.739 do you think it's important for psych MPs in 00:38:31.739 --> 00:38:35.369 2026? And what does it really mean? Yeah, I think 00:38:35.369 --> 00:38:37.190 this is one of the areas that I think I've even 00:38:37.190 --> 00:38:40.530 asked you about and just like the dynamic of 00:38:40.530 --> 00:38:42.750 the whole social media and just like, you know, 00:38:42.750 --> 00:38:45.349 even how to balance that. But I mean, the answer 00:38:45.349 --> 00:38:48.590 is 100%. You have some of these influencers or 00:38:48.590 --> 00:38:50.710 drifters that are just like saying stuff, doing 00:38:50.710 --> 00:38:52.869 stuff that have no business, but they have a 00:38:52.869 --> 00:38:55.889 following and people listen to them. And I think 00:38:55.889 --> 00:38:59.889 just the morph of podcasts and just the social 00:38:59.889 --> 00:39:02.670 media influencers, there's just a lot of misinformation 00:39:02.670 --> 00:39:07.010 out there. So I think, yeah, I mean, I think 00:39:07.010 --> 00:39:09.190 that would be, I mean, I'm sure even if you did, 00:39:09.190 --> 00:39:10.730 I don't know if you have a course or not for 00:39:10.730 --> 00:39:12.530 like that stuff, I'm sure you would get a lot 00:39:12.530 --> 00:39:14.050 of people that would be interested in learning 00:39:14.050 --> 00:39:16.369 from your experience. But that's something that 00:39:16.369 --> 00:39:18.210 I've considered of hiring someone to help me 00:39:18.210 --> 00:39:20.750 with some of that. I just. I have way too much 00:39:20.750 --> 00:39:22.429 on my plate right now with different business 00:39:22.429 --> 00:39:24.550 services or ventures that I'm looking at. But 00:39:24.550 --> 00:39:26.489 I know down the road, I need to hire someone 00:39:26.489 --> 00:39:29.530 that can help me with more strategic stuff. But 00:39:29.530 --> 00:39:32.889 I would say, yeah. I would say, I don't know 00:39:32.889 --> 00:39:34.789 if you agree with this or not. I don't know if 00:39:34.789 --> 00:39:37.269 that's going to be a real big referral source 00:39:37.269 --> 00:39:40.070 to get patients. But I think it's more of people 00:39:40.070 --> 00:39:42.190 are going to Google you patients all the time. 00:39:42.210 --> 00:39:44.230 Google the provider, I'm sure, or look up who 00:39:44.230 --> 00:39:46.289 they are. And if stuff comes up where you're 00:39:46.289 --> 00:39:48.690 educating, then that's going to give you a little 00:39:48.690 --> 00:39:51.699 bit more. you know kudos and stuff what do you 00:39:51.699 --> 00:39:53.619 think about from you and your experience and 00:39:53.619 --> 00:39:56.619 people you've coached um does it bring referrals 00:39:56.619 --> 00:39:59.000 or is it more just for like branding sometimes 00:39:59.000 --> 00:40:03.780 but i would say unless your social page is like 00:40:03.780 --> 00:40:06.900 specifically for private practice and you're 00:40:06.900 --> 00:40:11.099 like talking to the people who are like the niche 00:40:11.099 --> 00:40:13.840 of your practice like i think there's a therapist 00:40:13.840 --> 00:40:18.389 uh what's her name kelly sit with Kelly. I think 00:40:18.389 --> 00:40:21.349 her handle is she's in Florida and, you know, 00:40:21.349 --> 00:40:24.210 she has a page dedicated to her private practice. 00:40:24.329 --> 00:40:27.070 And so she gets a lot of patients that way. But 00:40:27.070 --> 00:40:29.909 I think kind of how I've done my social media 00:40:29.909 --> 00:40:33.480 focusing more like. broad, not necessarily. And 00:40:33.480 --> 00:40:36.659 that was never like my goal or intention. Well, 00:40:36.719 --> 00:40:38.139 I guess I shouldn't say that because I did start 00:40:38.139 --> 00:40:40.219 out with the page being like my private practice 00:40:40.219 --> 00:40:43.300 name because I felt more comfortable like just 00:40:43.300 --> 00:40:44.980 showing up under my business instead of just 00:40:44.980 --> 00:40:47.239 showing up as me. You know what I mean? But yeah, 00:40:47.320 --> 00:40:48.960 I wouldn't say like a huge referral source. I 00:40:48.960 --> 00:40:53.840 would say more opportunities as far as like coaching, 00:40:53.980 --> 00:40:57.820 consulting, different revenue streams have been 00:40:57.820 --> 00:41:03.489 come about from that visibility. Yeah. Yeah. 00:41:04.289 --> 00:41:07.409 Yeah. I mean, I think I just wish that everything 00:41:07.409 --> 00:41:09.289 in life is about plug and play. Most people just 00:41:09.289 --> 00:41:11.989 want something to easy to some extent. So I wish 00:41:11.989 --> 00:41:14.789 in a way there was more of these options because 00:41:14.789 --> 00:41:17.289 there are some very brilliant providers out there 00:41:17.289 --> 00:41:19.630 that just, I think, get scared about like the 00:41:19.630 --> 00:41:22.010 how you do everything and how much time consuming 00:41:22.010 --> 00:41:24.309 where it'd be nice if there's some like some 00:41:24.309 --> 00:41:25.989 service in between that would help them with 00:41:25.989 --> 00:41:29.659 that. I agree. I know. For physicians, there's 00:41:29.659 --> 00:41:31.960 a group called like, so me docs, and I think 00:41:31.960 --> 00:41:33.619 they do that kind of thing for physicians, but 00:41:33.619 --> 00:41:37.059 there's not really so much for psych NPs, but 00:41:37.059 --> 00:41:39.920 I 100 % agree. And this is like, even just like 00:41:39.920 --> 00:41:42.719 a small step, this podcast trying to get like, 00:41:42.800 --> 00:41:45.360 maybe people who would be more under the radar, 00:41:45.380 --> 00:41:49.860 like, to share their knowledge and their gems, 00:41:49.900 --> 00:41:52.420 because, you know, to your point, like, you're 00:41:52.420 --> 00:41:54.179 the psychiatrist you meet with, is he the one 00:41:54.179 --> 00:41:57.679 who did that therapy retreat? Yeah, that's cool. 00:41:58.269 --> 00:42:01.650 yeah the two -day workshop in fort collins colorado 00:42:01.650 --> 00:42:04.739 yeah But yeah, I think that, I mean, I think 00:42:04.739 --> 00:42:07.760 in the beginning, I mean, it's good to have a 00:42:07.760 --> 00:42:10.659 case consult with someone probably monthly. And 00:42:10.659 --> 00:42:12.880 then also if you can do group ones. So here in 00:42:12.880 --> 00:42:15.599 Washington, in Seattle, there's a group one that 00:42:15.599 --> 00:42:17.280 I got kind of invited to and I've been doing 00:42:17.280 --> 00:42:20.360 it for two months now. And it's the second Friday 00:42:20.360 --> 00:42:22.320 of the month, they meet for two hours and it's 00:42:22.320 --> 00:42:24.840 kind of round table. It's like 15 psych MPs that 00:42:24.840 --> 00:42:27.519 talk about cases or different things. So I could 00:42:27.519 --> 00:42:29.280 do a lot of this because of having a lot of assistants 00:42:29.280 --> 00:42:31.780 or staff to help me with everything else. But 00:42:31.780 --> 00:42:34.579 like once you are doing this for a while, like 00:42:34.579 --> 00:42:36.800 even with open evidence or with everything else 00:42:36.800 --> 00:42:38.820 out there and Carla, there's still going to be 00:42:38.820 --> 00:42:40.139 stuff that you're like, I just don't know what 00:42:40.139 --> 00:42:42.719 to do in this situation. So, yeah, especially 00:42:42.719 --> 00:42:44.860 with the world we live in, with layoffs and with 00:42:44.860 --> 00:42:46.619 AI and with everything else, there are certain 00:42:46.619 --> 00:42:49.159 problems that there's nothing we can do. It's 00:42:49.159 --> 00:42:51.599 just going to be what it's going to be. So, yeah, 00:42:51.719 --> 00:42:53.980 no, 100 percent. How did you find that group? 00:42:54.519 --> 00:42:57.139 It was actually a psych MP who's retiring and 00:42:57.139 --> 00:43:00.519 she reached out if anybody wanted her patients 00:43:00.519 --> 00:43:02.280 pretty much. And, you know, I'm going to be quick 00:43:02.280 --> 00:43:04.400 on that. So I met with her for a Zoom chat and 00:43:04.400 --> 00:43:06.000 then she mentioned about that group. And then 00:43:06.000 --> 00:43:07.599 I was like, well, is there any way I can join? 00:43:07.719 --> 00:43:10.659 And she's like, yeah, it's closed, closed end 00:43:10.659 --> 00:43:12.719 group. It's not like just anybody can come. But 00:43:12.719 --> 00:43:15.699 she's like, let me just talk to them. They get 00:43:15.699 --> 00:43:17.920 to know you. And then they kind of let me in. 00:43:18.039 --> 00:43:20.559 And they just their rules is that you miss no 00:43:20.559 --> 00:43:23.619 more than two sessions per year. So they want 00:43:23.619 --> 00:43:25.019 people. People are going to be interactive and 00:43:25.019 --> 00:43:28.239 participate in stuff. But yeah, there's there's 00:43:28.239 --> 00:43:30.980 different ones out there. That's cool. Yeah, 00:43:31.039 --> 00:43:32.800 you're definitely not shy to like put yourself 00:43:32.800 --> 00:43:35.679 out there, be like networking and building relationships, 00:43:35.880 --> 00:43:38.380 which I think is very, very, very, very important 00:43:38.380 --> 00:43:40.860 to build those relationships early, you know. 00:43:41.500 --> 00:43:44.800 So I think that's super smart. AI, how much time 00:43:44.800 --> 00:43:48.309 do you commit to learning like AI stuff? Yeah, 00:43:48.369 --> 00:43:51.730 I mean, recently I had put like a post about 00:43:51.730 --> 00:43:55.150 Claude for, I think, private practice, like a 00:43:55.150 --> 00:43:57.190 little Facebook group that I had just started. 00:43:57.530 --> 00:44:01.210 But I've been just, you know, maybe two hours 00:44:01.210 --> 00:44:03.309 a week of trying to look at it. I mean, I use 00:44:03.309 --> 00:44:05.269 it already in the practice with free with the 00:44:05.269 --> 00:44:08.489 notes. And but this just that world is just changing 00:44:08.489 --> 00:44:11.670 so fast. I was trying to just find someone to 00:44:11.670 --> 00:44:13.650 pay and just be like, hey, I need an hour, two 00:44:13.650 --> 00:44:15.510 hours, three hours consult. Here's, you know, 00:44:15.510 --> 00:44:18.320 pay whatever you want. But. it's growing so fast 00:44:18.320 --> 00:44:19.900 that there's no one that's really an expert in 00:44:19.900 --> 00:44:22.860 that field so um and it just depends on the industry 00:44:22.860 --> 00:44:27.159 and all that so um yeah there's uh i mean that 00:44:27.159 --> 00:44:29.039 could be a whole podcast on its own about like 00:44:29.039 --> 00:44:32.559 what are the different options um i i'll be interested 00:44:32.559 --> 00:44:35.000 i don't know if you're going in june to the site 00:44:35.000 --> 00:44:38.099 congress elevate that just the mini um in vegas 00:44:38.099 --> 00:44:40.800 but i'll be interested to see like what boosts 00:44:40.800 --> 00:44:42.559 they have there or what they talk about that 00:44:43.289 --> 00:44:45.550 Yeah. A hundred percent. I want to go. I'm not 00:44:45.550 --> 00:44:47.329 a hundred percent decided, but I would like to 00:44:47.329 --> 00:44:48.869 go. I have a couple of friends who are going, 00:44:48.949 --> 00:44:51.449 it would be cool to network. I think that's how 00:44:51.449 --> 00:44:53.789 you and I met back in the day, a couple of years 00:44:53.789 --> 00:44:58.150 ago. Yep. It was, uh, yeah, two years ago. So, 00:44:58.190 --> 00:45:01.119 I mean, those are, it's just. We got to get out 00:45:01.119 --> 00:45:03.000 of the silo work. You can't just be like seeing 00:45:03.000 --> 00:45:04.760 patients and going home to your family. Like, 00:45:04.800 --> 00:45:07.039 I mean, a perfect world maybe, but you just got 00:45:07.039 --> 00:45:09.139 to network. We don't know what the future holds 00:45:09.139 --> 00:45:12.280 and we don't know what stuff will be out there 00:45:12.280 --> 00:45:16.500 and stuff. I saw recently about the idea of AI 00:45:16.500 --> 00:45:19.860 replacing every single physician or medical provider 00:45:19.860 --> 00:45:23.159 out there. And the idea of that, it is possible. 00:45:23.260 --> 00:45:26.139 It's just, we might not accept it. So, and I 00:45:26.139 --> 00:45:28.380 saw some compelling stuff. So I'm like, ugh. 00:45:29.179 --> 00:45:31.039 Yeah, I think you got to just know what value 00:45:31.039 --> 00:45:33.440 you're bringing to patients and to anybody else. 00:45:33.579 --> 00:45:35.719 Because, I mean, there's a lot of stuff that 00:45:35.719 --> 00:45:37.840 as long as there's an algorithm, it can be automated. 00:45:39.360 --> 00:45:42.119 Yeah, absolutely. What would you say to the psych 00:45:42.119 --> 00:45:46.039 NP who just. graduated and is having a hard time 00:45:46.039 --> 00:45:50.039 finding a job yeah i mean my idea was always 00:45:50.039 --> 00:45:54.019 like um be able to be you know work for someone 00:45:54.019 --> 00:45:56.840 for a year at least and then um really decide 00:45:56.840 --> 00:45:59.039 if like entrepreneurship is for you because i 00:45:59.039 --> 00:46:01.860 think it's more glamorified than what it is like 00:46:01.860 --> 00:46:03.760 it's a lot of work it's pretty much a baby that 00:46:03.760 --> 00:46:06.320 never grows up but i've seen those cases where 00:46:06.320 --> 00:46:07.900 people live in rural america and they're like 00:46:07.900 --> 00:46:10.019 dude there's no jobs like there's nothing that 00:46:10.019 --> 00:46:12.300 i can do and stuff so i think for those situations 00:46:12.300 --> 00:46:16.559 then finding the thought of maybe a private practice 00:46:16.559 --> 00:46:19.340 might be right for you. And that might be the 00:46:19.340 --> 00:46:21.340 only option. In that case, for sure, I would 00:46:21.340 --> 00:46:23.340 say get someone who can provide you clinical 00:46:23.340 --> 00:46:26.320 information because you need clinical consult. 00:46:26.659 --> 00:46:29.099 And then also someone that does the business 00:46:29.099 --> 00:46:31.900 side, because I think that you need both of those 00:46:31.900 --> 00:46:34.380 coaches and put that into the cost for the first 00:46:34.380 --> 00:46:38.960 year. So I think those, I mean. They talk about 00:46:38.960 --> 00:46:42.179 saturation. And I do think that with some of 00:46:42.179 --> 00:46:44.199 the schools kind of pumping out, you know, providers 00:46:44.199 --> 00:46:46.960 and just jobs, you know, being different shapes, 00:46:47.139 --> 00:46:49.480 especially with the Medicaid cuts and some of 00:46:49.480 --> 00:46:52.139 these community health not hiring as many providers. 00:46:52.880 --> 00:46:54.900 There is going to be, you know, a saturation 00:46:54.900 --> 00:46:57.039 and stuff. What I guess what advice have you 00:46:57.039 --> 00:47:00.699 given the people that you train all this struggle 00:47:00.699 --> 00:47:04.039 with that? I mean, get your LinkedIn profile 00:47:04.039 --> 00:47:07.599 up to date. To your point of having found all 00:47:07.599 --> 00:47:10.119 those providers on LinkedIn, I think people underestimate 00:47:10.119 --> 00:47:14.599 LinkedIn. And so it's like, make it professional. 00:47:14.860 --> 00:47:17.880 Have a professional headshot. If you're in one 00:47:17.880 --> 00:47:20.039 of these mentorship or fellowship groups, put 00:47:20.039 --> 00:47:25.320 that on there. Really show some intention. I'll 00:47:25.320 --> 00:47:28.460 get messages all the time on social media. That 00:47:28.460 --> 00:47:32.110 one yesterday that was like, hey, Linda. Can't 00:47:32.110 --> 00:47:34.289 find a job like it just you could tell there 00:47:34.289 --> 00:47:36.550 wasn't a lot of time put into the message, which 00:47:36.550 --> 00:47:39.849 I I get like social media is like casual. But 00:47:39.849 --> 00:47:42.010 I think if you're, you know, more intentional 00:47:42.010 --> 00:47:44.309 with the communication that you do send out, 00:47:44.349 --> 00:47:47.489 because knowing that providers get a lot of inquiries 00:47:47.489 --> 00:47:50.650 and there you do kind of have to like differentiate 00:47:50.650 --> 00:47:53.449 yourself and be like, here's how why I would 00:47:53.449 --> 00:47:55.409 provide value to your specific organization. 00:47:56.469 --> 00:48:00.269 So. Yeah, I would say that. One of the questions 00:48:00.269 --> 00:48:02.590 I ask at the end of the podcast episode to all 00:48:02.590 --> 00:48:07.829 providers is, what does the phrase no prior auth 00:48:07.829 --> 00:48:10.769 mean to you? I mean, obviously, it quickly reminds 00:48:10.769 --> 00:48:14.769 me of just, you know, the prior auth that are 00:48:14.769 --> 00:48:16.650 great for companies, insurance companies not 00:48:16.650 --> 00:48:19.869 to pay for stuff. But I think what it means to 00:48:19.869 --> 00:48:21.889 me, if I really kind of sit back and think about 00:48:21.889 --> 00:48:25.150 it, it's just not letting barriers get to you. 00:48:25.420 --> 00:48:27.659 So, you know, whatever you want to get to and 00:48:27.659 --> 00:48:30.780 accomplish, you can. One of the best phrases 00:48:30.780 --> 00:48:32.360 I've heard in life is you can have it all. You 00:48:32.360 --> 00:48:35.820 can have it all at once. So there's percentage 00:48:35.820 --> 00:48:39.019 in our, you know, in providers that they want 00:48:39.019 --> 00:48:42.809 to have work life balance. depending on what 00:48:42.809 --> 00:48:45.010 stage your practice is if you do prior practice 00:48:45.010 --> 00:48:46.670 that's not going to be feasible and you have 00:48:46.670 --> 00:48:48.570 to accept that or you have to get out of the 00:48:48.570 --> 00:48:50.630 room and just go work for someone else and stuff 00:48:50.630 --> 00:48:54.730 so yeah i think that um just understanding that 00:48:54.730 --> 00:48:57.650 and just um that you know barriers are barriers 00:48:57.650 --> 00:49:01.150 but there's ways around them so yeah i do agree 00:49:01.150 --> 00:49:04.699 with you that i think people underestimate the 00:49:04.699 --> 00:49:07.420 work that's required. If you are going to be 00:49:07.420 --> 00:49:10.639 scaling a group, you know, kind of insurance 00:49:10.639 --> 00:49:15.099 -based practice, I think that people don't realize 00:49:15.099 --> 00:49:17.179 the repetitions that they're going to need to 00:49:17.179 --> 00:49:20.239 put in for marketing and for these things. So 00:49:20.239 --> 00:49:23.159 I totally, totally agree with you. If people 00:49:23.159 --> 00:49:28.110 want to find you, where can they find you? Probably 00:49:28.110 --> 00:49:30.690 just sending me a message on LinkedIn. I have 00:49:30.690 --> 00:49:33.909 like a website, but it's not the most up to date 00:49:33.909 --> 00:49:36.590 on it. But yeah, I mean, I'm working on some 00:49:36.590 --> 00:49:40.429 stuff. So I'll probably have you post my LinkedIn 00:49:40.429 --> 00:49:43.429 and they can message me there. Or if they, you 00:49:43.429 --> 00:49:45.150 know, anything on Facebook, they can reach out 00:49:45.150 --> 00:49:48.630 as well. Yeah. Okay. Awesome. I know I saw your 00:49:48.630 --> 00:49:51.050 like Miguel de la Mora website and I was like, 00:49:51.090 --> 00:49:53.090 dang, he was kind of ahead of the curve having 00:49:53.090 --> 00:49:56.730 his personal brand website up back in 2023. Yeah. 00:49:56.730 --> 00:49:58.849 Yeah. That's the one I just haven't. I mean, 00:49:58.929 --> 00:50:00.909 you can, there's a way to message on there, but 00:50:00.909 --> 00:50:02.750 it's not something that I, I don't have it all, 00:50:02.769 --> 00:50:05.150 uh, glamified. I'm sure like yours is and stuff. 00:50:05.210 --> 00:50:08.250 So, yeah, no, I get you. I get you. Okay. Well, 00:50:08.329 --> 00:50:11.329 thank you so much for taking the time. And, um, 00:50:11.630 --> 00:50:13.369 yeah, I know people are going to find a lot of 00:50:13.369 --> 00:50:16.010 value in this episode and, uh, it's just really 00:50:16.010 --> 00:50:18.969 inspiring what you've, what you've grown in the 00:50:18.969 --> 00:50:23.090 course of two years. So. yeah no no thank you 00:50:23.090 --> 00:50:25.289 thank you for having me i think that even your 00:50:25.289 --> 00:50:27.010 i mean your story's been inspirational since 00:50:27.010 --> 00:50:28.949 i met you and just a lot of stuff you were doing 00:50:28.949 --> 00:50:31.909 and where you're at now and stuff so thank you 00:50:31.909 --> 00:50:33.769 for having me and just being able to share my 00:50:33.769 --> 00:50:36.289 story and if anybody has any questions they can 00:50:36.289 --> 00:50:39.869 reach out awesome okay thanks miguel we'll see 00:50:39.869 --> 00:50:42.190 you next time okay all right bye