6 Ways Media Interviews Will Help Your Practice

Are you hesitant to respond to media interviews? Performance anxiety, lack of training, or placing little value on media interviews as a strategy for practice building may be among your reasons for shying away. You may have heard that interviews don't bring in an immediate influx of new referrals. I have been actively seeking media interviews on a regular basis for the past five years and I've never had a huge increase in new referrals as a result. However, I have seen many long-term benefits of doing media interviews, that have built my practice over time. Here are 6 ways conventional media interviews have helped grow my private-pay practice.

1) Increasing awareness of your practice and services

“If you build it, they will come” doesn’t necessarily apply to opening a private practice. Most private practitioners initially struggle to get clients in the door of their practice because few people are aware of their business. Media interviews increase the exposure of your practice and allow you to get in front of more potential clients. Continued exposure makes it more likely that potential clients will remember your name and will eventually call you if they need help.

2) Opportunity for community service and education

Media interviews provide volunteer opportunities to educate your community, increase awareness about issues that matter to you and to them. In addition to making a living doing something I love, I want to make a difference for as many people as possible and media interviews allow me to make a positive impact for people well beyond the therapy office.

3) Engender public trust and increase credibility

Television stations, radio stations, newspapers, and websites spend a lot of time connecting with their readers and viewers and building their “brand”. When you are featured in the media you get to borrow their credibility and trust as they put you in front of their audience. Regular media appearances have allowed a large number of people to hear my therapeutic philosophy, and get a feel for my approach, and see me as a resource.

4) Helps transition you from provider to "expert"

Regular media appearances help position you us as more than a potential counseling or coaching provider. Interviews allow the general public to view you as an “expert” in your field or specialty area. The role of expert adds value to you and your services and makes it more likely that clients will pay out of pocket for your services.

5) Provides potential multiple income streams

Surprisingly, some media appearances have transitioned into additional income streams. I’ve been invited to be a regular contributor on television or a paid blogger. What could be better for your practice than getting paid to educate the public and create awareness of your practice?

6) Helps provide fresh consistent content for website, blog, and social media

Media interviews help provide new content for your practice website and provides helpful resources to your social media followers. Sharing video of on-camera interviews and links to print or web interviews extend your reach beyond your location driving more traffic to your website. More traffic to your practice website means more clients for you (assuming they like what the see on your website).

So, what are you waiting for? The next time you receive an email from a news or radio producer asking for your expertise, consider saying, "yes!"

Why I Only Hire W-2 Therapists (W-2 vs. 1099 part 3)

I've noticed that private practice therapist tend to hire additional therapists as 1099 contract employees. Reasons frequently cited for choosing to hire therapists as 1099 employees is that they don't have to pay the therapists taxes. While it may be more "affordable" to hire therapists as contractors, in my experience, there are also "costs." (For an summary of the difference between W-2 and 1099 employees read part 1 in this series. To hear about my employment tax audit adventure read part 2.)

According to the IRS website, the general rule for classifying 1099 independent contractor is "if the payer has the right to control or direct only the result of the work and not what will be done and how it will be done" (italics added). It also states that an employee is not a contract employee if the services "can be controlled by an employer (what will be done and how it will be done)" and if "the employer has the legal right to control the details of how the services are performed."

In consulting with therapists around the U.S. I've heard about some of the "costs" of hiring 1099 employees. Some of the costs high turnover rates due to the part-time and often temporary nature of contract employee relationships. Some of those "costs" include lack of control over how and where therapy is done, inability to require specific paperwork, inability to require attendance at staff meetings or trainings, inability to request that therapists network and participate in community outreach to boost referrals.

Here are the four main reasons I only hire therapists as W-2 employees:

1) Overall Cohesiveness

My vision for Wasatch Family Therapy has always been to build a cohesive team with a shared long-term vision of providing excellent clinical services to clients across the lifespan from an attachment perspective, not just have a group of therapist doing any kind of therapy they choose.  Now that we have grown into a clinic of 18 therapists at 3 locations cohesiveness is even more crucial. When therapists are hired as 1099 contractors employers are not supposed to tell the contract worker how to do therapy, or make other specific requirements of the worker, such attendance at trainings.

2) Higher Level of Quality Control

If a therapist is going to work under my name and my practice name or "brand", I want to be able to have a say in how, where, and when they do the work.  I've spend over 10 years building trust, credibility, and presence in my region and I want to be able to be able provide mentoring, direction, and training in how my clinical team provides services.

3) Ability to Require Certain Activities

I want to be able to require certain activities from my team members that hiring them as 1099 workers does not allow me to do. We have streamlined forms for notes and documentation in our EHR system. I require each therapist to engage in at least one outreach or networking activity each month in order to create strong referral sources. I require attendance at two monthly staff meetings, and a certain level of professional appearance at the office.

4) Implication of Long-Term Relationship

I am not interested in hiring temporary therapists to provide services. Hiring 1099 workers generally implies a short-term relationship. I am interested in hiring therapists who have a shared vision and who I can invest in long-term, and who will invest in building the practice long-term. I want to build mutually beneficial relationships not just provide services. Hiring therapists as W-2 employees shows a greater long-term commitment to them to build their practice for the long haul. I also allows me to expect a greater commitment from them.

Would Your Practice Survive An Employment Tax Audit? (1099 vs. W-2 part 2)

Does the state tax commission really take the time to audit small private practices? I didn't think so, until my practice was selected for an audit.

A few years ago my clinic was selected for an employment tax audit. Lucky me, right? When the auditor walked into my office suite and saw many offices with different names on the doors, he looked at me pleadingly and said, "Please, please don't tell me that these therapists are all classified as 1099 contractors."

I replied, "I won't. We're all W-2's."

There was a look of relief on his face.He then proceeded to tell me that health and mental health private practitioners are notorious for incorrectly classifying 1099 employees. In his experience many groups are set up as contract workers when they are acting like employees (I'll go over into detail about the the IRS criteria for how to classify  an employee as a 1099 vs. W2 employees in a forthcoming post).

The auditor requested access to all of my financial documents including bank accounts, accounting,  payroll information and tax documents. He asked us questions about any large checks written directly to employees to make sure we were paying our employment taxes. After a brief review of my payroll and tax documents the auditor thanked me for making his job easier and left with a smile. I breathed a huge sigh of relief.

Had I hired the therapists working with me as 1099 I may have been penalized with a hefty fine and required to pay back employment taxes on all of the therapists' income. I was not in a position to shell out thousands and thousands of dollars. Had I been incorrectly classifying employees it may have put my practice in jeopardy.

Do you know the IRS criteria for classifying 1099 contract workers vs. W-2 employees? It isn't based on whether or not you want to pay your therapist's taxes or want to have them pay self-employment taxes. It isn't based on whether they are full-time or part-time workers. It isn't based on whether or not you provide benefits.

There are many misconceptions about classifying employees in private practice. I'll address theses criteria for how to distinguish between hiring 1099 vs. W-2 therapists in upcoming posts.

Watch for the next Therapist Blog Challenge coming next week, too!

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The Difference Between Hiring Therapists As 1099 vs. W-2 (part 1)

Should you hire additional therapists for your practice as 1099 or W-2 employees? I'll walk you through the decision process in this blog series so you can make an informed decision.

If your private practice is thriving and you are considering hiring additional therapists, one of the major questions is how to structure the employment relationship. Should you hire additional therapists as a 1099 contractor or W-2 employee?

In my private practice consulting experience and based on recent discussions in my Private Practice Toolbox Group it seems that most private practice therapists favor hiring therapists as 1099 contractors. When I ask why I often hear something like, "I hire 1099's because then I'm not responsible to pay the therapists employment taxes and it provides some cushion against legal responsibility for the acts of therapists providing contract services." While these statements are true, there is a lot more to consider when structuring the employment relationship and misclassification can be a costly mistake.

So what what's the difference between hiring a 1099 and W-2?

An 1099 independent contractor is a tax-related and legal term referring to an individual who contracts his or her services out to other businesses. An independent contractor is considered self-employed and is not considered an "employee" of the practice. The 1099 workers pays all of their own income tax in addition to self-employment taxes.

"Independent contractors do the work where, when and how they choose. Nobody tells them what order to do the job in, what hours to work, or when they can take off, " says Employment Attorney, Donna Ballman, author of How To Stand Up For Yourself Without Getting Fired.

A W-2 employee is an official employee of a company, or a private practice, whose taxes are withheld from and whose earnings are reported to the IRS at the year-end via a W-4.  The practice owner participates in paying the employees state and Federal taxes and has the ability to control how, where, and when the work is performed by the employee.

Michigan attorney Donald A DeLong says that control is the key issue. "If you control when the therapist works, where he/she works, how and when he/she gets paid, you require that he/she use your equipment, etc., then that worker is a (W-2) employee."

As I've researched this topic it is clear that there are no easy answers and a lot of grey areas. I hope to share some helpful information and resources over the next several posts to help you make the best choice when it comes to hiring.

The costs of inaccurately classifying employees

Inaccurately classifying workers can be very costly to an employer warns Vincent Porter, CPA of Porter & Company CPAs in Arlington Tx. Porter shares these words of caution with employers.

The IRS can conduct an audit of a business that is paying employees on a 1099 and hit them with back payroll taxes that can be very costly to a business not in compliance. This is a big issue we face almost daily with clients. They should understand that if they were to be audited by their State Unemployment agency or IRS they could face severe penalties for improperly classifying employees as contractors. Not only could they face unpaid employment taxes they could face heavy penalties.

In my next post in this series I'll tell you about my employment tax audit experience a few years ago!

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6 Reasons You Don't Have Enough Clients

Getting and keeping clients is a common struggle for private practitioners. Here are 6 potential barriers to a full practice and what to do about them.

1) You're not keeping the clients you have

It takes a lot less time, money, and energy to keep a client engaged in meaningful therapy than to find a new client. Keeping clients engaged in the therapeutic process requires additional skills. New skills might include setting expectations during the initial session that therapy is an on-going process. Recommend  that new clients schedule ahead 3-6 weeks (depending on your assessment of their need during the first session) instead of scheduling one week at a time.

Another strategy that will boost client retention is reaching out to clients who've dropped out of treatment without proper termination. I encourage my team of therapists to do this regularly by writing a hand-written card with their business card enclosed to clients who have not returned to therapy. The cards say something like, "You've been on my mind. I want you to know that I am here if you need me. If you'd like to take a break from therapy for a while that's fine. I'd like to offer you a free 25 min "wrap up" session where we can say goodbye." Many clients are very touched by this gesture and it is just the encouragement they need to continue coming to therapy. Even if clients don't continue in therapy, you've modeled how to say a healthy "goodbye".

2) You're not offering anything valuable to potential referral sources

I love that I'm approached regularly by a therapists trying to network and ask for referrals. You know the ones who I will refer to? I will refer to the therapists who approach our relationship as a mutually beneficial relationship. I am more likely to refer to therapists who, in addition to asking for referrals, offer their time, expertise, or referrals to me and my practice.

Several years ago I had a therapist contact me asking if I would refer couples to her for therapy. While she did offer to take me to lunch (which I didn't have time to do) she wasn't offering herself as a resource to me in any way. Additionally, I was annoyed because had this therapist had done her homework and looked at my website she would have seen that I work with couples and that I have several colleagues at my clinic who also work with couples. The key to developing strong referral relationships is to create mutually beneficial relationship, offering yourself as a resource to the other person.

3) Your online presence is weak

Have you Googled yourself lately? Have you searched for key terms in your geographic location to see where your website ranks? Potential clients are searching for therapists online and will generally click on websites listed on the first page or two of Google searches. If your information is easily found make sure the information found about you and your practice is accurate. Here are some resources to help you strengthen your online presence and make it easier for new clients to find you.

Does Google love your therapy practice? 5 elements of an effective practice website 4 reasons to start creating online content

4) You're not as good as you think you are

Most therapists think they are more effective than they actually are.  Therapists, like any other professionals have varying level or skill and success, but it seems that on the whole we are an overly-confident group.

A 2003 survey asked 143 counselors to grade their job performance on a scale from A to F... Of the counselors, 66 percent rated themselves as A or better. None saw himself or herself as below average (Sapyta, Riemer, Bickman, 2005, p. 147).

How do you find out if your clinical skills are above average, mediocre, or below average therapist? Start collecting outcome data from your sessions. A few years ago I tracked every session using the ORS and SRS rating scales for an entire year through MyOutcomes.com. This allowed me to establish a baseline, track each client's progress, and see where your scores fall compared to therapists around the world. I was relieved to know that according to these ratings scales I was indeed an "above average"  therapist, but I was not as good as I thought I was.

5) Your attachment style is sabotaging you

A therapist's own attachment style and relationship history impact their ability to keep clients engaged in meaningful therapy and maintain consistent referral sources. While I only have anecdotal evidence, my experience training therapists in a private practice setting suggests that therapists with a secure attachment style or slightly anxious attachment do better in private practice setting than therapists who lean toward the avoidant end of the attachment continuum. Additionally, if therapists have done their own work in therapy and have a handle on their own issues, they tend to be more successful than therapists who haven't resolved their own emotional wounds. If you're having a difficult time getting or keeping clients, may I suggest calling your own therapist and working on your own attachment issues?

6) You appear desperate

Therapists who are new to private practice may feel particularly overwhelmed by the details of running a business, and the difficulty of establishing a consistent clientele. Feelings of desperation are also felt by seasoned therapists whose client numbers ebb during seasonal changes, economic conditions, or other reasons.  Potential clients and referral sources can "sniff out" desperation, and whether they are consciously aware of it or not, they will be less likely to trust you and your services. Here are some questions to ask yourself to see if you're coming off as overly desperate.

• Have you become  too accommodating when it comes to scheduling clients?
• Do you feel overly discouraged if a new referral chooses not to schedule with you?
• When talking about your practice do you talk fast and feel anxious inside?
• Do you follow up with potential referral sources more than once a month?

I suggest  that you "act as if" and "talk as if" you have a moderately busy practice. Lead with the aspects of your practice and your expertise that you are confident in and you'll find more success getting and keeping clients.

References:

Sapyta, Jeffrey, Manuel Riemer, and Leonard Bickman. “Feedback to Clinicians: Theory, Research, and Practice.” Journal of Clinical Psychology: In Session 61, no. 2 (2005):145–53.

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