How to Scale to a Group Practice: From 1 to 55 Therapists in 3 Years with Nicole McCance

Welcome back to the Thriving Therapy newer podcast. We are here with Nicole McMance, a retired psychologist.

I'm gonna have her introduce Canc. Do you want to restart McCants? Yeah, I think you said. You said it right the first time, but just now you said McMahon.

McCants.

McCants. Yeah.

Okay. All right. Welcome back to the Thriving Therapy newer podcast. We're here with Nicole McCants. She is a retired psychologist. She sold her group practice. We're going to talk all about how you can scale by having a group practice, especially if you're interested in possibly selling it down the road. We're going to talk about hiring your first clinician if that's scary for you. I know that brings up a lot of fear. So welcome, Nicole. Please tell everyone listening your background story. Introduce yourself for us.

Thanks for having me. I'm so excited to be here. I am a retired psychologist turned business coach and it's still shocking saying that this many years later. I was in solo practice and I loved what I did. 15 years couples therapy, EMDR. I feel like we're just so lucky, like the difference we make in the world and what we get to charge. But what happened for me is I just became sick of hitting the ceiling in my income. And then in 2016, I become pregnant with not one baby, but two. Two babies. There's twins on the way. And my first thought was, how can I afford this? Two high chairs, two cribs, two everything. I can't see more clients. So in that moment was actually the first moment where I said, maybe I should hire. So guess what? I did nothing. I did nothing because there was no mentor guiding me. So for two years, fast forward. Jackson and Lucas are now two years old. The babies are here, and. And mommy is still working until 7:00pm Carly. I would get home and spend a half an hour with my babies before they went to bed. It was not the life that I envisioned. So it was one fateful night. I just remember seeing their chubby little faces waiting for Mama. I pulled in and I just broke down in tears. I walked through the door, I turned to my husband, Dan, and I said, I'm starting a group practice. I have no idea what I'm doing, but I'm going to do it. Fast forward three years because I got a business coach. She wasn't a therapist. I was able to grow it to 55 therapists, but the thing I'm most proud of is that it ran without me. So mama was home with Jackson and Lucas. I wasn't working evenings and weekends, but the Biggest thing was because it was so big and it ran without me. A psychiatrist wanted to buy it and at first I said no cause that wasn't my plan. But then I was like, wait a minute, you can do pensions and you can provide way more than I can provide. And so I did sell it in 2022 and now teach people how to do it.

Incredible. Yeah. You had to walk yourself through this process which I always say 90% of us are our own ideal client. Right. We had to walk ourselves through the process. It sounds like you're a natural teacher at heart, which is me as well. And here you are impacting so many therapists lives. And I just have to say I, I have a three month old and I, I get that fully. I cannot imagine having a business that doesn't run itself and not being able to be a present mom.

Yeah. Everything changes when you become a parent. Like 100, everything. They're my why. Yeah. And I think for a lot of listeners it's funny because those in my business coaching program, they're like planning to be a parent or are a new parent because everything shifts after that. Yes. And I do have a five step scaling method that I can quickly walk you through that, how I did it. Because people will often ask like how did you grow so fast with twins? And there is a proprietary method of how to do it the right way because let me tell you, I tried a lot wrong. And so I put a method together that works.

Yeah, I would love it. Let's start. Yeah. Tell us your five step method.

Amazing. I'll walk you through all five steps and then you can pick one and we can talk more about it. But step one is systemize your operations. It's so important and people skip this step. Please build the container before you fill it. So don't hire first. So many people hire and then guess what happens. They become the cqa, not the CEO that they thought they would be. They become the chief quantum question answerer. So first systemize. That's why I was able to sell. That's really where the freedom starts. And then step two is that's where you build your dream team. Then you hire, then you work glass and you find your mini me. I'll walk you through all steps. Step three is then I teach. How do you attract clients with digital marketing? I love digital marketing because it works while you sleep. But a lot of people stop here. But step four is convert clients with consult calls. They're just prospects. They come to your website. But now you need a process to convert without a conversion method like your, you know your conversion is probably going to be low if you don't know what you're doing. Especially with a group, you see a lot of therapists, they know what they're doing. But you need to train your people to convert. And then lastly is retain these clients with follow ups.

All right, so let's backtrack to the beginning the system before you hire. What's the biggest mistake? You see when people are setting up.

Their systems, everything's in their head. So if you have anything in your head, people will come to you and say, how do I resend that receipt? What do I do for the new client? Email. So the very first thing is to grab a Google Doc and write everything down. And I know some people are probably listening, being like, Nicole, I have no time. I'm a new mom, I'm a new parent, I'm overworked, whatever it is. So what I suggest is actually just record it. The next time you do it, do it in a loom, just obviously privacy mode. But start to record everything you do. If nothing is in your head, then you can create and you can delegate to an admin.

Then you can plug that loom into AI and say, give me a written sop.

Got it?

Right, exactly. Yeah. How can we work smarter, not harder?

You got it.

And what about hiring? So I first have to say I had a very mini small group practice back when I had my private practice and I didn't love it, to be honest. I think that having a group practice is not for everybody, but some people absolutely love it. So there's many different ways that you can can scale as a therapist and you can make more money and you can impact more lives and you can have more freedom and flexibility and security. Obviously the way that I teach and preach and was my live story is coaching group practice is obviously a way. And I've had many people come to me and be like, well, I don't want to start my coaching business. I am looking to scale. And I'm like, well based on what you're telling me, it sounds like you want to start a group practice. That would be the next best, easiest step for you. So there's different avenues. I want everybody to know who's listening. There's different avenues that you can go down to make a larger impact and have a larger bank account. Right. So if you're going the group practice route, make sure you have your systems in place, not just in your head. Then it becomes hiring. Okay, let's talk about this for a second because there's a lot of fear around hiring. Do you see that often?

So the systemizing is the most boring part. But it doesn't really bring up fear because you're just taking things. You're just hanging out with yourself, writing things down. That's kind of easy. Oh yeah, the hiring part is terrifying. I met you five minutes on indeed. And now I'm going to give you my reputation and my brand. Right. So this is why so it's called.

And be liable for you.

Right now I'm the McCants method. Okay. So I have proprietary methods for everything. I have a six step hiring model that we don't hire anyone until they go through all six steps. And it is hard. It is like it's really hard to get through all six steps. And I always say only hire your hell yeah. That when you leave that interview that you're like, that is a hell yeah. That is somebody. I'm so impressed. I can't wait for them to work for me. So for me, I was a baby boss. I was not confident. I didn't know what I was doing. So guess what I did. I hired baby therapists. Pre licensed interns. That was less intimidating for me to say, you know what? You're green, I'm green, let's build this together. But your very first baby therapist you should hire should be a mini me. Hire a version of you with a similar personality. Especially because I was moving clients over my own. Some of them I moved over to this new person and I did it the wrong way and I first hired someone that was nothing like me. And guess what? No one stayed. They expect the brand needs to be consistent. So have your first person be a baby therapist and have them be specifically a mini me.

I think a lot of fear comes around being able to fill them up. Like, okay, if I hire them and I use this process and I know they're really good therapists, they are a mini me. I know they're going to do really good work with the people that they're seeing. But am I going to be able to fill their caseload and this moves into the marketing piece, right?

Exactly, yes. Which is step three, which is perfect. This is one of the bigger, the biggest fears for sure. I talk a lot about this in my own podcast. Like how do you get them full? And this is where I teach the digital marketing as well as the organic marketing. The easiest way if we just go organic for a second is think about. Because here's the thing, people try all the Things when it comes to marketing, they throw spaghetti at the wall. But we know the 8020 rule. We know that 20% of what you're doing right now is giving you 80% of your results. So where are my referrals coming from right now? Oh, so the top three places are one. Word of mouth. Okay, so where do you go if you need marriage therapy, you go to your best friend who helped you. Or two, you go to Google. Or three, if it's really bad and you're not sleeping, you go to your family doctor. Like I need help. So I assist people specifically with Google, Google Ads, how to do them right. There's a whole process there. We kill it with ads. A lot of people in my program hit six figure months, by the way. Six figure months. One just hit one last week using the ads. But also wait. If your current referrals are coming from doctors, reach out to those doctors who already know you, like you and trust you and let them know that you're hiring. And then you turn that faucet on. So there's a whole process. I think that I truly believe in business coaching. You just need to connect with someone who's done it successfully and they'll tell you what they did. But so many people don't and stay stuck.

I love how you're describing it as a faucet, because as the CEO of your business, you should be able to turn on and off the faucet at any given time. If you don't need any more clients, you, you turn the faucet off. You need clients, you turn the faucet on. And if you don't know how to turn the faucet on and off and have an influx of clients if and when you need them, your business is going to be in trouble. Exactly. The people you hired are going to leave. Right. So what's step number four after they.

Now it's converting them because oh my gosh, they're coming to my website, they're booking the console calls. How I grew so fast was offering a free 20 minute consult call. And on that consult call, so your therapist is going to be offering free consult calls. And they should be 20 minutes because the last five minutes, not 15. I tried 15, I tried 30. And the sweet spot is 20. Do you want to know why it's 15 minutes? Building rapport, creating a gap, really setting, having them see that therapy works, but the last five minutes is closing the deal. I know this is like a sales term, but it's getting the credit card, it's going over the cancellation policy. But more importantly, it's booking the first four to six sessions and getting that commitment. People just don't have enough time for 15 minutes and then the. The person doesn't book.

Right. You have to have sales skills. And I think that this irks a lot of therapists. Right. And they're like, I don't want to be salesy. And I hear this all the time. It's the same story in the coaching world. Most people who add coaching to outgrow the office, they have a booming, successful private practice. And I'm like, listen, you're not new to sales.

Yes, exactly.

So if they have worked somewhere else, you know, they're probably not a brand spanking new clinician who's coming into your practice. They've done sales calls before. Oftentimes it's coaching them through a mindset shift. Don't you think of, you know, this is your first opportunity to really be the leader and be the therapist for this ideal client to actually transform their life. Is closing the deal.

Yeah.

It is a sales call. It is a consult call.

Yes. And you're changing. The thing is though, if you see it as sales, you will flounder because that's a lot of pressure. Sales is about you, not them. But if you see it as I know therapy can change everything for you, then there's conviction, and that is contagious. And they're like, okay, well, you believe in this, you know, then I believe in this. But I also think a script, I give people a script. And you know what, if people message me the word, like DM me the word consult call script, I'll give it to them. So consult, call, script, I'll give it to your listeners. I'm happy to do that. It is important to stick to a script. This is what like the biggest sales companies and departments do. And that may feel weird. Now, I don't mean a script. Obviously don't read this, but memorize it and then train your people in it and your conversion rate will be higher.

Yeah, you don't have to be robotic in it, but having a framework that you follow and that you can understand and conceptualize so you know what to pull from. Instead of floundering like you said in the sales call, we're doing therapy because.

We love helping people and then they feel fabulous after 20 minutes and they don't book.

Yep, I see that all the time. Okay, so can. Do you mind if we skip to selling your practice for a second? So this isn't most people's Intentions, I think when they start their group practice. Right. But it's like this nice cherry on top surprise that. Holy cow. You can have a really successful business and then it can be even more successful because you can sell it and you can make a lot of money. So what have you seen? I would love to hear some real life examples of anybody who you have mentored who has then went on to sell their practice after building it from scratch. I think oftentimes we need proof that this is possible for us and it's your story. But do you have any other real world examples you can totally.

So my program isn't to build, to sell. It's just to build. So it feeds you for your life. I sold. You know what I mean? So are there people in my program that are like, you know, I want to sell one day. I specifically, though, I think you should build anything to sell one day because that means it can run without you. So one American and one Canadian both got offers by. So what's happening now? A lot of these equity companies, like private equity, are reaching out and being like, I want to, I want to buy. I did not sell to a private equity firm. I don't think I would, to be honest. I think I wanted to sell to a healthcare professional who's a genuine person. You know, he's from the Maritimes, like, good old. Yeah guy. And he took over. And that felt really good for me. So I'm actually very picky. I'm like, do not all the time. I'm like, don't sell. Like. And funny enough, my accountant told me, nicole, you are going straight up when the stock market is going straight up. You don't sell then. You sell when you're stagnant or you're going down. But my other accountant, yes, I had to. My tax accountant was like, honestly, who gets this in their lifetime? Like, you need to take this deal. So I did, you know, but here's what I teach people. That they make seven figures, that their business makes seven figures. And multiple have one last week, multiple. Multiple so much that one Canadian is now in a position to buy group practices. I helped her scales hers. It is now worth multiple million dollars. That two weeks ago, she said, you know what? I'm going to start buying them. So I don't know what's going to happen from here. Maybe more people will sell, but I work with people that are in their 30s, 40s, so they're just not ready to sell yet. And that's okay. This is just feeding their family and giving Them the freedom. So why sell?

Right. Makes sense. But it's also something to work towards in the future if they want to. Right. The option is there if. If they.

Exactly.

Because there may become a point in their life that they don't want to run it anymore.

Yeah.

But I love that you said, regardless, whether you're going to sell it or not, you should pretend like you are going to sell it so it can run itself. And that goes back to the very first step that we talked about is having those systems not in your head, having everything documented, having your SOPs in place so that if you did sell it or something were to happen to you or you are busy with the kids and somebody has a question, you can just refer them to the SOPs. The Troubleshooting Guide.

Exactly. And then eventually you have a clinic manager. Eventually you have a clinic director. So there's tons of people in my program that it runs without them. That's the ultimate goal. To have this asset that will feed you for the rest of your life that you can one day sell if you want. But you are not running it. Someone else is doing supervision. They've actually hired directors. Like, they're literally not running it anymore. They're traveling.

Yeah. What's one piece of advice you would give to anybody who is thinking about starting a group practice, but they're scared to do so? Because the mindset piece is huge. We talked about the fear of hiring, but even the fear of starting because there is so many floating pieces. Yeah. I'm sure. Holds people back.

Yeah. Get a business coach. It doesn't have to be me.

Yeah.

You know, I'm not. I'm actually not just saying that because I am one. Truly, there's zero chance that I would have scaled to 55 therapists in three years without a business coach. Zero chance. I had no idea what I was doing. I literally felt like it was in a dark woods and there was 25 paths and I would be going down the wrong one, and then I would be going in circles. You can't do this alone. If you want to build something really, really big and you want more freedom and you want to get to the top of Mount Everest, the fastest path is linking arms with someone who have already done it.

Touche. I always say, what's wrong with taking a shortcut if you know exactly where you want to go? It's like a hop, skip, and a jump when you have a mentor, especially who has taken the path that you want to take. Yes.

And especially with people. Because you had said you didn't love a group practice. And I think managing people, that's an element that can be the hard part. Maybe that was for you. So having a coach where it's like, okay, how do I find the right people? How do I deal with this? Because there's just a lot of nuances. You really want to find the right people. And that's what I help people do. And there's a million questions when that comes up.

Yep, you're exactly right. So where can people find you? Where do they get access to your free resources? I know you have a hub of them if they're interested in that consult script you had talked about. They find you on Instagram and DM you. Right. So can you tell everyone where's the best place that they can find information?

I have a podcast, the Business Savvy Therapist. If you love podcasts, let's hang out over there. I also have a weekly masterclass where I teach you. It's called how to build a seven Figure Group Practice. It's every week. I'll send you the link for that so we can hang out live. They can ask me questions, all the things and I will give you my console call script. Yes, it is yours. I'll give you my Instagram link. Nicole McCants method. All they have to do is message me, consult call script.

Amazing. I will include all of that in the show notes. Thank you so much, Nicole for enlightening everybody who has has listening and interested in building their group practice.

Thanks for having me.