Running a Multi-Million Dollar Clinic 7 Days a Week Without a Front Desk: Katie White’s Story

I think you just gave me a recipe. Like, your entire front desk or front office team right now is remote.

And we're open seven days a week, and often we're open from eight to eight. I'm not on the hook for payroll benefits. I don't have to deal with sick days or paid sick days.

How to get smarter in business and in life. This is the question, and I'm on a journey to get you that answer. I'm going to interview the world's top entrepreneurs and deconstruct their winning secrets. Going to talk about everything from marketing, money and living a bucket list life. I'm Rick Lau, healthcare entrepreneur. I grew and exited my 127 locations in my 30s. Welcome to the Clinic Boss show. All right, everyone. Welcome to the Clinic Boss Show. Today I got a very special guest, like a good friend of mine, Katie White from Courtney Massage. And you know, and I was checking your website. You got a team of 18 now and you got 400 plus Google reviews, Katie, you know, like, did I get this right? Like a team of 18?

We're fluctuating. I think we might be. I think we might have 14 right now.

Okay. Wow. But still, like, last time I spoke with you, you were not at these numbers, so it still looks like you've been, like, growing like crazy. Right? You know?

Yeah, we came back after Covid. Covid was challenging because we lost about half of our clinicians due to various personal things that individuals were going through. And so, yeah, built the team back and, yeah, have a really solid group in there and seeing lots of patients every week. And, yeah, it's. It's good. Business is good.

And what's. What's your. What was your secret sauce, you know, Right. In the last year?

Maybe you think, you know, oh, secret sauce in the last year?

Yeah. What has contributed to your growth in the last year?

I think probably just, you know, the systems that I've implemented over the years, just keeping on with them. And we've been in business for like 15 years now. So I think that really helped was just having that. That experience and yeah, just, you know, keep on keeping on because you see the trends up and down throughout the years and just keep on doing what you do and, and things. Things get better.

Yeah. And I'm curious, you know, what are some. What are some, like, economic trends or maybe industry trends that you see in right now that you're concerned with, like, with your business, you know, and I know one of them is like Bill 36 that we talked about, but, you know, what are some other ones that are kind of concerning? You just were like the economy going and where. Maybe where the. The profession is going. Right?

Yeah. So with the economy, you know, you see people more reluctant to spend money. And so one of the things that I see is cancellation and no shows at an all time high. And because of COVID you know, we weren't charging people if they were ill. We did not want them coming into the clinic. We still don't want them coming into the clinic. But it just seems to me that that is kind of a free pass for a lot of people. Just say I'm sick and then not show up and not be accountable to pay for their treatment that they missed. That is really, really tough. I also see, you know, clinicians wanting to make more money as they need to stretch out their finances and. Yeah, just the cost of running the clinic, the overhead, it just keeps climbing as well. So, yeah, it's. Those are some of the things that I, I'm concerned about is the inflation and how expensive it is to operate and, you know, trying to conduct business so that we're most efficient and the clinicians can make the most amount of money.

Yeah, I think we see that in everywhere. Like, you know, the inflation or the prices are squeezing, like everybody. Right. You know, not only from the, I guess, the patient, the consumers, but it's also how you run your clinic. Right. You know, and payroll, like, payroll of like the front, but also the therapist working there. Right. You know, and it's something I see right across the community. It's like, it's way harder to run a business now then, like pre Covid. Right. Like, hey, I think we're just saying that, like, just before the show, you know, like before COVID everything was fairly predictable. And you could, you know, you could run the clinic without like, you know, without. You could run a clinic and not being too optimized now, like, there's kind of no room for error. Like, you have to be really on top of it right now.

Yeah, yeah. And it just seems like every month the cost of goods is going up. So last month you made it. You might have paid, you know, $120 for that bucket of laundry soap. And then next month, who knows, maybe it's up to 130. You just don't know.

Yeah. Wow. Wow. So Bill 3, Bill 36. Let's talk about this, right? You know, you brought it up and super controversial. Maybe like in, maybe in. In, like, maybe in a minute or so describe what it is and what impact does that have for. Yeah, like physical therapists, chiropractors, massage or even like doctors, right?

Yeah. Bill 36. Yeah. So they are going to enforce it, I believe next month. I think that's when they're really wanting to implement the, the shift. So they're going to be amalgamating the individual colleges into a group of four or five colleges, I can't remember off the top of my head. And there's going to be new regulations and bylaws and a lot of the clinicians will lose their anonymity to how they practice. And in a health care system that's already struggling, I think it's going to put even more pressure on British Columbia because clinicians are leaving. They are not going to accept these new conditions and they're going to leave. And I've, I know people who have left. I've talked to people who are considering leaving. And so I think it's going to put more pressure on our healthcare system because as most of us know, many communities that there's no doctors, they're shutting down emergency care because there's no staff. And so a lot of other modalities are picking up the slack for people's health care. And so it's going to cause even more stress on the general public, it's going to cause stress on the clinicians who are not going to be accepting of some of these new bylaws. And there's so much unknown. We just don't know all the impact that it's going to cause. But in my opinion, it's not good.

So. So in this bill 36, like, in essence, you're saying all the different colleges is going to amalgamate into like, a few of them. And is, and who is it run by then?

The government. So instead of elected board officials governing the individual colleges who have got experience in those modalities, it'll be unelective government employees who are running the colleges.

And why is it that they want to do that?

Control, overreach, tyranny, Pick any one of those. I really, I, I think you could go down lots of rabbit holes why they want to do it. But like, in my opinion, anything the government takes over and tries to run, they do a horrible job at it. I mean, look at when they attempted to.

I agree. You don't have to explain it to me. I want to just agree. Yeah, I'm just trying to understand, like, economically why they do that. You know, is it to, you know, is it to, like, make some significant changes or is it to, like, you Know, boost the amount of, like, you know, like, clinicians, like, working on the workforce to serve more people. Like, what's kind of why. Why. Why amalgamate all of them together? Right.

Well, they're using. One of their standard trigger words is that it's for public safety. That's why. That's, you know, the thing that we've heard. Oh, it's for public safety. So take that as you will.

Okay, cool. And then is there any province or state that's already started this, or is BC kind of the first one?

I believe they're trying to ram a similar thing through California.

Okay, wow. And then in the. And then once again, like, is it, like, so. And this. What I've seen, like, you know, in, like, this one I'm seeing right now, like, in. In Canada. Right. And also, like, in the US Is that, like, just with all these changes that are happening right now with, like, even insurance and Blue Cross. Right. Like, they're changing what you can bill as a physical therapist. So there is, like, these insurance reimbursement threats, you know. Right. That are going on right now. Right. Where as a. As a pt, you can't build this, this, this, you know, or you can't build with a kin, or you can't bill under, like, if you did this type of, like, activity. Now, you were talking about, like, not only is the insurance companies, like, making these changes, but also the government is changing the regulatory bodies. Right. You know, and how they're being managed. Right.

Yep.

That's crazy.

Oh, it is. It is absolutely insane. And I. I'm just glad that I'm more towards the winter of my career and have developed other skills and ways to earn an income that I don't have to accept it if I don't want to. I feel bad for people who are really locked in for new graduates who owe a lot of money, for people with families that are dependent on them. Those people are gonna. It's gonna be harder for them.

Yeah. And. And. And I just want to say that, you know, like, this is happening in B.C. it's likely. Well, it would likely will happen in Ontario as well, which. And then they'll spread right across the rest of the country. Typically, it usually happens like that either starts in B.C. or in Ontario, and then it cascade right across the country, and it's. And if it's happened in California, it's going to cascade right across the US as well, which is crazy. You know. And. And what would you. Are the top three things that you think will impact from a From a clinician standpoint. Right.

I think one of the things that's particular, particularly disturbing to me about Bill 36 is the vaccine mandate.

Okay, so vaccine mandate, which is controversial, right?

Extremely controversial. And not even, not even the mandate coming from the provincial government, but coming. Even coming from the world homicidal organization. So that's, to me, that's crazy. Also the threat of massive fines for non compliance, up to 200 or $250,000, they can find the clinician and for.

What, like privacy mean or, or for non compliance.

And really the way that the bill is written, it's quite arbitrary. It's 600 pages. I don't know if anyone's fully read it and comprehended it. And so they can just kind of make it up as they go along. But the other part is the threat of jail time for a clinician. So all of a sudden you can have this official coming into your practice, your private practice, and taking private medical patient records, possibly going to jail and having massive fines thrown at you.

Well, the insurance company and the colleges do it already. But the only difference now is that you're saying that it's like, you know, like, it's like the government doing it. Right. You know, which is, you know, very different. All right, what's number three? Like, you know, what's other. What's the third, what do you think is the third biggest impact for a clinician? You know? Right.

I think just. I think it's the. Well, we don't even know what it's going to be because it's like, how is, how are these new officials going to operate the colleges?

So.

So, like, for. I'm a massage therapist, so one of, one of the most immediate things that we're seeing is the way that they're changing how we. In the past, we used to have to get continuing education credits, and now they've changed it over so we actually don't have to get credits by taking outside courses. Now we have to do something else, which I have. I don't really know what we need right now, even though I need to figure it out by the end of October. But I'm just like, I need to, I need to look at it, but I'm resisting it. And so I think just change. We've had so much change over the last few years, and now it's more change. So change. The change has been exhausting. So, you know, I think it's just another opportunity for clinicians to put out more time and energy when they're already struggling with, you know, burnout, fatigue, you know, all the things that clinicians have to contend with.

So it sounds like more paperwork. It sounds like more paperwork.

I'm sure there'll be more paperwork. Yeah.

Oh, man. Okay, so. All right, so let's move on. Let's talk. Let's talk about the other thing you talked about. You're talking about it's getting more and more expensive to run clinics now. Right. You know, and. And. And you told me that your one things you've done recently, right, in the past couple years is that your entire front desk or front office team right now is, like, remote. Like, you've hired virtual assistants, right? You know, is that. Is that like, can you talk about that? And how's that going to help you? At least, you know, help you on the P and L item? You know, like the, you know, the costs are on the front desk, which is a big component of, like, most clinics right now, right?

Yeah. Yeah. I'd say front desk is probably the biggest expense for most clinics in my experience. And so when we shut down for Covid, we wanted to keep. We wanted to keep our phones open, we wanted to keep communication with our patients going. And so we set our. Our front desk people up at home. And at that time, they were all employees. And so we did some training and got them going. But even before we shut down for Covid, we'd already hired Call Hero to answer the phones. And it was around that time to Call HERO started to beta test to have, like, individual agents assigned to individual clinics. And I was very interested in that because I only had two front desk staff. And so in the event, if they were sick or needed a holiday, we would have coverage. And so it all kind of came together around the same time where we went virtual. And it was a combination of, like, contractors and employees, and, you know, between the. The contractors and the employees, they were answering the phone, they were booking patients, they were doing the billing. My employees were working on marketing, doing all the things that front desk staff do. And we got through Covid, we kind of limped through it. It was very hard on the staff because some of them were extroverts. And so to be at home by themselves, it was not a good fit. I did have one introvert, and she loved it. She was able to stay at home and not go anywhere. And so that really worked for her. Then down to I had one leaving for a maternity leave and then another one. She started having some health challenges. I was really reconsidering employee model versus contractor model and so I ended up hiring another team of virtual assistants that were also contractors and set up very similar to coloro. I went with. Also went with Ginger Desk, because Ginger desk would. And that's what I really needed help with, was doing the direct billing. And so with contractors, it had. It gives me a lot of, like, manic, or they need to go on mat leave or the agent standing by. So I don't have days where I need to put aside everything that I'm doing to jump on front desk and take over. And I also don't have to have the expense of training someone new because that is very costly to train people.

Yeah. Hey, Katie. So can you maybe. Can you describe what your front office teams looks like? Like, how many people do you have? Like, what's the breakdown? You know? And. Yeah. Can you do that?

Sure. Yeah. So there's. I think that. I think there's a Call Hero team of, like, maybe five or six agents that answer our phone.

Okay.

And then I've got one virtual assistant that is designated to my clinic through. Through Call Hero. And she's lovely, and she works about 20 hours a week on the front desk. And she is involved in. She kind of helps manage the Call Hero team. She's the liaison between us and the Call Hero team if there's any problems. She does direct billing. She works on my marketing. She fills out my scoreboards. She's just a delight. She's been with us for over a year, and. And she's a real integral part of the team. And then with Ginger Desk, we've got one virtual assistant dedicated to our desk, and we had one for a year, and then she got her promotion, and so we've got a replacement. She started with us in January, and she's amazing, and she really troubleshoots. If there's any billing problems that can't be figured out, she solves them. She does a lot of problem solving with patients. Like, if there's complaints or something that come in, we get her to call the person. And. Yeah. And so she works five days a week, and she's probably putting in about. Probably close to 20 hours a week as well.

Okay. And that's your entire team. You got, like, a part. You got a virtual assistant. You got a virtual assistant from Call Hero. You got a virtual assistant from Ginger Desk. And then. And then you're also using Call Heroes, like, answering service. Right. You know, like, is that it for your, like, front office team? You don't have anybody else?

Okay, that's it. And we're open seven days a week. And often we're open from eight to eight. So we've got a lot of coverage that's required. And so if I had to pay someone to stand at the front desk and be there, it would. I. I wouldn't be able to afford to do that. It would not make any sense. It is. It can be a little bit frustrating sometimes, not having somebody at the front desk. We definitely have to put it out there so that patients are aware that there is nobody there. And if they have a problem filling out a health history form or there's an issue with their billing, that we need to deal with it with a phone call or over email because there's no one at the front desk. And so for some people, they would prefer to have someone at the front desk. And sometimes it's hard on the clinicians because if someone comes in hot, the clinician is frontline. And so we've had that issue, too. Or someone's come in. And probably, like most clinics after Covid, people are running a little bit hotter these days, a little bit stressed out. So, yeah, you know, before we jump.

Into the patient experience, you know, which we could do after, I want to go kind of the nitty gritty. So you got. You got Call Heroes answering a service which answers, like, I guess, all the. All the phone calls. Right. You know, and then what does that one virtual assistant do that you have with Call Hero versus the one from Ginger Desk? Like, what do they do differently? You know, like, how do you put down their task?

Yeah, yeah. So the difference between Call Hero and Ginger Desk. So one thing is Ginger Desk is Canadian. Like, the. All the call agents are Canadian. And so English is their first language. So with Call Hero, that's not the case. And so if it's a. If it's a delicate situation, I will have the Ginger Desk va phone.

Because there's complaints, right?

With complaints, yeah. Because a lot of people, they're really paranoid, right, about getting a call and giving out any kind of financial information or health information, like their program. Oh, it's got to be a scam. Scam. And so we've had that happen. And, you know, just to be very blunt here, there's racism is still alive and well, and we've had to deal with some of that.

Yeah.

And, yeah, our Call Hero agent, she speaks very good English. She's very, very clear. She's got very, very fluent in English. And. But just sometimes people are very suspicious and wary. And so Jana does make a lot of calls, and she does talk to a lot of people, but if it is like a very sensitive subject, I will have the Ginger Desk agent call specifically for that reason. And so, yeah, and as she does, she does a lot of the marketing. She puts all the content out into a planner. She goes through the numbers and fills out the scoreboards. She replies to the Google reviews. She really goes through Jane and she's sending out, you know, return visit reminders. So she's working really hard behind the scenes to keep the clinicians schedules full. And then with Ginger Desk, actually just.

Before we jump to Ginger. So then she does the marketing, the weekly scoreboard, she does like response to Google reviews. Does she do the billing too? Like billing?

Yep, she's trained to do the billing.

And, and, and then what else? Like inbound calls?

Like, yep, she does inbound, she does outbound. She also works as a liaison between us and the Call Hero agents.

And so she does reactivation calls to you or. No.

Yeah, she does reactivation calls. And I'll have her audit calls. Like if something comes up and we need to know exactly what happened on that phone call, I'll ask her to audit that call. And so that's one of the great things about using the Call Hero software is everything is recorded. And so because I've had people, you know, say some ridiculous things and I, I'm like, okay, let's see the receipts, let's have a look. And then you look at it and you're just like, that actually did not happen whatsoever. And yeah, so I really, I like that feature because there's, you know, there's side of the story and the other side of story and somewhere in between is the truth. And with the calls are recorded, you get to the truth.

Yeah, yeah. And then what about collections? Does she do the collections too? Or is it like.

Yeah, we all, yeah, we all work on accounts receivable. Yeah, we absolutely do. Yeah. And the three of us, between Call Hero Agent and Ginger Desk Agent, the three of us get together every week and have a meeting and we go through, you know, what worked, what didn't work, and you know, problem solve. And we call ourselves, we call ourselves the dream team because we've got each other's back and, and everybody gets along really well. And yeah, it's a real, it's a very sweet team. I really, really like them and I'm very appreciative what they do.

That's awesome. And then, and then the Ginger desk va. It sounds like she handles complaints. And then what else does she do outside of complaints.

So she does billing. She does billing. And if we've got. And so she also does reconciliation of the bank statement statements.

Okay, so she's doing bookkeeping now, right?

Yeah, she's doing some bookkeeping. And if, you know, when we're onboarding, both of them actually work on the onboarding, like, onboarding them onto Jane, onboarding them onto our systems and who. Like, new clinicians.

Okay.

Yeah.

Okay.

And so, yeah, so she'll also, like, get them set up with our direct billing on the individual accounts. She will make outgoing phone calls. She will liaison. The both of them will liaison with the clinicians. We have a Slack channel. And so if the clinician needs, like, a schedule change or, you know, they need help doing something, they can reach out and ask either one of the ladies to help out with that. Yeah, yeah. So between the two of them, they do a lot.

How do they decide, like, who does what? Because I feel like there's a. There's a bit of overlap, you know? You know, and maybe that was by design because you want them to back each other up if the other person's not doing it, right? No.

Yeah. And because we're open. We're. Because we're open. You know, like, some days we're open 12 plus hours a day. So Ginger Ask. She works mornings and then Call Hero, she works afternoons and. And weekends. So they're, you know, there are some times where. Where they're. They are on at the same time, like, a little bit of overlap, but really it's the time that dictates it.

Okay, so what I'm hearing, what I'm hearing right now, like. And maybe you can help me. Like, you know, like, you're open seven days a week from eight to eight, which is 12 hours a day. And, like, you're really just spending 40 hours, like, a week on payroll. And half of that payroll. Right. Is like, overseas with Call Hero. Right. And it's a fully remote team. Right. And all the calls that don't get answered between either of your VAs, like the morning and afternoon shift, it's actually answered by Call heroes. Like, you know, like answering service. Like a virtual receptionist. Right? Is that. Did I get that right? Like, that's kind of your, you know, your business model, right?

Yep. And. And the Call Hero agents, they are available six days a week. They start answering the phone at 5am and they go till 8pm so they do answer the bulk of the calls. But with the Call Hero software, you know, we can see. See those calls that are missed, we can listen to any voicemails. And now we've got opportunity to use a texting system through the Call hero portal, which is fantastic. We're just, we're actually at a meeting about it the other day and we're like, wow, this is actually really well utilized by patients. They're absolutely loving it. So it does, it does cut down a lot on having to do callbacks because they can just do a text back and yeah, we're in very close communication with the Call Hero agents and if they've got something that comes across that they don't know how to deal with, they'll slack us. And then we have a little internal system so we know that it's been dealt with so it doesn't slip between the cracks.

Interesting. If you enjoy my content, I write a clinic owner newsletter. I share with you what's trending right now in marketing, selling your business, recruitment operations, front desk and more. Become a better clinic owner. Join over 22,000 clinic owners who get this free newsletter each week. Go to clinicowner.com to sign up today. What type of like cost savings have you had? Like, with this? Because this is pretty, you know, like it's very difficult to open eight days a week. Eight to eight, you know. Yeah. Like, you know, and really it sounds like you just hire like you have equivalent to one full time equal event paired up with like call heroes answering service. So like do full, like, you know, full coverage. Right? You know. Yeah. Have you seen a big cost savings through like this, this way of running your front?

Yeah, for sure. Because, you know, and going from an employee model to a contractor model. So now I'm not on the hook for payroll benefits. I don't have to deal with sick days or paid sick days. And for me it's the, the mental real estate that's freed up in my head about worrying about somebody quitting or somebody walking out. I don't have because that, I had that before with employees. You know, they start to feel like they're invincible and you can't run the show without them. And in a way they're kind of right. Right. Like you've got that temporary time where you're like, okay. And that happened to me, you know, like I had to let one go. And while we were training the, the new people, I worked every day for three months. I was pretty cranky, Rick. Like, I don't want to work every day for three months. That's not good for anybody. And so that was a huge thing for me is like no one's going to hold me hostage. No one's going to hold it over my head that the show is going to go on regardless of what one person does or doesn't do.

Yeah, yeah. I'm just working out the math right now. If you're open 12 hours a week, right? Like 12 hours a day, seven days a week, you need 84 hours of coverage, right?

Yeah.

And that assumes no overlap. So really, like, you probably need like two and a half, like, ftes full time. Right. Front desk.

Yep.

Two and a half to maybe three to like fully cover everything. Right. And so with what you're doing right now, it seems like you went from three FTEs in the front to like one. Right?

Yeah.

Plus an answering service. But I won't keep this in mind. Like, you're also, like, you got 14 people in your clinic. And so I just want to say, like, what you've created is actually quite. Actually is quite innovative, you know, right now because I don't see a lot of clinics doing this. I'm just being straight up. That's why I want to, like, meet with you. Like, like, I want to like, how is Katie actually doing this? Like, how can you actually grow a practice has 14 people and just have one like FTE in the front, you know? Right.

Yeah.

Seven days a week, 12 hours shift. And like, I think you just gave me a recipe. Like, this is like insane. You know, I don't, I didn't really fully understand until I called it. I was like, wow, like you like uncracked this right now. Right. Which is pretty, which is pretty awesome. Right. You know?

Yeah. I think the next evolution would actually to be have like a TV screen in the clinic with a VA on the TV screen assisting people. I think that would be one way to level it up so that if, you know, some people, they do want to see somebody and if that person was on a screen, I think that would be effective.

Yeah. Is that the next step for you or no?

I don't know. I don't know if that is the next step or not, but I've thought about it.

Yeah. What was your front desk turnover like before you hired, like before you decided to go like full remote? Was it a lot like you're just. It was just constant turnover with like, just hiring like local minimum wage employees, like, you know, staff that typically don't. Yeah. Don't stick around for a long time.

Yeah, it was, you know, typically you. You'd have them for about a year and then they'd want to move on I did have one. She started out. She started out in person, and then her husband got a. A job in another city, so she moved. And I ended up hiring her back as a virtual assistant. And so I did have some that did stick around for a while, but typically it was about a year and they would want to do other things. Yeah, yeah, It's. It's hard. It's hard to keep people. Whereas.

Well, I think the quality of hires, too. Right. You know, it's not just, like, the pay, which is one thing, but it's also the quality of hire. Like, you know, when you put a job posting out, like, you know, you'll get whatever 100, like, resumes. You know, you've gone through this, right? You know, actually, like, I'll share the story. Like, we just hired a marketing coordinator. You know, I put a job posting out. I had a thousand people apply, right?

A thousand.

A thousand. Because mine was a remote job. So I went right across the country, right? I had a thousand people apply, right? And out of a thousand people, there was only, like, 30 people that actually made the first cut in terms of, like, their resume because I wanted them to, like, do a certain thing, right? Like, I want them to respond. I gave them, like, a little question to respond to, and then like, so only there's only 30 people who responded and had the right resume. Right? And out of that 30, we only interviewed three of them. Right? And out of the three, we put them on like a 30 day. You know, like, we gave them a project to work, a paid project to work on, and we only. Only one of them passed the test, and that was the person that we hired. Her name right now is Desiree. Desiree, you're listening to this right now. So we have. We had this conversation. So.

But.

But that's my point is that of a thousand applicant, there's only one. Yeah. That passed the Rick Loud test. And Katie, I think it was probably very similar to, like, what you experience, you know, Right.

Oh, totally. Yeah. The last time we did group interviews, we had. So before COVID we'd get like 90 resumes. After Covid, I think we had 30 resumes come in, and of those 30, we invited 15 to come in for a group interview. Of those 15, we had seven come in for the group interview. One of them left early during the testing portion, and so then we had six, and then we pared it down to three and then got our one. But it was. It was like, wasn't good.

But like I said to you, the mentally is mentally Draining, you know. Right, yeah, yeah. It takes up your brain, really. And then secondly is that, like, you know, I think this thing people don't really talk about is the impact it has on your clinic culture. Right. Yeah. Because your front is constantly rotating, you know. Right. Whereas now you could just, like, now, like, you know, like, with, like, you know, your remote team or using companies that do it, like, it's their problems. There's less of it. Like, in theory, it should make your clinic culture better because, like, you know, is. Because. Because of the way this is set up. Right. Is that something you notice, Katie, or not really?

Totally. Because each of those companies, gingerdesk and Call Hero, they've got managers. So if there's a problem, I talk to their managers and they deal with it. And so I like that. And then again, for me, with the clinicians that I've got, you know, there are things that come up where I've had some of them come to me and talk to me about why they'd want to get front desk staff back in the office. And I just have a very succinct conversation with them about the finances and how expensive it is and the stress it is on me. And that I don't. I don't want to manage in person because I don't want to get stuck working three, three months every day. Again, like, I'm. I'm not willing to do that. And for a lot of massage therapy clinics, because that's what we are primarily, they don't have front desk. Like, the clinicians are responsible to do their own billing and their own booking and run their own finances. And so I think we found a way where we can provide more services for the clinicians and still keep the cost in check. And you can't make everybody happy. And I'm at the stage in my career where that doesn't bother me so much.

Okay, well, yeah, yeah. I think you're also looking for fit. But also, how can you run a business that's easier and more profitable? Right. You know?

Yeah, yeah, exactly. And honestly, like, I run. I run the clinic from my home, and I like that. You know, I raise. I raise toy poodles. I've got. Right. Like, how cute is that? I offer puppy therapy. People that want to come out. I've got aging parents that live beside me, so I like being available for them.

And you don't treat anymore, right?

I do, yeah. I still go in one to three afternoons a week and just see a couple patients and.

Because you want to or because you have to.

I want to. I still enjoy being a massage therapist. I still like the dopamine.

You want to keep your license? You want to keep your license with Bill 36?

Well, and that's actually one of the changes is now we have to work a minimum of hands on hours. Yeah, that's actually a good point.

Are you good? Is that good? Yeah.

Yeah. But I still like being a massage therapist. I like going in and connecting with the clinicians. I do quality control when I go to the office. You know, it's just an opportunity to keep my finger on the poles, keep connected to my team and keep connected to patients that some of them I've seen for, you know, over a decade. So. And I bring some of my dogs in there and do a little bit of puppy therapy at the clinic as well.

So tell me, how do you manage a remote team? Like what is. Like. Yeah, how do you manage remote team? Like, what does your org structure look like? What does the communication rhythm looks like? Like each week for you? Right?

Yeah. So I've got weekly meeting with the VAs and you know, when I get up in the morning, I just go and I check the email. I check, like, I just check and see if there's anything that needs addressed because I'm, I get up early, I get up at like 5, 6 in the morning. And so I just have a quick peek and see what's going on.

So you do weekly zoom calls, right? Is that what you're saying?

Zoom calls, Right, Zoom calls.

And then, and then it sounds like you got slack channels. You slack. So that like, that's your, how you communicate with like, I guess your, your, your VAs, right, or your front desk on all the, all the different, like, like burning issues or complaints or like categories, right?

Yep. And same with clinicians. Clinicians are, they're also slack as well. A lot of my clinicians, they've worked with me for many years and so they'll off, they'll send me a text or they'll give me a call and I don't have, I don't have set rhythm meetings with my clinicians, which I know is not the best, but that's the way it is right now.

And so no clinician meetings. But do you do staff meetings or like you do staff meetings or do you do like staff parties, quarterly parties or annual parties? Like what's the, what's the meeting rhythm of like the, the of your team of 14 then outside of your VAs?

Yeah, yeah. So we do an annual Christmas party and the Clinicians have actually said they want to start doing, doing like a summer party. So I'm like, okay, we'll do a summer party. And we used to do in person meetings and then co hit and then we started doing like zoom meetings and then everybody got super burnt out on the zoom meetings. And I have been asked to start doing in person meetings again where it's like a Wisdom Wednesday where, excuse me, either one of our clinicians is talking about their expertise or we're bringing someone local in.

So clinical rounds. Right. You know. Right.

Yeah. So they'd like to get back to that. And so that is actually something that I need to work on. I get with the bookkeeping team, they'll send me tasks, task lists of things that I need to do. I need to approve payroll. So we do that bi monthly. I answer emails, I work on recruitment. It's I, I block and batch as much as I can in my calendar. But it really.

You saw you, you sound like you've been part of clinic accelerator for a little bit.

Yeah, I've definitely learned a lot from clinic accelerator and I, I don't think that I'd be where I am right now if it actually wasn't for clinic accelerator because I did learn a lot and just as a clinic owner, just gaining that confidence and that knowledge. So, yeah, it is so awesome to.

See you manage like a remote team because a lot of owners aren't doing this, you know, like I. You could run your clinic in Hawaii or in Florida right now if you wanted to. Right. You know, Right. Outside of you trying to, you know, get your hours for Bill 36, obviously. Right. You know, and Kate, I don't know if I shared this with you, but I've been, I've, you know, like, you know, me, like I've, I've. I've been running a remote business for like eight years now. Right? Yeah, like all my businesses have been remote. And I took my remote business to a next level where in the last, you know, in the last, in the last seven months I've been traveling like overseas. Right. Like I'm in Spain right now. Right.

Awesome.

So I'm running my team, my, like my businesses, my leadership team, you know, remotely, you know, like, you know, in Spain right now. Right. And my, me now, my rhythm is very similar to yours. You know, I do weekly zoom calls with my leadership team. You know, I do one on one zoom calls with like all my direct reports, you know, and, and then, you know, every, every two weeks we do all hands calls, you know, so all the department heads, you know, all get together and you know, they present like, hey, you know, their wins, you know, what they're going to be working on this month and where they're stuck. And then like, so everyone gets kind of like this update, which is similar to like, kind of your Wisdom Wednesday, you know, and, and then once a year, like, our remote team will get together. It costs a lot of money, you know, because every time we fly everyone in, it's like 30, $40,000. Right. But like once, twice a year, we'll fly everyone in and we will have like a three day, like, party of like, you know, like. Yeah, a three day party.

Well, and I know you're a generous host, so I'm sure they're pretty, pretty awesome parties.

Yeah. Yeah. So. But it's awesome to see you do it at a clinic level, which is amazing because I wish more and more owners kind of do that. Right? So super cool. Let me ask you, like, I think you talked about some of the complaints, you know, that you have working with like, vas, right? You talked about, you know, like, you talked about speaking English, but the English is fluent. But you said that, like, maybe the accent might rub some people the wrong way. Right? You know, is that, is that what I kind of heard, Katie?

That's exactly what you heard. Yeah.

Okay. What other complaints have, have you seen? Like, you know, have you experienced with working with like, maybe overseas VAs, you know? Right.

I. I think it's like just the communication. Like, sometimes the VA might not fully understand, and so they'll repeat what they're hearing. And so, you know, and, and people can be really impatient and they don't want to have someone repeat what they're saying. But basically that it does just boil down to some of the communication. And I mean, like I said, I'm really glad that the calls are recorded because I listen to them and I'm like, that is not what happened on that phone call at all. And, and I've even got on the phone with some of the patients and called them out on it, and I'm like, that's a you problem. That's not a we problem. And get over it.

But this is solvable, right, Katie? Like what you're saying, like, this is solvable through training, communication and also training them on what, what the cultural norms are for the patients in your community, which is like, hard, you know, like, you know, if you really think about it. Right. You know, so.

Yeah, and like, you know, sometimes people are phoning and they think that they are in the building and they're asking like, well, why is the door locked? Or where is my clinician? You know, if a clinician is running late and they're phoning the office and the agent is in the Philippines, they don't know what's happening. Right? Like, they don't know what's going on. And so ultimately, it's training the clinician. If you're going to be late, call your bloody patient and tell them, because that's a. That's a you problem and you've created it, so you need to be accountable for that.

Okay, so that's solvable, right?

Yeah, yeah. And that's the thing I've really learned. It's like, there really isn't any problems. There's only solutions.

Okay, well, the patient being late, you know. Right. You know, the patient being late or.

The clinician being late. So, yeah, sometimes.

I'm sorry, clinician? Yeah, clinician.

And sometimes the patient is late. So they're gonna phone the office and. And say they're late. And that's no problem because we'll get a. Like, I get a slack message, but I also have it come through on my phone as a text message, and I can forward it to the office, to the clinic cell phone. So the clinicians, they can always get the messages from Call hero in real time, so they know what's going on as well.

Okay, cool. So can you describe once again, like, you're running a pretty big practice right now, seven days a week, five hours a day, you know, remember, it reminds me of, like, Brenda's clinics in Victoria. Right. You know, like it's seven days, like full shifts, which is incredible, you know? You know, can you explain to me what that patient experience looks like? You know, so from the moment they call and book, to them maybe like leaving the first appointment, how would you describe that, like, experience, you know?

Right, yeah. So they would phone and they would book, and we use Jane. So then they get all the emails from Jane, if they're a new patient, to fill out their health history form and upload their billing information. And then the day before they come in, they get a. Another little survey to make sure they're in good health to come through. Like, and then. So then they'll. They'll come in and there's a sign on the door that says, notice we don't have in person reception. So. And if they miss that one, there's another sign inside that says, we don't have in person reception. You know, take your shoes off, your Coat off, have a seat, have a glass of water, use the washroom. Here's the WI fi. Your therapist will be with you shortly. And so they.

Is the door locked or not locked generally?

Now it's unlocked. We had it locked for a long time. That was causing problems because people would show up and the door would be locked and. Or it'd be raining and the door would be locked, and they wouldn't like that. So now the door is pretty much unlocked all the time, so they can just walk in and.

And what's the general reaction typically, of a new patient? Because this is not normal. Like, they're not used to seeing this. Like, this is almost like going to, like, one of those McDonald kiosks for the very first time, and you're ordering, like, a Happy Meal because you're too embarrassed to, like, order a Happy Meal with a real person.

Yeah. You know, I think for the most part, it. People just roll with it. You know, it's like you do have the options.

They get it, right? Like they get it and.

Yeah, they get it. But there are people that don't read their messages. They don't read the signs, and, you know, I call that learned helplessness. It's like they're just kind of bobbing around in life expecting a guide. And it's like, no, you actually need to be reading. You need to be aware of what you're getting into.

And.

Yeah, but for the most part, people don't really have a problem with it. The only time it's a problem is if they are showing up. They haven't filled out their health history form. They haven't uploaded their billing information. They haven't read the sign. Like, they just come in and they, they. They're totally unprepared. And.

But your VAs are following up with them on that anyways. Right. You know, so, like, you should be able to cash. Like, you should be able to catch that 95%. Like, you're.

You're.

You're talking about the 5% of them right now, not the 95. Right.

Yeah, it's. Yeah, it's very, very, very little. And we do work really hard to prevent that from happening because we don't want to burden the clinicians with. With any kind of extra, Extra work that they don't need. Don't need to do.

Katie, something I learned from someone that you may want to consider is which really help that. That new patient show up for the first visit and deal with, like, all these. Yeah. Just to get them, like, you know, totally on board is the clinician putting together like this like 30 minute, like 30 second, like welcome video. Right. And they send. Text it to them or they email it to them so that they watch that before they arrive, you know, and, and, and, and, and, and welcome them for the very first time so that they sh. That they show, arrive and pay.

That's a great idea, actually.

Yeah, yeah. And then this way is personalized. It comes from them, so you still have the patient experience, but then like, and then you also explain to them like, hey, this is how it works, you know, and this is like totally normal, you know, and so then, because if you like that, you can use that call hero text messaging. Like, you just text it to them and you'll know, hey, by the way, have you, have you watched this? You know, like, you know, like Katie just made the special video for you. Right? Blah, blah, blah. Right? You know?

Yeah. What was that email app that you could make videos? And it would, you'd make it once, but it would personalize it to the person's name. Like, it would, you'd actually sound like you're saying, oh, hi Rick or hi Paul or whoever you're sending it to. Do you remember that?

Oh, no, there's, there's tons of these AI generated videos. Right. You know, but even as, like to make it super personalized, like, I would just get that. I was just, I would just get that clinician and do it, you know? You know, like it's like 15, 20 seconds, you know, like they're building their caseload. It's amazing welcome video that they get. It's text to them, you know, like, hey, I'm excited to meet you, welcome you to like, blah, blah, blah, and then you like, da, da, da, right? You know, and talk about what it looked like and I'm, you know, and then it'll help you reduce your cancellations and also care plans as well.

Right, Right. Oh, so actually get the clinician to do the video.

Yes, yes. You got your clinicians doing so much already, so you might as well just add that one. It would help them with their caseload. That's my point. Right, and so only 15 seconds, right? You know, just text them. Yeah. And one thing I just, one thing I just want to add too, is that like, I just want to like, for people listen to this, like, Hades clinic has 400 plus Google reviews, everyone. Okay? So if any of you actually have a doubt on whether you could actually run a clinic of 14 staff with a remote front office, which is made up virtual assistants, that don't work at your practice. Hadee showed that it's possible and you could do from an amazing patient experience because you got the 400 views show for that. Right, so.

Oh yeah, I just had a look. We are at 406 Google reviews with a 4.9 average.

Yeah, yeah. It's like amazing, right? You know?

Yeah, there. Yeah, there. And, and the thing is, those Google reviews, they're not all directed at the clinicians. Some of them actually do mention the, the VAs and the administrators.

Really?

Yeah.

Wow, that's awesome. I think I'm gonna look at that, you know. All right, so. So they, they come in, they take the shoes off, they sit down, you know, and then what happens? Then it's just back to normal then, right?

Yeah, they just have a seat and then the therapist comes out. Hi, I'm so and so. Come on in. They get their treatment, the therapist walks them out of the room, they collect their jacket and their shoes, and if the clinician is so inclined, they will rebook them themselves. And I heavily encourage that.

It's like what percent actually rebook them? Schedule them in.

I would say 80%.

And 80% of your clinicians will book like that patient on that first visit themselves.

Yeah, and they'll rebook it. And I, and I, I'm like, take five minutes and book them their whole case plan. Like this is how you keep your caseload full. And you can easily tell who's doing it because you just look at the schedule and those that are booked up weeks in advance, you know they're doing it. And those that are taking same day bookings, you know they're not.

Okay. And then for the 20% that don't rebook, then what happens?

So call them.

Right.

So yeah, she will send them a return visit reminder encouraging them to rebook.

Text or email or call or biddable.

It is an email.

You should start doing text now. You have a higher conversion rate.

That's actually true. I wonder if we can text the return visit reminder through Jane. I'm going to write that down and have an investigation because yeah, texting is the way to go for sure.

If you can, I would just do it manually through call Hero. Right. You know, just copy and paste. Right?

Oh, okay. Yeah, no, that makes sense. Yeah, that's actually a really good. Yeah.

And then. Yeah, and then, and then payment. You don't have to worry about payment because which is the most awkward conversation because all the payment collection, all the payment stuff is, is done right before they arrive. So the Payment's taken care of. Right? You know, am I right?

Unfortunately, no. Because if you, if you bill insurance before the appointment, that's considered fraud.

No, what I mean is you've collected a credit card. Right.

For the most part. Some people are a little bit leery about credit cards. And we don't have a point of sale machine in the office. So if they want to pay by debit, we'll take E transfer. So we'll take credit card, E transfer or cash. And in the very odd instant, they're usually like over 80, they'll want to write a check. Which I'm like, yeah, sure, we'll take a check.

But who deals with. Oh, let me back up. So what percent of them will take the. Will have the credit card information before they arrive on the first visit? Like, is it 80%?

I would say 80. I'd say maybe even higher.

Okay, so 90%, let's just say 80% of the people before they arrive in the first visit, the VAs already like have their credit card information. Like, like their credit card information in like Jane in this case. Right. You know, Right. So that they could bill afterwards. Right. And then for the 20 that don't have it and they want to pay debit or, or, or like checks or cash. Like who had like the clinician, what, the clinician handles that afterwards or yeah.

So if they pay, if they pay by cash, then the clinician takes the cash and then they record it in Jane. As to clinicians, so we know they've got the money. So there's no like float at the office. And if people want to pay cash, it's like, okay, bring in the right amount because we're not going to have change for you. And then, and some people do get a little bit confused about, well, why can't I pay by debit? Well, if it's debit, Visa, we can run it through Jane, but we don't have a terminal in the office. So can you send an E trial and most people can send an E transfer, I'd say.

So the clinicians trained to say this or like the VAs do on the follow ups?

Both.

Both. Okay.

So it's just, you know, constantly reiterating, this is how it is. This is how it is. This is how it is.

These clinicians must not like doing that part of the job. Right. Or do they?

The clinicians tend to only like doing the hands on work. Anything extra and above, they don't really care to do it. But I've got, I'm very fortunate I have a good team and they do it and they. Well, right. And it's just, you know, we don't, we don't accept learned helplessness. It's like, just do it and okay. The problem, often if there is a problem, it will be with people who are elderly, who don't know technology, are afraid of technology. Technology are afraid to give their credit card, don't know how to upload a picture, those kind of things. It's. Or they don't have an email. You know, like last week we had a patient 101 years old coming in. Well, guess what? She doesn't have an email. How are we going to deal with that? Well, from the olden days, we have laminated health intakes and the clinician knows that they're going to have to sit down and spend a couple extra minutes with that patient and then upload it to their Jane profile. So there's just, you know, anomalies that come in. And again, they're not problems, there's only solutions. And we just have to get creative how we're going to work around it.

And we're also talking about the 20%, not the 80%, 80% of them. Like, like the process works, you know, it's getting the majority of them. It's like, how do you deal with exceptions right now? Right. You know, so.

Exactly. Yeah. Most people, it's no problem. But if there is a problem, oftentimes it is because they are older and they're just not technically inclined. So if I have a 30 year old that's having problems, I raise my eyebrow and say, what really is the problem? Because if you're in your 30s, you've grown up with it and it shouldn't be hard.

Yeah. All right, Katie, last question. If you were to start all over again, you know. Right. And I want you to remember when you were just a sole preneur. Okay. You're just starting off, you know, this is like, you know, like, you know, it's just you working by yourself. Okay.

Yeah.

And let's just assume that you have like, you know, 20 to 30 hours of caseload. Right. Who would your first hire be? Right. If you were to do it all over again.

Yeah, if I were to do it all over again, That's a bit of a tough call.

Would you still go remote or would you hire like someone locally?

Oh, God, I would go remote all.

Okay.

All day. Yeah, yeah, for sure, for sure I would. Yeah.

So what, so what would your first hire be like? You got 20, 30 hours. Hours a Week of caseload, you know.

Right, yeah. Well, If I had 20 to 30 hours of caseload, I wouldn't be worried about building my caseload. So I probably, I would hire admin. I'd hire someone to take the phone calls and do the billing and that's what I would, that's what I would do because personally I don't like doing that kind of a job. It's not my ceiling of excellence. And so I would delegate it out.

Okay, so you'll hire like a va, like remote. Right. You know, would you do an overseas one or you do the Ginger desk one, which is local, your first one.

I think it would really depend on. I would, it would depend on how much money I had to spend because Call Hero is more economical than Ginger Dusk. They both, I think it's.

Isn't it like a third the price?

Well, Ginger Dusk just changed their plan and I don't know if they did it straight across the border. They did it just with me. But it, it is, it can be significantly different. A big difference. Yeah. And also. Yeah, it would just, it really would just depend on what somebody needs. Right. Like do they need to have, how often is the phone ringing? Do they need to build their caseload? Because that's one thing that Call Hero has been amazing for is, you know, those same day phone calls and booking in. Because like I mentioned before, a lot of RMT clinics don't have someone answering the phone. And if someone is in pain and they're phoning around, they're just going to keep on going down the list until they find someone. And thankfully, because we've got 406 Google reviews, we're at the top of the, we're on the top fold and people are looking for a massage. And Courtney, I mean I've had people, they couldn't sleep in the night because they were in pain. They've called, you know, 5:30, 6:00 clock in the morning trying to get an appointment and couldn't believe someone actually answered the phone and they were able to book in that day and also have somebody, you know, kind of empathize with what they're going through. And so that's a, that's a kind of loyalty that is priceless.

Yeah, well, yeah, I know, I love that. So it sounds like, you know, like that va, like that you would hire, you would actually get them. Sure. To answer the phones, to do the billing and the min stuff, but also to work on the marketing. Like let's get those Google reviews up, you know. Right. And Also making sure that like maybe pair it up with like an answering service to answer those phone calls so that like you could get the Google reviews and also be able to like capture like all those people who are calling because they want a last minute appointment, which is like pretty much everybody.

Yeah.

Would you agree or at all?

Totally. Yeah, absolutely.

So I'm going to bring it back to the original question asked in the very beginning. I asked you what your secret sauce is for growing so like 14 clinics. Right. I'm just going to say like from what I'm hearing is, you know, the fact that you made your business like way simpler. It's more profitable given how expensive things are. You are like you got a shitload of Google reviews and like you're actually answering the phones when no one else is, you know, to capture those last minute appointments. And that's why you were able to like, you know, like, you know, have 14 like, you know, like therapists on your team because most, most clinics that you've seen like they're stuck at one or two.

Yeah, yeah, it's true. It is true. And we've got, yeah, we've got nine treatment rooms at the clinic. And so it's got, we've got, we could grow even bigger. And yeah, people are always like, Katie, aren't you worried about the saturation rate? Like isn't. They're gonna get to a point where you just, you're saturated. And I'm like, I don't think so. I don't think there is that point. If you're providing a good service and you have a good reputation and your clinicians are, you know, doing case plans and rebooking their patients because yeah, like when a patient really loves their clinician, they will be loyal to them full stop.

Amen. Well, Katie, thanks. Thank you for your time. And how do people find out more about you? How do they get a hold of you?

They can email Courtney Massagetherapy gmail.com they can give the clinic a call 250-897-0069 and they can have, they can have the experience of having the phone answered by call hero and see how fast I can get back to them. And if they, if they want to email me@katiewhite rmtmail.com that'll come right to me and I'll be happy to chat with anybody that wants to chat.

Cool. Sounds good. Well, thanks for coming on the show, Katie. Appreciate that.

Thanks for having me, Rick. It was really nice to catch up and have fun in Europe.

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