The RDtoCEO Podcast
Dive into The RDtoCEO Podcast, hosted by Registered Dietitian and CEO, Eva Haldis, where she shares her journey in entrepreneurship, with discussions on the basics on building a private practice and becoming a confident CEO. The RDtoCEO Podcast is your go-to resource for mastering the art of transitioning from a dietitian to a successful CEO.
The RDtoCEO Podcast
What Makes Group Practice Hard & Is It Worth It? Ft. Hannah Turnbull MSOL, RDN
In this episode of the RDtoCEO Podcast, I have my very first guest on the podcast who is my business coach, Hannah Turnbull MSOL, RDN.
Hannah founded NourishED Colorado to create a space where people can recover from eating disorders through connection and compassion. Though Hannah no longer sees nutrition clients 1:1, she continues to hold the vision of the company and leads the team in doing the work they love. Outside of her work at NourishED Colorado, you can find Hannah supporting other values based group practice owners and co-hosting the business podcast, Weight Inclusive Innovators. Outside of running her businesses you can find Hannah in the Colorado mountains on an adventure, in her van somewhere in North America with her partner and doggos, at a coffee shop learning spanish, or connecting with friends over food.
We delve into the challenges, strategies, and key steps involved in growing a dietitian group practice, with Hannah sharing valuable insights from her experience in business when it was just her as a solo clinician, working part-time scooping ice cream, to overseeing a team of 9+ clinicians, in addition to now coaching over 35 group practice owners (including yours truly! 🙋🏻♀️).
Resources Mentioned:
Where To Find Hannah:
For Business Coaching - http://valuesdrivengroup.com/
For Hannah's Podcast (with co-host, Morgan Sinclair) - Weight Inclusive Innovators Podcast
For Hannah's Group Practice, NourishED Colorado - https://nourishedcolorado.com/
Books Mentioned:
Hidden Potential by Adam Grant
Radical Candor by Kim Scott
Where To Find More from Eva:
www.rdtoceo.com
Want a question answered on the podcast? Send me a message, or a text message, and maybe it'll be featured in an episode!
You can send me a message on IG -
https://www.instagram.com/evahaldis_rd or https://www.instagram.com/rdtoceo
Find more about RDtoCEO at https://www.rdtoceo.com
For episode updates and coaching packages, check out our website - www.rdtoceo.com
Affiliate Links Often Mentioned:
Gusto for Payroll - https://gusto.com/h/eva6486
Practice Better- https://practicebetter.partnerlinks.io/evahaldis9298
*Please note that while we strive to provide valuable insights, our podcast is not a replacement for personalized legal or financial counsel. We strongly advise consulting with qualified professionals for specific advice tailored to your individual circumstances.*
Welcome to the RD to CEO podcast. I'm your host, eva Haldis, registered dietitian, who one day found herself a whole CEO of a business. Join me as we navigate the world of entrepreneurship so you can go from being an RD who sees clients in private practice to a confident CEO growing the practice of your dreams. Hi everyone, and welcome back to another episode of the RD to CEO podcast. I'm so excited today for this episode. It is the very first interview that we have on the podcast and it really only felt right to have this conversation with probably the person who's helped me the most when it comes to developing as a business owner and really making that shift that I'm always talking about, of being the RD who has a practice of then becoming a CEO and leader, and that is my own business coach, hannah Turnbull. If you don't know, hannah Turnbull is a registered dietitian with a master's in organizational leadership. She founded Nourish Colorado to create a space where people can recover from eating disorders through connection and compassion. Though Hannah no longer sees Nutrition Clients 101, she continues to hold the vision of the company and leads the team in doing the work they love. Outside of her work at Nourish Colorado, you can find Hannah supporting other values-based group practice owners like myself and co-hosting the business podcast Weight Inclusive Innovators myself and co-hosting the business podcast Way Inclusive Innovators. Outside of running her business, you can find Hannah in the Colorado mountains, on an adventure in her van somewhere in North America, which she was in during this recording, with her partner in Doggos at a coffee shop learning Spanish or connecting with friends over food.
Speaker 1:I've worked with Hannah for a few years now I think two or three years. I've worked with Hannah for a few years now I think two or three years and she's just been so pivotal for me in the last few years of really being able to grow my team. When I first started working with her, I think I only had one employee at the time who was very part-time, and I just added on our fifth dietitian to the team, fourth and fifth actually the last few weeks and we also have a sixth employee who is our amazing administrative assistant and I really credit Hannah a lot with supporting me through that and just giving me the confidence to do this really hard work. So as I was editing the podcast towards the end, I was noticing how much I was saying the word like, and in this episode.
Speaker 1:Hannah and I talk a lot about how important it is to just do the thing, and do it imperfectly and learn from it. And I was cringing editing and now that I say you're probably going to notice it, but I was like I'm going to keep it in because that is the whole point of the message we're trying to share here today is that being a group practice owner or being a business owner does not come naturally and there are going to be things that we have to do and try and see if we like it and see how it feels, and so I felt it was okay to leave in all the very many likes that I say towards the end. So here's the episode, and to doing things imperfectly, let's get to it.
Speaker 2:Hi Hannah, Hi Eva, I'm so excited to be sitting with you and having a conversation and just exploring a different dynamic today.
Speaker 1:I know we were just saying, before I hit record, how I'm used to showing up to these meetings and just telling you all the things that have been going on in my business. So I have to remind myself today that I'm going to be asking you the questions a little bit. It'll be a little bit different than usual, but I'm excited.
Speaker 2:Me too.
Speaker 1:As this podcast is about transforming from being an RD who has a private practice and sees clients to really transforming into that visionary leader CEO Hannah has been just so pivotal. I mean, I would say probably if I didn't work with Hannah, I mean, who knows? But I think because of my work with Hannah I've made this shift and I honestly think this podcast is probably in large part to the work that we've done together. So I knew this would be the perfect first guest and especially to talk about group practice, because I think, especially when you have a group practice, that's really where that leadership CEO part has to really show up, and pretty quickly, I think, once you're in it.
Speaker 2:I noticed as you were explaining that you were giving me way too much credit and I like that you corrected at the end of this is something you've gotten out of our work together, because it really has been me just supporting you and watching you shine and grow this thing, and I'm excited that we get to explore the topic of group practice together, both as group practice owners and I know I've been part of your journey, but you have been absolutely rocking it out with your practice, so I can't wait to hear what insights you have to offer the listeners as well.
Speaker 1:Well, thank you for saying that. That's really kind and especially coming from you, and I think this is actually really where I'm hoping our conversation goes today, because I think, yeah, I think there's a lot of benefit from having a business coach, obviously, and I think it's just like in our work as dietitians, right we sort of find the right fit for us, but also some of it comes with like challenges that we have to decide whether or not we want to take, and I think that's really that's really where I think that separation becomes more evident from when you're just in practice to when you're really having to make a lot of hard decisions but a lot of exciting decisions too, as a CEO and leader.
Speaker 2:Yeah and you're kind of speaking to you know, in the beginning, when you're starting out solo, there's a lot of scrappiness that can happen, where maybe a mentor isn't the best use of your resources and when I say resources, I mean obviously financially the most, because it does cost money to get coaching right and if you're being scrappy you're trying to just get a handful of clients eventually build up a full caseload.
Speaker 2:You can get pretty far without mentorship. And then group practice kind of goes next level. And because we're relational beings, people thrive in mentorship when they're trying to do something bigger than themselves. And that's essentially what group practice is right. It's no longer just you being the clinician, the biller, the admin person, the boss of your business. You are going to be bringing other people into the mix. And really the thing that I see group practices really take off with and become sustainable with is leadership, and that's that's that's the secret. Right Is being able to be a leader, and the way we learn leadership skills is by going through some shit, having a sounding board, and a lot of the time that sounding board is a mentor.
Speaker 1:Absolutely. Yeah, I mean, really it can help. Especially, I think and I think you're right the relational part is really key and I find, even for myself it's like a joke between my husband and I that my drug of choice is therapy. I really externalize that's how I process. I have to externalize information and having somebody who is a sounding board but also has a different perspective, to help really shift your thinking or just even to reflect back, like why this decision, what's going on here, and so, yeah, it's such a huge benefit. But I think you're right, I think different stages of being in business, when that mentorship is going to be helpful. But before we get too into the weeds on talking about group practice, that I think you and I both can fall quickly into, I want to just take a step back and actually learn a little bit more about you and your story of you know becoming and growing from an RD to CEO yourself, and to tell us a little bit more about your business, your businesses, actually your multiple businesses and, yeah, where you're at now.
Speaker 2:Yeah, oh, it's been a while since I've told my story and I always find myself wanting to be like let me give you the short version. But I'm feeling today like maybe I won't filter anything and I'll try to give as much of the scope as possible. So we got to take it back to like circa 2015, when I was a student and I was, I remember, sitting in a class. We were talking about insurance billing and pretty great, I guess. Sitting in a class and we were talking about insurance billing and pretty great, I guess that we covered some of that in class. I can't tell you what it was, but I remember getting handed a packet and I actually still have this packet to this day and I'm like, oh, I should pull that out and look at it and see if there's anything I'm missing. But I remember being handed that packet, looking at it and being like Holy shit, I'm never going to be in private practice, like I'm not organized enough, I'm not dedicated enough, I'm not detail oriented enough. I'll definitely go X, y, z.
Speaker 2:I didn't. I don't think I knew exactly what I wanted to do at that time. So that's the first memory I have of even entertaining the idea of private practice? I wouldn't. I was like, no, that's not for me, which is really funny because I have always been an entrepreneur and I've also always worked, ever since age 12, when I started babysitting and cutting my neighbor's grass, so something wasn't quite clicking for me there. And also, before I decided to switch to dietetics because I had an eating disorder, I was in the business school for accounting to be an accounting major, so there was a major not knowing myself in that moment, where I just kind of brushed off private practice.
Speaker 2:So, fast forward to 2017, when I graduated, I took a job at the hospital and it was chill, it was great, I covered things, it was easy. I was really understimulated and so I'd like hurry up and do my hospital work and I would then start my blog. So I used to be healthy. Hany, I actually had that pull up on my web browser the other day, I think. I logged into like an old Google account and then it showed that as a tab and I was like, oh my God, this website's not still live, right? This is so cringe.
Speaker 1:That's so funny. I had no idea that you had a blogging background.
Speaker 2:I did, yeah, and it was something I started as a student and that was really circa 2016 and 2017. It was a big blogging time and so I was like, cool, I'm just going to start this thing. I have a lot of thoughts, I have things to say and I want to share them and I want people to be able to access this information because it's important. And then I realized, like when I got my RD and started working at the hospital, I was like, oh, I could take on one-on-one clients. Don't know what that means, but I'm going to try to figure it out. So in 2017, in the fall, I had my first nutrition counseling client ever. Super slow build from there.
Speaker 2:I ended up moving to Denver from Missouri, which is where I grew up and went to school, because I wanted to go to the mountains and I was super privileged at the time. My partner he got a job as a travel nurse, so, like, all of our basic expenses were covered. So I quit my job which I've never done before without something else lined up and moved out to Denver in 2018. And at that time I went two weeks without a job. I was supplying for treatment centers because I wanted to get more eating disorder experience. I knew that's the population I wanted to work with. I ended up working at an ice cream shop, a mom and pop shop here in Denver called Bonnie Bray Ice Cream Shout out to them, they're great. And they hired me as a manager and I was actually making more money than I would have as an eating disorder dietitian, with tips and management pay. So it's pretty sweet. I got free ice cream and I did have to manage high schoolers, but most of them were like really good kids a couple little turds, but you know there's always a couple and I didn't have to use my brain too much Like. So. It was a physically demanding job lifting these like 30 pound buckets of ice cream and I had a really strong wrist from scooping ice cream and I also make a stellar cone to this day. So that's kind of how I supported myself while I was building my private practice, because it wasn't just like shiny, oh my God. All these clients rushed to me like I had no connections.
Speaker 2:It took about a year for me to fill up my own solo caseload and I needed to support myself in the meantime. So that takes me to 2019, in January, when I was finally full and I was like, oh great, this is good. I think full. At that time I had about 18. And I felt good enough to leave the ice cream shop and know that I had a steady income quote unquote, because ebbs and flows. But I had enough to live on to cream shop and know that I had a steady income quote unquote, because ebbs and flows. But I had enough to live on to where I could put my full force into the private practice and at the time I was sharing one office with a therapist that was in a therapy group Still really close friends with all those therapists to this day. It's so awesome and I really am grateful that they were such a landing place for me.
Speaker 2:I think it's important to share like this early part of my story because anybody who maybe has heard of my work now like having a nine to 10 person group practice I do consulting and all this stuff Like I really did start at the quote unquote bottom of working a second job while building my private practice, having times where I had five clients and then sharing an office space, like I didn't full out get my seven office suite right off the bat. You have to go through all of these stages before you can do the big thing. Circling back to 2019, that's when I was getting flooded with referrals and I felt like I was doing it and I was thriving and I was like you know what it feels really not great to refer these clients out, even though I had a lot of trusted referral sources and it was fantastic. But I wanted to mentor somebody and I wanted to take them under my wing and I wanted to be able to keep those clients in-house and support the business, while also supporting a more green dietitian or someone who didn't want to run the business. And so, august 2019, I hired my first clinician.
Speaker 2:After that, the next hire was in January 2020, not knowing what was coming. And so then we were a small group of three. At that time, we had one full-time office space, and then we're starting to explore renting half of an office from the same therapy suite that I was in Pandemic hit. It's really funny because the dietitian who joined my practice in January 2020 was really excited to be in person because she'd been working somewhere else where she was virtual, and then, lo and behold, two months later she is back to virtual. So, luckily, she was really comfortable with it, but was just like a little bit of a bummer. Comfortable with it, but was just like a little bit of a bummer.
Speaker 2:And since January 2020, all the way through the pandemic we have fluctuated as a team between eight and 10 people. At all times we went from small to medium, edging on large group practice, and that's kind of where we've landed with Nourish Colorado. Before it was Nourish Colorado, we were Nourished with Hannah, and then it got real awkward when I had a couple other people that weren't named Hannah, and so we then adjusted and I think we're pretty settled into Nourish Colorado. So, to date, I don't see clients anymore. I stopped seeing clients a year ago, this month, which is bananas. And you know, we have a practice manager, we have a supervisor and I really run the business operations and think about the vision and that feels really good to be in that place. But you know, taking back to October 2017, when I saw my first client, until at the time of this recording, it's May 2024. That's seven years. Did I math that right? Yeah, seven years of the work.
Speaker 1:I think that's so helpful to hear and there's so many parts of your story that one I didn't know about and are very similar to mine actually, and I'll share a little bit in a little about that. But it's so helpful to hear because I do think and I was just listening to Hannah's podcast Way Inclusive Innovators that she co-hosts with Morgan Sinclair, and I'll link this episode in the show notes on group practice, but I think it was this episode or maybe it was the one that you recently posted about money. Anyway, you guys were talking about money in one of these two episodes and I think you had mentioned, maybe your income no-transcript to being able to do it on your own. So it is really important to hear that it doesn't all just start out, you know, very glamorous and doesn't always stay glamorous either.
Speaker 2:And now when you have a bigger team, yeah, the money stuff is so interesting because I can tell you when I quit my job and in my first year of private practice like my first, I'm going to say half year actually hitting the ground, running more in Denver, I think my first year I made $13,000. That was my revenue and I can tell you now, like nourished is inching towards a million in revenue. So you know, I don't get paid that, I don't need to get paid that, and it takes time and consistency. And when you're doing group practice in a values driven way where you prioritize people and you're still maintaining profit, that's the most sustainable. But what that means is slow, stable growth, which is not sexy, it's not.
Speaker 1:Absolutely. And I think that can be really hard place to be, because I think when we're only and I don't think a lot of people go into the work as RDs in private practice for the money per se, maybe they have an expectation of what that money will look like. But I think a lot of us go into the field because we want to help people but also have an expectation maybe what that money will look like. And then, if it doesn't, it's like oh my God, what am I doing wrong? Or other stories we tell ourselves if the money is not in alignment.
Speaker 1:And I think in the conversation around group practice in particular, a lot of times I hear people going into it because they're like okay, I've filled out my caseload and I don't want to refer out and I'm going to make more money. And I find that it really does take a while to really actually start making profit and growing your own income as the owner of the practice. In group practice, depending on where the revenue is coming from, if you're seeing a lot of clients and that's a big part of the revenue versus at a certain point, something has to give. But, as you said, really making it a values aligned business and really thinking about those things outside of just okay, how am I going to make more money? Yeah, you can make more money by seeing 15 people and having clinicians who see a full caseload and everyone's burnt out, but then what is that going to bring in the end of the day, right?
Speaker 2:Well, first of all, eva, I'm like smiling so big because seeing you at this place in your group practice you know we've worked together for a couple of years now and I'm just like, boom, you fucking got it. Like the fact that you can conceptualize it and speak to it and explain the nuances so beautifully, I'm just like, yeah, you've been through it and you fully understand it and I think that's fucking awesome because it's really hard. Someone might be listening and not fully understand what we're talking about because they haven't been through it yet, but there is a really well. First of all, yes, you can make more money with group practice and see less clients, and that's great.
Speaker 2:If that's your only motivator, you're going to be deeply dissatisfied and hate this no-transcript.
Speaker 2:You will make more money if you kind of get to a more medium size, but you have to want to be responsible for people, lead a team, have strategy and settle in for the longterm and know that it doesn't just instantaneously happen. Like there is that crossover point you were kind of speaking to, where the group practice owner often has to maintain a pretty decent caseload if they still want to get pretty decent pay while they're building a team, slowly, whittle it down over time and then the team's revenue will replace their pay. So then they'll just kind of be where they were as a solo person and then eventually it'll flip to where there's enough people on the team that's going to have enough profit left over and just account for a bigger position for the group practice owner to be able to make more money and I think, just even in starting your own private practice, there's a lot of maybe privilege that can come with being able to, you know, maybe make less money or make not more money for a little bit of time.
Speaker 1:Right, that makes it not always super accessible for everybody, but I think this is really where having a good strategy from the start, which I almost think, like you were saying, you got that like insurance packet I think I said this in my first episodes like, of course, we don't get this education in school, but even if we did, it wouldn't have made a difference, because until you're sort of doing it, you can't really apply it almost, and so I think we can have some strategy. But I think the biggest takeaway and I'm going to ask more questions around this but is you have to sort of be willing to try things and make hard decisions and shift things in order to grow and actually sustain this type of job, especially in group practice. Because, yeah, money is not going to be enough, it's not worth it, because there is, unless you like doing it. Which I think brings me to my very first question that I had for you and with the interesting part of your story which I was like what?
Speaker 1:When I was in college, I also had my own eating disorder background and so I was like I don't know if I want to like go right into. You know, I knew I shouldn't be a dietitian at that time, but I had my first major. That I was going to do was business management, cause I was like I'm going to go to beauty school Cause I love doing hair and makeup and open my own salon. And then I was like no, I don't want to do that.
Speaker 1:And then I was was in grad school for nutrition. I also had a blog, a food blog called Love and Grub, and the same thing I was like I felt like I had something to of life, because I think those parts were always sort of there. We had to figure out where it made sense for us. But I think that that is like really interesting that we have actually kind of a similar story.
Speaker 2:I'm imagining one of those memes. They haven't been around for a while, they're kind of like a past meme. That would be like a something starter pack.
Speaker 1:So this is like the group practice starter pack, where there's like the business management, there's an eating disorder, there's denying private practice and you're not going to do that and it's just like yep, this is the starter pack, this is the pipeline to group practice ownership, yeah, and there's probably like seven projects in between all those things, because you cannot just do one thing like go to a hospital job and do your work and leave and be happy with that, because I think that's also probably what makes people really great group practice owners. But I'm actually curious from you, as a group practice owner and somebody who works primarily with group practice owners in your coaching business what do you think makes somebody a good fit to be a group practice owner, or what do you think makes somebody a good fit to be a group practitioner, or what do you think would be a good insight for somebody to say like, yeah, group practice actually might be a good fit or maybe won't be a good fit for me.
Speaker 2:Yeah, this is an interesting question because I think Adam Grant changed my mind on this a little bit. So if you're not familiar with Adam Grant's work, he's an organizational psychologist and maybe we'll link his website in the show notes Fantastic human. I have learned so much from him and I know I've had you read a book or two by him. But he talks about not personalities, because I used to be like, okay, as a group practice owner, you need this personality. I don't think I ever said those words, but I was kind of implying it. But it's really character traits that a group practice owner can develop to be successful.
Speaker 2:And before I dive into what I think those are, I just want to give the caveat of, like there are so many different kinds of people who are leading group practices that I've worked with over the years. You know I've worked with over 35 different group practice owners. It might be closer to 40 at this point, I can't remember. It's been 100 years and I see introverts, I see extroverts, I see people who are across the divergent brain spectrum, like so many people who have different struggles and different strengths, who have different struggles and different strengths, and so I just want to say that before I dive into what traits character traits I think people can work on and develop, because it doesn't matter where you start. You might have some of these things naturally, but these can also be worked on.
Speaker 2:So if you, I don't want anybody to like be looking for the checklist and then be like, oh yep, I don't meet these, so it's not going to be a good fit for me, that's not what we're here for, and a lot of these are just human traits. So first one is openness and curiosity. I put them together because, like you were kind of alluding to earlier in our conversation, someone has to be willing to receive feedback or willing to do hard work or willing to figure things out, and I think you can't have openness, like openness to that, without also having curiosity. So the openness is like I'm here for it, let's go. But the curiosity is the leaning in and wanting to discover more, and it also kind of goes with execution a bit right Of like the ability to do, because the openness and the curiosity are there but the doing and the exploring is also a piece. So I'd say those three openness, curiosity and doing are three character traits that I think every group practice owner needs.
Speaker 1:And I love that you kind of gave that caveat, because I think you're right and I think in Adam Grant's latest book, where he talks about I think it's called Hidden Potential, about a willingness to try things, that really makes a big difference. So I think the openness is like the thing that's at the core and then sort of leaning into the others makes a big difference. And I agree with you that the personality actually isn't as important as it is those kind of character building skills that we can learn if we're willing to try them.
Speaker 2:Yes, and you know I won't say that having charisma and being extroverted makes the job easier, because if you're a people person and you don't mind people accessing you, that is a little bit easier in group practice, right, because people want access to you and you're managing a team, and especially when you're in kind of the smaller group practice days, it can help you tolerate more right. But on the flip side, if you're somebody who's more introverted and more reserved, there's a lot of space for having somebody move up in your company and be that point person so that you can do the thing that you love of running the company. There's just so many iterations of how you run your team and who's in leadership with you and management. I would say another character trait I think is important for a group practice owner to develop and work on is grit and tolerating discomfort, which I think go hand in hand, because it's not just yay, I'm going to add somebody to my team. Yay, we're going to bring in more revenue. Yay, we're at a point where we can get people raises. Yay, everything's up.
Speaker 2:It's in such a flux all the time and, as you know, in a given day you can fluctuate from like this is the best job ever. I'm thriving. I fucking love this to. Who can I sell this to? Best job ever. I'm thriving, I fucking love this to. Who can I sell this to? I'm going to fucking burn it down this evening and I'm done. And that's just experiencing the whole range of human emotion which is part of life and very real, because in a given day, the range of emotion just fluctuates so much, and so you have to have a way to self-regulate and be able to tolerate those things, which is where I think grit comes in.
Speaker 1:Yes, and this makes me think of on TikTok. There's a. You know those like things that people will say like what's this thing? And then people will stitch it. I don't know if you're on TikTok, but that's what happens and there's one that's like what do people mean by when they say marriage is hard? Which is funny to me because I've been married this year it'll be seven years and so what I was thinking. I was like I think we're talking a lot about how wonderful and great and I think people have a perception of how wonderful and great group practice is and now we're talking a little bit about what, those days where you're like I don't want to do this anymore, why am I here? What's going on. I wonder if we could talk about what makes group practice hard, and then we'll talk about what makes it so great, so that we can kind of round it out to not scare people but also not give a false impression that this is like the best thing.
Speaker 2:That's easy. I can tell you what is fucking great about it and what's hard about it, and it's the same thing and it's people, and it may surprise you where I'm going to go with this. So the positive side is like when you are choosing who's joining your team and getting to serve the clients that come to your practice and you're very intentional, you will find that you hire the most wonderful people. And one of my rules for lack of a better word for hiring is I want to really fucking like my coworkers and really care about them. So if I feel like there is something where HR don't come at me, I want to just hire somebody because I don't like them. But I do think it's important for company culture and fit that there is a good interpersonal vibe between us, because that's I know how a client's going to feel with them, I know how the team's going to feel with them, like dynamics, so important and the people make the experience Like if you're working with folks who are not stoked on the job and again people get burnt out Like that's real, that doesn't mean they're not stoked on it, but like not good communicators, not open, not curious that makes being a group practice owner really fucking painful. Not curious Like that makes being a group practice owner really fucking painful. What makes a company great and group practice ownership great is when the people are great, and I only hire great people.
Speaker 2:The hard part of group practice is the people. Because you care about people so much and you want to do right by them. You're responsible for them. You're responsible for their livelihood of, like, giving them a place to work. That's meaningful and you're also responsible for them as in for their sense of security and finances and benefits and things, and I think people really struggle with that.
Speaker 2:You also are going to disappoint your team because they're going to want things or have needs that you can't meet, and that's something I work on a lot with group practice owners is just the people pleasing and those pieces that come in, because being a good leader does not mean you do everything that your team wants and you wax and wane and you bend and you don't have a backbone.
Speaker 2:They actually look to you and join your team so that you will say no to them sometimes and I know that sounds really weird, but they are looking to you for the guidance because this is your company and that can sometimes have pressure and bring up our own shit. Like I used to say, being a clinician will make you look at your own shit so much, and that is true, but being a group practice owner is next level, because it's just levels of looking at your own shit truly. So the people are the best part and the worst part, and it's not even the people themselves that's the worst. It's the responsibility and the disappointment and wanting people to be well. And then also, people are people and so people are going to do things where you're like, oh, that didn't feel good or like, oh, they're leaving and that really sucks and that's life.
Speaker 1:I couldn't agree more. I think you're absolutely right that it is both those things that makes it worth it and also makes it so challenging at the same time, and just hearing you talk about this, I mean this is really the shift, right? This is where you go from. You have a practice, you start growing and then there's a whole new challenge of now you have a person that's depending on you, coming to you for things, who, depending on how you're structuring your business like if you work like Hannah and I do, or have maybe an eating disorder practice or a weight inclusive practice it's really important for us to have clinicians who are aligned with the same values as us, and so it was important for me, as I was hiring, that the person that I was hiring also had those in alignment, and I didn't right away realize how important it was also that they didn't need to have maybe lots of experience, but it was really that people. You're absolutely right, you want to be around the people you want to be around, and that's the beauty of having your own group practice, and it's not to say that the people you don't hire are bad people. They're just not your people, and I really make a big.
Speaker 1:I mean, when I'm hiring, I really think about okay, am I going to want to meet with this person weekly? How am I going to feel leading this personality or the way that they're? Maybe you know the way that they talk about, things like is that going to be a good fit for me? Because things like, is that going to be a good fit for me? Because, yeah, I think the dynamics and the team is going to be really important, how you know what parts of me are maybe like activated by a certain personality. How, then, that's going to show up in my leadership to them?
Speaker 1:Right, and so, really thinking about it outside of, I'm going to hire this person and, yeah, a lot of us who are dietitians come in as, like, type A perfectionists, people pleasers probably a lot of us too and wanting to make people happy. But then you realize you're starting to sacrifice, maybe yourself, or you're worrying about things that are maybe outside your control or just not in alignment with the team you want to build, or whatever it might be. And that's where the shift either can go okay, I have to be open and willing and do things that are really hard, make hard decisions, have hard conversations, or I can keep doing this other thing which I see a lot of times people kind of like not setting boundaries for themselves out of whatever a lot of fears, probably a lot of scarcity fears but it's at their own detriment and it's at the detriment of their team, I think. Ultimately, at the end of the day, it's going to like maybe it's working right now, but like how sustainable is that really going to be for for a group practice to keep going?
Speaker 2:I like to think of group practice as an ecosystem, as a symbiotic relationship in everybody has their role, everybody's working together.
Speaker 2:Relationship in everybody has their role, everybody's working together, everybody's winning.
Speaker 2:And so the pieces you just talked about about like making sure it's a good fit for everybody really feeds into that model of your team is benefiting from being at your group.
Speaker 2:They're not resentful, they're not wanting to be out on their own, they're happy you're taking care of all the insurance bullshit, and the group practice owner is feeling fulfilled from getting to support people, getting to watch them thrive and do meaningful work, helping them develop as clinicians, and so both of those pieces really have to be there and there's a ton that goes into that and we're kind of speaking to the dynamics of a team, but there's also talking about what people's desires are, and so all of that really has to align to make the hard less hard, because you don't get to avoid the hard.
Speaker 2:Like it's not, like you have the perfect team and there's no conflict, everybody's happy, the money's flowing, clients are thrilled Like you can have the best systems in place and have the best people in them. They're still going to be something that can happen and that is also kind of fun, like type two fun, because we want challenge, we want to fix and solve problems, we want to overcome things and that's what group practice gives you. It's part of the fulfilling part, even if it's hard.
Speaker 1:Yeah, absolutely, I mean you're right. I think that, like having that role where you are, you know whether it's hard yeah, absolutely, I mean you're right. I think that having that role where you are, whether it's fixing or dealing with things that come, or putting out fires, sometimes that part is really fun and also really really hard at the same time. And as we were talking, I was thinking actually I was thinking about this as I was thinking about our episode today of sayings you have that have really stuck with me. And this really goes into I was thinking about this as I was thinking about our episode today of sayings you have that have really stuck with me. And this really goes into, I think, how.
Speaker 1:I think about group practice, leading, but also growing my team and hiring. If it's not a how yes, it's a no. What was the other one? Hire slow, fire, fast, and probably those both things can bring up a lot when you hear them for the first time. And I think even over the years of us working together, I've adapted what my hell yes is right Like hell yes is not always going to look the same.
Speaker 1:For example, I've always been like okay, I want somebody that wants to work full time and I have a situation now on my team that I'm like let's try something a little bit different, like this can be a hell yes, a little bit differently than I'm used to. And also you know that that like second piece of just you know, taking our time with certain things and maybe not so much with others, or really trusting ourselves and listening to ourselves I think that's maybe what we're also getting at is like there's this sacrifice that sometimes we we do as group practice owners or you know being like almost like I don't wanna say martyrs, but like putting this on ourselves when maybe we don't have to of of, you know, not honoring our own needs or not honoring, like what our own parts are telling us are, like this is not working and we just like don't want to hear it because we're afraid of maybe failure or the people pleasing part is probably the big one. And like this comes back to the hard part around the people is what if a clinician isn't working for your team anymore? But you know them, you know they're a great person? You just feel bad, like there's so many parts that come with that that make that part hard.
Speaker 1:I mean, I guess maybe where this is going is like I wonder what advice you have for people who are like, okay, but I don't want to hurt someone's feelings, or now this is their job and I'm going to fire them. Like what am I supposed to do? How do I honor and like, build a value aligned group and business without? How do I deal with that like hard, hard stuff that we have to kind of ultimately do sometimes as the owners?
Speaker 2:Oh, I feel like I could talk for hours on this, but I'll start with. The easy answer is I can tell you a book recommendation, and I highly recommend every leader to read this book. It's called Radical Candor and it talks about communication as a team and basically it's this framework with, if you can imagine, a quadrant and all the different ways that we can communicate. Top quadrant is Radical Candor. Bottom quadrant, on the left, is ruinous empathy. I believe one of the quadrants is obnoxiously aggressive and then the other one, I feel like it's not as common. Well, I don't even want to say it's not as common, but I always forget what it is. Do you remember the quadrant? I see your eyes, can you look it up? Common, but I always forget what it is. Do you remember?
Speaker 1:the quadrant. I see your eyes. Can you look it up? Do a quick oog? Ruinous empathy, obnoxious aggression, manipulative insincerity, or insecurity and sincerity, I think.
Speaker 2:Yes, okay. So these are four ways that people tend to communicate or default to, and who knows what all influences it. It's probably our attachment, it's probably our parts, it's all of it right. Like, how we are relationally in the world influences how we lead a team. A lot of people who are deeply empathetic fall into the quadrant of ruinously empathetic, which means that you are so empathetic to somebody that you're actually harming them and you're harming yourself, like it's not benefiting anybody. So, avoiding hard conversations, continuing to not have expectations or accountability for your team, all of those things make a communication style and a dynamic ruinously empathetic, where this person is just like not having accountability and not having to take ownership, and then they're continuing to do the thing, they're not learning, they're not growing resentment all around.
Speaker 2:Radical candor is when we care personally and challenge directly. So in a situation where, like, let's say, someone's not hitting their numbers, that you need them to and they're reasonable numbers and they've agreed to it, and you just keep saying, quarter after quarter, it's fine, it's fine, it's fine. You're not actually helping them because they're probably not making the money they want to make. It's hurting the company, it's making you resentful. You're on the edge of having to discontinue their benefits and you're not having the hard conversations with them, so they don't even know that it's not fine and that is ruinous empathy, where you're just like, I care about them and I don't want to disrupt this piece and you know, I think it's fine. They're going through a lot Like yeah, that's totally reasonable, like for a couple of seasons, but to not have an end date or an ongoing conversation about it doesn't help anybody. And so the more candid the radically radical candor way would just to be you know, I care about you, I want to have a hard conversation. Let's figure out how to have shared accountability in this and let's set a timeline for working towards this and say what we're both going to do here. And I think that is how we challenge people pleasing. We don't get to control how somebody responds to that.
Speaker 2:And this is where the higher level piece that needs to be worked on is company culture and talking about communication styles and making sure everybody's on the same page so that you don't get into these ruts.
Speaker 2:And again, the only way to know that these ruts are a thing is that you get into them and then you correct. So you know you and I are on the other side of this talking about it, but like we've freaking been there where we don't want to have a hard conversation with somebody, or there's a conflict, or we are being ruinously empathetic, like that's how we know what it is. Again, you don't know until you go through something. So, as we're having these conversations, we're not going to help anybody avoid what you have to go through. It's just to get through it a little bit faster so you can lean more into that leadership work on those people pleasing tendencies and really thrive in the leadership position and feel good about what you're doing. And, at the end of the day, one way, people please, it doesn't serve anybody and I think that's important life stuff, right?
Speaker 1:So many thoughts coming my way. I think the way that you have really helped me also just really think about it is, as you're explaining, you know, radical candor. I mean you're also zooming out a lot on the bigger picture of, like. You know, being this like empathetic person and really trying to like be there for your team is not a bad thing, but there's a cost to it at the end of the day, right? So if they're not meeting numbers or they're not seeing the clients they see, or they're having a lot of clients not great retention, so there's a lot of different clients, right? So if you're not having those hard conversations, I always say to my team too, it's not just about me and the bottom line. I want my team to make more money, I want them to have more benefits, I want to be able to offer more things to them, I want them to have a better work-life balance and I want those things for myself. But when we kind of zoom out on it, it's not just having these candid conversations just because for us as the owners right but it really does help our team grow and develop as clinicians, because all this stuff that we're doing is also going to be really important for them as clinicians, because all this stuff that we're doing is also going to be really important for them as clinicians, especially in the work that we do, as working with eating disorders and I think you're right about the people pleasing.
Speaker 1:I mean, I certainly have a lot of those parts in my life, obviously, I think, in the context of any relationship, depending on if that's positive or negative for you but, like, people are going to feel what they feel and we really can't control for that. But we can help lead and, once again, I did not start this way. I've been working with Hannah. Probably I can't remember it's been like two or three years, so this has been like years and I think making those hard decisions and doing those hard things ultimately then get you to this place where, like you and I are having a conversation and talking about these things, like I wasn't here three years ago and able to think about business in this way. But it's through having these tools of like yeah, like having hard conversations and looking at things from a bigger picture way of how it's going to serve me and the team you know, that really takes us into that RD to CEO place.
Speaker 2:One of the things that I've been prioritizing, as I've been in my group practice for several years now and working with many people and having some time that I've spent coaching folks. You know it's been coming up four years of coaching people, which is wild. I'm focused on what's going to help people be sustainable leaders, as in they're going to keep being able to do this, and that's really why this is important, too, for protecting your own peace and making sure that you can show up for your team and be the leader you need to be, and it's a process and it's also important for everybody involved. So you will flounder in that place of people pleasing, not knowing how to lead, working stuff out on people that you don't mean to, and then you keep developing those leadership skills, and that's really where I find a lot of people are like you know what? Yeah, I am a fucking CEO, I got this and they really can own that role.
Speaker 1:Yeah, I mean it takes time, and I say this to people because, you know, in the practices that I work with for business coaching, you know we start as clinicians who don't know what we're doing. Like I think about being an intern back in the day and like being like how am I going to calculate these two feeds? And then I'm doing it so fast. I'm so bored because of how quickly it becomes. You're the person then training, and the same thing happens when you're an outpatient or you start counseling and I've done this when I have new clinicians I'm like you're going to say the wrong thing because you're human and we can, of course, beat ourselves up about it. Or we can say like, okay, that didn't land. You know, I give a lot of analogies and sometimes they really work and sometimes they really don't. And then I just I just note it and I say, okay, that didn't work.
Speaker 1:And you know, that's where that like curiosity part comes in and our practice compassionate curiosity is like our motto of the team.
Speaker 1:But it's really just about being like, okay, I'm going to make mistakes and like, probably one of the hardest business things I've ever had to do, I am not proud of how I did.
Speaker 1:I mean, I don't even want to say I'm not proud of how I did it, but I would do it so differently now. But I had to do it wrong or had to do it in this way. That didn't feel great to know that. That didn't feel great for me and now I've learned from it and I think that's that's like the key is, like we're, we're not going to be like born as like entrepreneurs that know what we're talking about day one right, just same way we weren't as clinicians. And so, yeah, it takes time and all the hard things like leads us here, and so I think to just like conclude this conversation that I do think could go on and on, I'm curious for you was there a moment that you could you noticed for you that you're like I am like, like you were saying like you kind of like, yeah, I am a leader, like when was that like moment for you, if you can kind of account to like when you went from being that RD to a CEO?
Speaker 2:I don't know that I can identify the specific moment in time.
Speaker 2:I think it's a becoming and I want to say really in the last year, as I've invited other people into leadership with me and really delegated it not just like fake leadership light where I'm like you're a leader and you have these two tiny responsibilities, I'm like, no, I'm going to ask you to do this big thing and if you fuck it up, that's okay and you might need to fuck it up to learn and I will help you fix it and you just got to take care of this.
Speaker 2:I feel more like a leader now with actually letting other people do things out the company and plan for the future. That's values, aligned and considerate of everybody makes me feel like a total fucking CEO, more than in the past, where I'm like, fuck, I got to fix this insurance thing, like just being very reactive and trying to make it all work and doing too much. Now that I have space and I can step away and really see the vision of the company and see everybody thriving in their roles, I'm like, yeah, I did space and I can step away and really see the vision of the company and see everybody thriving in their roles. I'm like yeah, I did it, I'm doing it, I will continue doing it.
Speaker 1:That's so interesting and I love I'm actually it's nice to hear because I think, yeah, like you're obviously steps ahead of me and where I'm at as far as where my team is, but I bet, like a couple of years ago you would have had a different kind of like marker and it sort of like moves. That's helpful for me too, to say that like you're still, cause there's obviously, even though I'm hosting this podcast, all about becoming a CEO and leader. Like there are times that I don't feel like that and then there are times when I do and I think there's going to be that like goalposts is sort of like moves and shifts with like where we're at in our business, and so it's helpful for me just keep that in mind too, as I'm growing that like even you maybe don't always feel like you know you're talking about the same way I don't, and that's normal.
Speaker 2:I think the moment we get too comfortable and we take full ownership over something, we stop being the student and we stop learning, and that is a very dangerous place to go into and it takes away our openness and our curiosity. So I think we always need to be on the edge. I would say there's a low level humming anxiety with business, which my business coach, ken, talked about. It's just you always got to be a little on the edge and figuring out like what can I do better? What's shifting in our industry? How is my team doing? Are people outgrowing their roles? What's going on? It really comes down to staying engaged and staying open, and leadership is life work.
Speaker 2:I didn't talk about this earlier as I was sharing my story because I really wanted to focus on the building the group practice piece, but at different points in, you know, from 2017 until to date, I did start coaching other group practice owners and I also went to grad school to get my master's in organizational leadership, because I knew I wanted to get my master's degree Also, you have to as a dietitian, by this year going forward, I believe, or your grandfathered in before then degree Also, you have to, as a dietitian, by this year going forward, I believe, and so or your grandfathered in before then.
Speaker 2:But I knew one I wanted to have a different option outside of dietetics, because I don't think we're all going to do this forever, and I wanted to get more support with leadership, and so I worked on my master's in organizational leadership because I knew, like I have so much work to do here. Let me get into the weeds of the research and literature and theory and all of those things and see what I can bring to my practice. And that was part of me being literally a student.
Speaker 1:Yeah, how many years into your practice were you your group practice until before you started your master's.
Speaker 2:I started it in 2021. So I was about three years into my group practice, which is kind of the point where you feel, you know, if you've been consistently hiring two or three people a year, getting people situated, starting to delegate some stuff, you really having to be the leader and less of just a clinician with a couple of people you know. That was the point where I was like, okay, I need some more support around this.
Speaker 1:Yeah, I think I was. I was thinking about that because I think there was probably a point early in your group practice where you weren't even thinking about it yet. Because I think and that's I keep coming back to that because I don't want anyone listening to be like why am I? This feels overwhelming, or this feels like you know, I don like I'm not thinking about this and is that bad? Because, yeah, I think there's a point where we can get comfortable, where we know how to bring in referrals. We maybe have been doing the actual work for a while, so we're running through revision. We feel really confident about that. But, just like anything else, there's going to be times where there's going to be these like oh no, I didn't learn, what am I supposed to do with this situation? It's usually a people situation and that's where I think we start craving more and I think people can have group practices and not be all into listening to podcasts about leadership and all this stuff. But once again, I think it's going to be the difference between how sustainable is it going to be? Are you going to like it?
Speaker 1:I used to think in my old job I want to have a private practice so I could take Mondays off, which is going to sound so corny. And part of the reason why I think I look forward to Mondays is I have a toddler and he goes to school on Mondays. If you're a parent you can relate, but I honestly do. I'm excited for Mondays because I love my son and I'm also excited that he's going to go to school and I get to work and do the things. And sometimes it's like an anxious place that I'm like I have stuff to do, but most of the time I'm very excited and my goal used to be like I want to take Mondays off, but now it's like, oh, I can't wait for Monday to work on this stuff and have time to do it.
Speaker 1:Your story, hannah, is so great because you started as a dietitian and then you're like I'm going to take this client I don't really know what I'm doing and then I'm going to work at an ice cream shop until I grow it and then I'm going to hire and you know you didn't get to tell some of the maybe other parts of the journey of like having to make hard decisions and change things in your practice along the way, but you've shifted and then eventually you start doing coaching and I think things that you probably even taught me like two years ago has changed now and I think that's like the thing that I really hope people can take away from. It is like we have to just start somewhere and being okay with that and then also like know that slowly this will start to like sort of build up this I don't know library in your head of things to pull from, like kind of how we are now.
Speaker 2:Hope that made sense like kind of how we are now. I hope that made sense 100%. I have two last thoughts that I want to leave people with. One is you have to go through your own journey of this. You know we're talking about our journeys several years in and we can talk about it because we've been through it. Your journey is not going to look like ours at all. Our journeys yeah, there's similarities, but still so different and that's a beauty of it is like everybody's group practice is different, like we can give you tools and spreadsheets and thoughts and experiences we've been through and then you take it and make it your own.
Speaker 2:The other piece I wanted to say in why my coaching has shifted over the years and I'm really focused on leadership and communication and dynamics and things is people leave jobs for two reasons money and bad bosses.
Speaker 2:The money piece is difficult when you're an insurance-based practice. Margins for different pieces of the finances are what they are. They're just objective. You and I talk about that and we can only pay people so much and keep a healthy business and so if somebody leaves for the money, I'd rather them do that and I respect that over them leaving because I was not a good leader, because I didn't do my own work, and the thing that keeps people at jobs even if they wish they could be paid more, and they know the implications of an insurance-based practice, whether you're a therapist or a dietitian is that they have good support and strong leaders and people that care about them, and so I always want to make that known, and I think that's more important in life than money, to be honest. Yes, money helps have access to things, and at a certain point, if you had a really shitty boss and made a shit ton of money, you'd probably be pretty miserable 100%.
Speaker 1:I mean, I think it makes all the difference and I think why it's important for me, and I think for you as well, to create a working environment that people want to stay and work until they don't which inevitably we're not going to do this forever.
Speaker 1:They're not going to do that forever Like we're not going to do this forever, they're not going to do that forever.
Speaker 1:But I think, being okay with like knowing that we're doing the work and growing the teams that we are that we feel like proud of and aligned with from a values place. I mean, I think this is, like you know, hannah's business coaching is called values driven group but like it's really, I feel, like the core of the work that you do with people, because it does come back to that. And, yeah, I think I can feel good about knowing like there are limitations to the money, like you said, as far as you know, being an insurance provider, but the parts that I can really control is how I'm going to show up as the boss and the owner of the team, and it does make a big difference and like I can sleep at night knowing that I'm like doing things imperfectly, in alignment, and continuing to grow and change and so, yeah, this was so great talking and I feel like I learned a lot even in here. You know this wasn't a coaching session per se, but yeah, any last thoughts.
Speaker 2:No, I just want to big you up and say I'm so fucking proud of you and all the work that you've done and I'm so excited to see you go. All the work that you've done and I'm so excited to see you go into this next chapter where you're going to be coaching people For those listening. If you're looking for a coach, highly recommend Eva. She's fucking awesome and knows her stuff and 100% recommend you.
Speaker 1:Thank you. You're the best and I couldn't do it without you. And you know, I think, yeah, I think, think the beauty of the work and we've talked about this too, as I shifted into doing more coaching is, like Hannah's a couple steps ahead of me, so where she's at really helps me, where I'm now in a medium-sized practice and, I think, where clinicians who are maybe first starting out, especially in group practice you know, I'm now a couple of steps ahead and can have this perspective and, yeah, I think that's going to be the beauty of mentorship too, is that it'll change as we grow, but couldn't do any of it without you. So thank you so, so much for all you've done for me as a person, let alone a business owner, cause it's not just like this has helped me as a business owner, but it's also had a lot of ripple effects in my life, because I actually, for the first time, I think, feel confident in what I'm doing.
Speaker 1:I was having brunch with a college friend two weeks ago is the last thing I'll say and I was talking about something with business and I was like, yeah, just really confident. And he's like I can tell when you talk about it, it's like a different person and like I just feel so solid in it. But I really feel like, yeah, having great mentorship, great support has been key for me, so thank you for that and thank you for being my first guest.
Speaker 2:Absolutely, this was so fun. As you know, I could fucking talk to you forever, so happy to come back anytime and can't wait to see who else you bring on the pod. Thanks for having me.
Speaker 1:Thanks for listening to the RD to CEO podcast. Be sure to check out the show notes for any resources mentioned or find more at wwwrdtoceocom. Never miss an episode by subscribing wherever you get your podcasts. See you next time.
