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What do you find to be the most challenging aspect of having your own practice or business?

I hear so many comments from new and seasoned therapists alike about how hard it is handle the business-side of their practice but I was wondering what members here find most challenging. Even if you work for someone else, you likely have some responsibility in promoting/marketing yourself or even in keeping up with returning client phone calls, etc. What is it that trips you up or that you always find challenging?

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Gee, Felicia, if you and I could clone ourselves we'd have it made!

My main challenge is that in my medically-oriented group practice, about half of my business is insurance-based. I do almost all the filing myself...I have so far had no success in finding someone who does it as efficiently as I do, and I have found that it causes me more stress to turn it over to someone who screws it up that it does for me to do it myself. I am still waiting for Mr. or Ms. Right For the Job to come along. I suppose it is a sign of the present economy that when I have in the past couple of months advertised for "a person experienced in insurance billing with excellent knowledge of medical terminology" that I received a couple of hundred phone calls and resumes from people who know NOTHING about it and are just desperate for a job. That whole experience has made me very hesitant to run another ad.

If you're reading this and that job description sounds like you, call me!
I get overwhelmed by the paperwork side, especially the bookkeeping/tax paperwork and also having time to move things forward instead of just maintaining the stuff I currently have going. I recently hired a bookkeeper to get my paperwork in order and it was reasonably priced and will free up so much time that the second thing I mentioned will hopefully not be such an issue. It took me five years to look at farming out some of my responsbilities, but our businesses can be as busy and complex and any other and there's nothing wrong with getting some help. We'll see how it goes!
Marketing myself is absolutely the hardest thing I've found in this business. I'm a good therapist, I love working with people and helping them feel better, but I have a very difficult time getting myself "out there" and trying to educate people as to why they need me. It's tough for me!
Hi Felicia...great question by the way..i've been running my own practice for 17 out of 20 years of my Holistic Healthcare Career...13 years ago I started a small company and became incorporated. At one point i had a staff of about 6-7 therapists working for me..but alas..many therapists do leave the field in just a few years which primarily is what happened to my staff..i would train them via an apprenticeship for 2 years solidly as I built a client practice for them..and then usually w/in just a year or two at the most..they would leave the field..not just me..the field of massage therapy..as it seems that our field can be quite transcient. I also taught in the field advanced courses in massage therapy techniques for almost 10 years..etc...and since then..well...i stopped teaching despite the 12 curriculums that i wrote myself and also..i stopped having a staff and am now a much happier single practitioner...with the motto of "less is more"!

So what's the most difficult challenging thng about handling a business and/or the business side of my practice...well there are many aspects..having to learn how to market yourself..how to set up advertisements for yourself...design and/or have someone help you to design a business card...setting up a website which i am right now in the midst of doing so..and boy is that going to be a huge project..putting in a website information that encapsulates all the different services that I do...it would have been much easier in the first 5 years of my practice because i didn't have so many different services / techniques that i did then..so i would have written less..now 20 years later there's a lot more to write and it's a big project..another challenge is keeping great books...bookkeeping..having an accountant to make sure that all the taxes are paid and processed well..making sure that you have a good lawyer to advise you..on many things..reviewing a lease for instance before you sign it..so that you are protected..and so that the lease contract doesn't eventually come back to bite ya...cause there was that little extra something that the landlord slipped into there when you weren't looking..and you signed the contract and were bound to it..not knowing all the aspects...which means you have spend lots of extra time...checking everything out..and seeking out great advice from accountants..lawyers...web designers...printers for business cards..how about artists to do some artwork on your card if you want to design a logo for yourself/company as was the case with me 13 years ago...then there's just the plain old taking care of processing the bills...keeping good files...and tracking your viable business writeoffs with great documentation lest you be audited someday and find yourself with all those well tracked expenses and then oh no...you're in a big tax audit dilemma..but hey it was only making sure that all your paperwork and expenses were filed correctly and valid...that's all...doesn't seem like a lot but it adds up...here's another thing..setting up phone lines for business and/or highspeed internet..always getting the best deals for yourself and your business...and one huge part of the business as it relates to clients...it's such an easy one..but so often overlooked...actually return phone calls when a client leaves a message within a reasonable amount of time..you'll stand out amongst the rest of the therapists who don't think that it is important enough to return a phone call. I cannot times a client has told me thru many years of a practice.."thank you so much for returning my call" and then afterwards divulging that out of 7 phone calls they placed to other therapists..i was the only one that called back...even when they came for the appt...i was still the only one that called back...i remember teaching a seminar on business practices...for massage therapists...and that was my biggest piece of advice..i'd say.."so you want clients..you want to build your practice..it takes a lot of things to accomplish this...but here's just one simple thing...that will make you stand out amongst all the rest...just return phone calls...in a timely fashion...no one believed me that it could be as simple as that...and you know what...many of my students didn't follow my advice but still complained about not being busy enough...and soon after dropped out of the profession altogether...!

What's challenging to it all..you ask...to keep calling yourself to a higher and higher ground of business practices...to keep pushing yourself even when you don't feel like it...to make sure that things are done in a professional manner...that your filing is on the mark...your accounts are balanced...your business card represents you well..and your website when you get that up and running...that you represent your industry in the community well and realize that in doing so..people think of all massage therapists...as you are so presenting yourself to be...following up with clients and not just for a session to make money..but to really support them and show care...for their well being..even if you just spend some time on the phone with them...it all comes back to you you know...cause you really care for your clients..ahhh word gets around..that plus..and here's the big one..they really really really want a great therapist..who is also a really good business professional..too...each part of the equation is as important and the other...i've heard from clients that they've left their therapists because they didn't practice good business professionalism..didn't take the business part of it all seriously...despite the great therapy that the therapist gave to them...it's really important to clients that you are on the mark in both arenas..and that in one huge nutshell is the most challenging thing...to balance all of this...and do in a way that is genuine..professional..yet caring...and shows that you're in it to really help people first and foremost...and you're a business person too..and oh..by this way..this your bread and butter too..and you get to make that bread and butter by helping people..and that makes all the difference in the world to you and to your clients especially.

Anyway..hope that helps...Felicia...perhaps though a lot of this you already knew...if so..then perhaps it just helps to hear it again...and perhaps there are a few things that you didn't know...either way..it's a great question..and one that i believe every therapist including myself need to be asking ourselves all the time..so that we can all continue onward and upwards to even higher and higher standards in our profession!

Be well and good luck..diane
being 15 mins early
HAve you looked at office ally? This is what they do at no charge to the practioner. You may want to check out their information - I think it costs only $29.95 a month from what I remember.

Additionally, how did you start your medical massage practice. This is the direction I am interested in taking my specific line of work. I recently signed a contract with a local hospice and focus currently on oncology but I have no idea how to market to the medical community and how to get set up with the insurance providers. Any help would be greatly appreciated!

~Michelle B

Laura Allen said:
Gee, Felicia, if you and I could clone ourselves we'd have it made!

My main challenge is that in my medically-oriented group practice, about half of my business is insurance-based. I do almost all the filing myself...I have so far had no success in finding someone who does it as efficiently as I do, and I have found that it causes me more stress to turn it over to someone who screws it up that it does for me to do it myself. I am still waiting for Mr. or Ms. Right For the Job to come along. I suppose it is a sign of the present economy that when I have in the past couple of months advertised for "a person experienced in insurance billing with excellent knowledge of medical terminology" that I received a couple of hundred phone calls and resumes from people who know NOTHING about it and are just desperate for a job. That whole experience has made me very hesitant to run another ad.

If you're reading this and that job description sounds like you, call me!
Laura,
Since I am a medical/coder biller from the past - you need to find someone with that background. The proper coding sequence as you will know is important to receive the most in benefits...of course medical terminology is a must too.

If you are ever in a pinch and need some help, just call me. If i'm available to help you catch up, I will do so. My practice initially 20 years ago was all insurance billing - I know how time consuming it can be. I decided after a couple of years to let it go and only use it as needed.

I do understand nowadays that it is a great advantage to help people out with this extra service. Good Luck

Laura Allen said:
Gee, Felicia, if you and I could clone ourselves we'd have it made!

My main challenge is that in my medically-oriented group practice, about half of my business is insurance-based. I do almost all the filing myself...I have so far had no success in finding someone who does it as efficiently as I do, and I have found that it causes me more stress to turn it over to someone who screws it up that it does for me to do it myself. I am still waiting for Mr. or Ms. Right For the Job to come along. I suppose it is a sign of the present economy that when I have in the past couple of months advertised for "a person experienced in insurance billing with excellent knowledge of medical terminology" that I received a couple of hundred phone calls and resumes from people who know NOTHING about it and are just desperate for a job. That whole experience has made me very hesitant to run another ad.

If you're reading this and that job description sounds like you, call me!
Thanks Diane. I am not asking for myself so much (in terms of my massage practice anyway.) I am just interested in finding out what most therapists find challenging so that I can be of better help to them through my consulting and training services.

As you said it is a balancing act to be good at the business side along with being a strong hands-on ability. I was lucky to be able to do both early on and am sure that is why I was so busy. In fact, I often tell people that I am not the best therapist necessarily, just the best one at getting my name out there and getting clients to come back! And I found good people to help me with my weaknesses (bookkeeping and paperwork!) so that I could focus on the parts of my practice and business that I really enjoy(ed) - seeing clients, marketing and developing/growing the business. The latter two are what I now focus my consulting and training on for the most part.

Thanks again for your input and ideas!

Felicia


Diane Carol Slevin said:
Hi Felicia...great question by the way..i've been running my own practice for 17 out of 20 years of my Holistic Healthcare Career...13 years ago I started a small company and became incorporated. At one point i had a staff of about 6-7 therapists working for me..but alas..many therapists do leave the field in just a few years which primarily is what happened to my staff..i would train them via an apprenticeship for 2 years solidly as I built a client practice for them..and then usually w/in just a year or two at the most..they would leave the field..not just me..the field of massage therapy..as it seems that our field can be quite transcient. I also taught in the field advanced courses in massage therapy techniques for almost 10 years..etc...and since then..well...i stopped teaching despite the 12 curriculums that i wrote myself and also..i stopped having a staff and am now a much happier single practitioner...with the motto of "less is more"!

So what's the most difficult challenging thng about handling a business and/or the business side of my practice...well there are many aspects..having to learn how to market yourself..how to set up advertisements for yourself...design and/or have someone help you to design a business card...setting up a website which i am right now in the midst of doing so..and boy is that going to be a huge project..putting in a website information that encapsulates all the different services that I do...it would have been much easier in the first 5 years of my practice because i didn't have so many different services / techniques that i did then..so i would have written less..now 20 years later there's a lot more to write and it's a big project..another challenge is keeping great books...bookkeeping..having an accountant to make sure that all the taxes are paid and processed well..making sure that you have a good lawyer to advise you..on many things..reviewing a lease for instance before you sign it..so that you are protected..and so that the lease contract doesn't eventually come back to bite ya...cause there was that little extra something that the landlord slipped into there when you weren't looking..and you signed the contract and were bound to it..not knowing all the aspects...which means you have spend lots of extra time...checking everything out..and seeking out great advice from accountants..lawyers...web designers...printers for business cards..how about artists to do some artwork on your card if you want to design a logo for yourself/company as was the case with me 13 years ago...then there's just the plain old taking care of processing the bills...keeping good files...and tracking your viable business writeoffs with great documentation lest you be audited someday and find yourself with all those well tracked expenses and then oh no...you're in a big tax audit dilemma..but hey it was only making sure that all your paperwork and expenses were filed correctly and valid...that's all...doesn't seem like a lot but it adds up...here's another thing..setting up phone lines for business and/or highspeed internet..always getting the best deals for yourself and your business...and one huge part of the business as it relates to clients...it's such an easy one..but so often overlooked...actually return phone calls when a client leaves a message within a reasonable amount of time..you'll stand out amongst the rest of the therapists who don't think that it is important enough to return a phone call. I cannot times a client has told me thru many years of a practice.."thank you so much for returning my call" and then afterwards divulging that out of 7 phone calls they placed to other therapists..i was the only one that called back...even when they came for the appt...i was still the only one that called back...i remember teaching a seminar on business practices...for massage therapists...and that was my biggest piece of advice..i'd say.."so you want clients..you want to build your practice..it takes a lot of things to accomplish this...but here's just one simple thing...that will make you stand out amongst all the rest...just return phone calls...in a timely fashion...no one believed me that it could be as simple as that...and you know what...many of my students didn't follow my advice but still complained about not being busy enough...and soon after dropped out of the profession altogether...!

What's challenging to it all..you ask...to keep calling yourself to a higher and higher ground of business practices...to keep pushing yourself even when you don't feel like it...to make sure that things are done in a professional manner...that your filing is on the mark...your accounts are balanced...your business card represents you well..and your website when you get that up and running...that you represent your industry in the community well and realize that in doing so..people think of all massage therapists...as you are so presenting yourself to be...following up with clients and not just for a session to make money..but to really support them and show care...for their well being..even if you just spend some time on the phone with them...it all comes back to you you know...cause you really care for your clients..ahhh word gets around..that plus..and here's the big one..they really really really want a great therapist..who is also a really good business professional..too...each part of the equation is as important and the other...i've heard from clients that they've left their therapists because they didn't practice good business professionalism..didn't take the business part of it all seriously...despite the great therapy that the therapist gave to them...it's really important to clients that you are on the mark in both arenas..and that in one huge nutshell is the most challenging thing...to balance all of this...and do in a way that is genuine..professional..yet caring...and shows that you're in it to really help people first and foremost...and you're a business person too..and oh..by this way..this your bread and butter too..and you get to make that bread and butter by helping people..and that makes all the difference in the world to you and to your clients especially.

Anyway..hope that helps...Felicia...perhaps though a lot of this you already knew...if so..then perhaps it just helps to hear it again...and perhaps there are a few things that you didn't know...either way..it's a great question..and one that i believe every therapist including myself need to be asking ourselves all the time..so that we can all continue onward and upwards to even higher and higher standards in our profession!

Be well and good luck..diane
Hi Laura -

A few weeks ago I posted a question on a Linkedin.com group about insurance billing software for massage practices for a consulting client.. It might be of value to you to check out the answers that came from it, Here is the link:

http://www.linkedin.com/groupAnswers?viewQuestionAndAnswers&dis...

I think there were some other answers on other groups too, but this one was the most active. Just go to my profile and scroll through my various spa/massage groups to see the other discussions:-)

Here is my direct profile link: http://www.linkedin.com/in/feliciaebrown

Let me know what software you pick or add your own comments to that discussion. I'd love to hear your insights!

Felicia

Laura Allen said:
Gee, Felicia, if you and I could clone ourselves we'd have it made!

My main challenge is that in my medically-oriented group practice, about half of my business is insurance-based. I do almost all the filing myself...I have so far had no success in finding someone who does it as efficiently as I do, and I have found that it causes me more stress to turn it over to someone who screws it up that it does for me to do it myself. I am still waiting for Mr. or Ms. Right For the Job to come along. I suppose it is a sign of the present economy that when I have in the past couple of months advertised for "a person experienced in insurance billing with excellent knowledge of medical terminology" that I received a couple of hundred phone calls and resumes from people who know NOTHING about it and are just desperate for a job. That whole experience has made me very hesitant to run another ad.

If you're reading this and that job description sounds like you, call me!
I already have the insurance billing software (FileMaker 1500, the version for electronic filing), and I personally don't find it difficult to use. The issue, is of course, that insurance companies are in business to see how many claims they can get out of paying. If every i is not dotted and every t is not crossed correctly, that's an excuse for them to kick back the claim. I don't have that problem when I do it myself. I actually submit to our network, who then submits to BCBS and the other companies.

I hired someone who had 19 years of experience with this recently, had even taught it in a community college, and it took her an hour to process a claim. I have timed myself--I can do one in less than 10 minutes. I cannot afford to pay someone who isn't at least as good as I am at it, or preferably better! Like I said, it just causes me less stress to keep on doing it myself.

As to how I started this, Six years ago when I started my own practice, I spent a week or so creating a database of every doctor and dentist in the area, and then sent them all a letter introducing my business and invited them to an open house so they could see what sort of professional operation I run. I ultimately hired a chiropractor to work here, since many of the major companies don't want to pay for massage unless it's done under a chiropractor. Where there's a will, there's a way.
I find the aspect of wearing all of the hats and trying to keep moving forward very challenging. As a former electrical engineer, I'm used to planning ahead for future milestones and moving things into place for improvement. The simple day to day of DOING the business gets in the way of this aspect GROWING the business and making significant changes.Another major challenge- which we all probably face- is "being undercapitalized" . I can only move so far ahead based on what I can finance my self. How to market efficiently ( this does NOT mean following the advice of "marketing experts") is the next most challenging item.
I've been fortunate to build and all-cash business. I don't choose to work with insurance companies for many reasons. to begin to free myself up,I have been able to bring on two people and offload some of the day to day while building their clientele and training them in aspects of business. I make many of the products that we sell in our office, and barter or work with others who make local hand-made quality items in order to carry interesting and useful things for gift shopping. Staying in touch with this "network" of local businesses and people that help to support me can be time consuming and challenging, but is well worth its weight in gold.
Returning calls is essential. The best thing I've done is bring in a part time helper who can answer calls and book while we are in session.I make use of FREE technology even if it is a pain at first,By hooking up with google for free wireless appointment updates from our calendar, my part time assistant and i can book from anywhere and check schedules and have everyone updated on appointments.
Just being in business is a challenge right now- and if we can keep our doors open we are a success. It's important to remember that day to day too.
Diane,
Hi you said it in nutshell, and being rather new in my wonderful new career change (1yr.), I am so grateful that one of my friends here contacted me and invited me to this site so that I could read these wonderful educational stories, blogs and forums. The people have been so nice, and after the story you wrote I could not help to make this comment. Sounds to me that you have had a wonderful career full of challenges and extreme learning conditions which Im learning right now and I know I have long row to hoe, and Im excited about it. I think the website that I have been maintaining is not what it should be but untill the funds are there it will just have to do. What I really look forward to is minding my schedule and keeping my clients on time so that I can get them out and I can get the next one in. true callbacks are extremely important, I know my clients appreciate my calls, especially the ones the day before and oops I forgot THANK YOU for calling. Peace Travis

Diane Carol Slevin said:
Hi Felicia...great question by the way..i've been running my own practice for 17 out of 20 years of my Holistic Healthcare Career...13 years ago I started a small company and became incorporated. At one point i had a staff of about 6-7 therapists working for me..but alas..many therapists do leave the field in just a few years which primarily is what happened to my staff..i would train them via an apprenticeship for 2 years solidly as I built a client practice for them..and then usually w/in just a year or two at the most..they would leave the field..not just me..the field of massage therapy..as it seems that our field can be quite transcient. I also taught in the field advanced courses in massage therapy techniques for almost 10 years..etc...and since then..well...i stopped teaching despite the 12 curriculums that i wrote myself and also..i stopped having a staff and am now a much happier single practitioner...with the motto of "less is more"!

So what's the most difficult challenging thng about handling a business and/or the business side of my practice...well there are many aspects..having to learn how to market yourself..how to set up advertisements for yourself...design and/or have someone help you to design a business card...setting up a website which i am right now in the midst of doing so..and boy is that going to be a huge project..putting in a website information that encapsulates all the different services that I do...it would have been much easier in the first 5 years of my practice because i didn't have so many different services / techniques that i did then..so i would have written less..now 20 years later there's a lot more to write and it's a big project..another challenge is keeping great books...bookkeeping..having an accountant to make sure that all the taxes are paid and processed well..making sure that you have a good lawyer to advise you..on many things..reviewing a lease for instance before you sign it..so that you are protected..and so that the lease contract doesn't eventually come back to bite ya...cause there was that little extra something that the landlord slipped into there when you weren't looking..and you signed the contract and were bound to it..not knowing all the aspects...which means you have spend lots of extra time...checking everything out..and seeking out great advice from accountants..lawyers...web designers...printers for business cards..how about artists to do some artwork on your card if you want to design a logo for yourself/company as was the case with me 13 years ago...then there's just the plain old taking care of processing the bills...keeping good files...and tracking your viable business writeoffs with great documentation lest you be audited someday and find yourself with all those well tracked expenses and then oh no...you're in a big tax audit dilemma..but hey it was only making sure that all your paperwork and expenses were filed correctly and valid...that's all...doesn't seem like a lot but it adds up...here's another thing..setting up phone lines for business and/or highspeed internet..always getting the best deals for yourself and your business...and one huge part of the business as it relates to clients...it's such an easy one..but so often overlooked...actually return phone calls when a client leaves a message within a reasonable amount of time..you'll stand out amongst the rest of the therapists who don't think that it is important enough to return a phone call. I cannot times a client has told me thru many years of a practice.."thank you so much for returning my call" and then afterwards divulging that out of 7 phone calls they placed to other therapists..i was the only one that called back...even when they came for the appt...i was still the only one that called back...i remember teaching a seminar on business practices...for massage therapists...and that was my biggest piece of advice..i'd say.."so you want clients..you want to build your practice..it takes a lot of things to accomplish this...but here's just one simple thing...that will make you stand out amongst all the rest...just return phone calls...in a timely fashion...no one believed me that it could be as simple as that...and you know what...many of my students didn't follow my advice but still complained about not being busy enough...and soon after dropped out of the profession altogether...!

What's challenging to it all..you ask...to keep calling yourself to a higher and higher ground of business practices...to keep pushing yourself even when you don't feel like it...to make sure that things are done in a professional manner...that your filing is on the mark...your accounts are balanced...your business card represents you well..and your website when you get that up and running...that you represent your industry in the community well and realize that in doing so..people think of all massage therapists...as you are so presenting yourself to be...following up with clients and not just for a session to make money..but to really support them and show care...for their well being..even if you just spend some time on the phone with them...it all comes back to you you know...cause you really care for your clients..ahhh word gets around..that plus..and here's the big one..they really really really want a great therapist..who is also a really good business professional..too...each part of the equation is as important and the other...i've heard from clients that they've left their therapists because they didn't practice good business professionalism..didn't take the business part of it all seriously...despite the great therapy that the therapist gave to them...it's really important to clients that you are on the mark in both arenas..and that in one huge nutshell is the most challenging thing...to balance all of this...and do in a way that is genuine..professional..yet caring...and shows that you're in it to really help people first and foremost...and you're a business person too..and oh..by this way..this your bread and butter too..and you get to make that bread and butter by helping people..and that makes all the difference in the world to you and to your clients especially.

Anyway..hope that helps...Felicia...perhaps though a lot of this you already knew...if so..then perhaps it just helps to hear it again...and perhaps there are a few things that you didn't know...either way..it's a great question..and one that i believe every therapist including myself need to be asking ourselves all the time..so that we can all continue onward and upwards to even higher and higher standards in our profession!

Be well and good luck..diane

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