All Things Private Practice Podcast for Therapists

Episode 102: Rethinking HR: Unconventional Strategies for Building Extraordinary Teams [featuring Ashley Cox]

Show Notes

Moving from solo practice to group practice can bring up a lot of questions and uncertainties about HR strategies, conscious leadership, and fostering a people-first culture.

In this enlightening episode of the All Things Private Practice Podcast, I have the privilege of interviewing Ashley Cox, the visionary mind behind SproutHR, an innovative HR consultancy.

We talk about...

  • πŸ”Ž **Hiring Strategies That Make a Difference**: Ashley shares her expertise on developing hiring strategies that align with your company's values and mission. Discover how to attract and retain top talent by emphasizing culture fit and shared purpose.
  • πŸ’š **Prioritizing People Over Profit**: In a world often dominated by the bottom line, Ashley and I unpack the power of putting people first. Learn why valuing your team's well-being can lead to greater long-term success and sustainable growth.
  • 🎯 **Finding Quality Applicants in a Competitive Market**: In an era of fierce competition for skilled professionals, Ashley offers insights into effective recruitment techniques that resonate with candidates seeking purpose-driven workplaces.
  • πŸ€” **Why Many Bosses "Get it Wrong"**: Ashley delves into common misconceptions and pitfalls that leaders fall into when managing their teams. She sheds light on how reimagining leadership and HR practices can lead to more harmonious and productive work environments.

Tune in to this captivating episode to gain actionable insights on how to transform your leadership approach, attract exceptional talent, and create a workplace that thrives on human connection and shared values. Ashley's passion for cultivating meaningful workplaces is contagious, and her wisdom is sure to inspire positive change within your organization.

Don't miss this opportunity to unlock the keys to nurturing a thriving work culture that fosters success, satisfaction, and genuine well-being for all.

More about Ashley:

Ashley Cox, PHR, SHRM-CP is the Founder and CEO of SproutHR, a boutique HR consulting firm that advises women-owned businesses on how to hire and lead profitable, sustainable, and impactful teams with confidence, ease, and fun.

At SproutHR, Ashley and her team focus on values-based hiring, compassionate and intentional leadership, and amplifying impact. They revolutionize the do-it-yourself mindset to one of exponential growth – hiring the right people the right way scales business and electrifies the bottom line – making women-run companies thrive.

A certified HR professional with over 17 years experience, Ashley has worked with businesses nationwide – from local brick and mortars to online agencies to multi-million dollar national & international companies. 

She was a top recruiter and leadership expert for J.Crew and Kroger where she hired and developed everyone from the newest hourly employees to C-suite level executives. 

She is also an SME (subject matter expert) for the world’s leading HR organization, SHRM (Society for Human Resource Management), an expert trainer for various 1000+ employee organizations, the author of her debut book Transform Your Stories, and host of The Impact Ripple Podcast. 

Transform Your Stories guides women to overcome the stories that hold them back so they can become confident and courageous leaders who create a resounding impact in the world.

SproutHR & Transform Your Stories have been featured on ABC News, Brit + Co, SHRM, and The Rising Tide Society.

For more information, visit:

Book a Free Call – Not sure what your next step is with growing and leading your team? Join Ashley for a free call to discuss where you are, where you want to go, and what's getting in the way. Whether you choose to work with Ashley or not, you'll walk away with more clarity around your next steps to reach your desired goal.


πŸŽ™οΈListen to more episodes of the All Things Private Practice Podcast here


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A Thanks to Our Sponsors: The Receptionist for iPad & Heard!

✨ The Receptionist for iPad:

I would also like to thank The Receptionist for iPad for sponsoring this episode.

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✨ Heard:

I would also like to thank Heard for sponsoring this episode.

Doing your own accounting as a self-employed therapist is stressful. I get it because I've been there. When I first started my private practice, I wasn't sure how much to save for taxes or how quarterly taxes worked. I didn't want to fuck up and get in trouble with the IRS. That's why I'm so glad I found Heard, the financial back office for therapists.

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PATRICK CASALE: Hey there, everyone, you are listening to another episode of the All Things Private Practice Podcast. I'm your host, Patrick Casale. I'm your host, Patrick Casale. I'm joined today by Ashley Cox. She's the founder and owner of SproutHR. We're going to talk about hiring today. And we are going to talk about some myths and some common misconceptions. 

So, Ashley, it's really great to have you on here. And I'm looking forward to having this conversation.

ASHLEY COX: Thanks so much, Patrick. It's a pleasure to be here. And I'm excited to talk about this, and some of the myths and misconceptions, like you mentioned because they are out, there, they are aplenty, and we're going to do a little myth-busting today.

PATRICK CASALE: So, you know, the way I usually run this podcast is pretty loose and conversational, see where it goes. And you know, you submitted some topics, but before we started recording, you mentioned something that actually feels more exciting to me to talk about. And I think it is the topic of there is no good help out there, I can't hire anyone, nobody wants to work. And you said that's just bullshit. So, that felt really in alignment for me and my audience. So, I would love to have that conversation because I agree with you 100%.

ASHLEY COX: Yeah, yeah. It's funny because people have been saying this, I think, for as long as people have been hiring. It's not new, but it does seem to be a lot more prevalent these days. And it seems that you're hearing this sort of rhetoric more often. 

And I work with a lot of group therapy practice owners, and I'm hearing this over and over, right? I'm hearing, "Well, I just can't find anybody, and Indeed isn't working anymore. And nobody wants to work, and everybody wants, you know, a million dollars for five hours a week."

And I get it. I hear a lot of this. And I'm also very quick to call bullshit on it because I'm also seeing the opposite. You know, I see amazing people who are wanting to be part of group practices, I'm seeing amazing team members who want to contribute in meaningful ways. And they also want the things that are important to them. They want the things that they value in their personal lives, in their work lives. And I think that's where we're finding a chasm or a gap between what we want and need as group therapy owners, and what our potential candidates or potential employees want and need as individuals.

PATRICK CASALE: Yeah, absolutely. Couldn't say it better myself. And, you know, I do own a group practice. We have 15 therapists. We just hired two more. We have two psychiatric providers. We have an office manager and a scheduler. So, I find it really hard to believe that good help doesn't exist because our staff is pretty wonderful. And I have probably responded to about 60 applications via email over the last two and a half weeks with just, unfortunately, a generic blanket, "We're not hiring right now, but circle back in the fall." Statement because it gets too overwhelming. 

But here's what I think the differences and I think you hit the nail on the head immediately is that people are definitely willing to work, people are definitely willing to work hard in a profession that is pretty fucking exhausting emotionally and physically. And they're willing to be a part of a team. But you as the group practice owner have to create the culture, and the camaraderie, and the team. And your values have to align much more in the people over profit mentality instead of like really feeding into the capitalist system that we live in because if you're not going to treat your staff well if you're not going to, you know, go the extra mile or include the extra benefit, or the extra dollar of pay, why would I come work for you if I could go do this on my own? 

And I think that people get lost in that because it's really easy to get lost in the narrative of, "I'm just going to hire, I'm just going to hire, I'm just going to hire." And then all of a sudden you've created just chaos and you don't have good pay structures in place, you don't have incentives, you don't have ways to help people grow professionally, and develop, and that's where a lot of burnout comes up, and that's where a lot of turnover comes up. And you know as well as I do that turnover is expensive, onboarding is expensive. I would much rather treat my employees well and reduce our turnover than be constantly looking for employees and hiring. And we're blessed to be in that position. But I'd love your take on that.

ASHLEY COX: You're hitting the nail right on the head because what I'm seeing out there in the way of job descriptions and job postings, you know, a lot of people want to say, "Well, Indeed isn't working the way that it used to." 

Yes, it's not because the candidate, the end user, the person you are trying to attract has realized that they have a lot more value and a lot more worth than what they maybe have previously thought or felt. 

And so when I see job descriptions that are saying must have 10 years of experience, must have this degree of certification or this licensure, and I'm going to pay you the equivalent of 12 to $15 an hour, people are going, "I don't think so, I'm worth more than that. Thank you, next. I'm going to go take a look at what other options are out there."

So, you have to really be mindful of how we are asking people to show up for us and how we are showing up for them. And I think that's exactly where you hit the nail on the head there, Patrick because it has to start first with our values. You know, if you're saying things like I charge what I'm worth, or I create a practice that fits around my life, but then you're not doing the same for the people that are on your team, you're out of congruency, you're out of alignment with your values, and people pick up on that. They're going to call bullshit on that just as quick as I'm going to call it because they're going to say, "Hey, that doesn't feel good. That doesn't feel right. You're saying this on your website, when I read your About page, when I read your company info, when I read, you know what your culture is like. And then on the job description, you're telling a very different story."

And so people are going to be really quick to call that out. So, if you're not getting hits on your job description, there's probably something that's out of alignment there. And people are picking up on that. They are way smarter than we give them credit for.

PATRICK CASALE: Absolutely. I agree 100%. And, you know, so many of these job descriptions are also written in like this robotic in personal like language that doesn't speak to the user experience or the applicant, and I have been hired several times to write job descriptions for therapists because I'm like, let's embrace the company culture, let's embrace what you really want to offer people. If you really want to ensure people only work four days a week, emphatically state that and state why, if you want to talk about like, the time off, and the actual self-care because we love to throw that buzzword around in this profession and not actually practice it. And it makes a substantial difference. 

But here's the thing is like, it can all be lip service, but on the other end, you have to be practicing what you preach as the employer because, again, as a private practice coach, I constantly am asking for feedback internally with our group practice of like, "Why would you work here knowing you're going to make less money instead of working for yourself?" Because I teach people all over the country how to work for themselves, so it feels a bit hypocritical for me to say, "Well, I'm the employer in this relationship and you know, I'm profiting off the work that you do."

And in the constant feedback, is that we have connection, we have camaraderie, we have teamwork, support, people feel challenged, people feel like there's leadership tracks, there's development tracks, we're actually promising, and delivering, and over-delivering what we've said we're going to do, and we pump most of the profit back into the company. And I think we've been open now for, I was in private practice since 2017 but a group since January 2021. So, a little over two years now. We've only had two employees leave in those two years. And those two employees left to start their own businesses. And I don't blame them for it. But I also acknowledged that not everyone is set up for business ownership. Like, I don't want to deal with the admin side, I don't want to deal with the marketing side, I don't want to deal with the ups and downs of when the client don't come in or any of that stuff. So, I get why group practice is still an enticing possibility for people. And that's another misconception is nobody joins group practices anymore, everyone goes into private practice. And that, again, is bullshit.

ASHLEY COX: It's total bullshit. And I hear this all the time, too. I'm sure we hear a lot of the same things, Patrick. And it's interesting because where you are in your career right now, as a group practice owner is very likely that you are surrounded by other people who are entrepreneurs, who are group practice owners, who are on the same journey, which means that you're not seeing the thousands of people who have absolutely no interest in this life whatsoever. They just want to do what they're great at, and get a paycheck for it, and feel really fulfilled, and go home. And they don't want to have to deal with, you know, business taxes, and licenses, and all of the things that come with running a business and leading a team. 

And that's okay because we need those people, right? If you're going to grow a group practice, we absolutely need those people. And so, thinking that nobody wants to work in a group practice is a huge misconception. And I think that's where a lot of people get kind of stuck in their mindset. 

You know, the things that we think absolutely have an impact on the way that we act and the way that we show up in this world. So, if we think, well, nobody wants to work anymore, or nobody wants to work in a group practice, the actions that we take are going to start to reflect that. And then we're going to fall into confirmation bias. And we're going to only see the bad things. We're only going to see the people that want to start their own practice versus work in a practice. 

But so many people want that teamwork, hey want that camaraderie, they want people to bounce ideas off of, they want that culture, that experience that you're talking about. And they don't want to have to create that for their own self or for other people. 

And I know one thing that's so, so important to remember is that when you go through your therapy training, you get your credentialing, you get your licenses, your degrees, all these things, they don't teach you how to run a business. And that's a whole different ballgame, right?

PATRICK CASALE: Yeah, absolutely. You're spot on. And, you know, they don't teach you how to run a business, so a lot of people are out there flailing and I know a lot of absolutely wonderful clinicians that are just terrible business owners. And that's a reality for a majority of people who do try to own a small business, in general. It's not just mental health professionals, it's like, so and so who wants to open up a cupcake shop. Like, anyone is going to struggle. 

And the reality is some people are much more inclined to overcome the obstacles and barriers that get thrown your way when you're struggling as a small business owner, some people are like, "I can't deal with this, I'm packing up shop, and I'm closing my doors." 

And my clinical director at our practice is a good friend of mine. And she at one time was my clinical supervisor. And we started our private practices together. And she packed up her business very quickly because just could not handle the business side of it, and then reached out to me a year later, and was like, "Can I join your team?" And I was like, "Hell yeah, I know, you're an amazing clinician. Like, I don't need you to be anything other than a wonderful supervisor, and that I know you can be."

So, small business ownership is just not for everybody. And the reality is there are quality applicants out there who are looking for good employment opportunities. The problem is there are so many fucking bad employment opportunities. And I've been at conferences before where group practice owners have said, "I can't find applicants." And you know, this is like roundtable discussion stuff. And everyone's offering feedback. 

And, "Well, how much are you paying?" And it's like, "Oh, you know, like, $24 to $30 an hour."

And I'm like, "What?" Like, I make more than that when I was bartending like big times, to get a master's, and then come out of school and jump into a $20 an-hour job. Like, that's not going to fly for people. And I think we've seen a movement post-COVID. And I think COVID was a big catalyst for this of people who-


PATRICK CASALE: …want to leave their agency jobs because it became very apparent very quickly that community mental health organizations, as we've known for a long time, just do not have the resources, but also oftentimes, do not care about the employee. So, it's been a mill for a long time. So, people said, "If you're not going to take my health seriously, during a global pandemic, fuck this. I'm going to start my own business." And a lot of people did. And that's when All Things Private Practice was born. It was kind of a perfect storm, really, for me. 

But what I saw was so many people going out on their own, who honestly hated it because they were like, "I'm so lonely, I don't know how to get clients, I don't feel like I have adequate supervision or consultation, I just want to be a part of something where I can be treated well and not taken for granted or under-appreciated."

And when I interview people now, you know, my interview style is quite lax, like this podcast, but I will tell them straight up, like, this is the expectation, this is how it runs. And everyone will always say, "That feels too good to be true." And then a month later, they will text me and say, "This is amazing, but I'm still waiting for things to like, go sideways." Now, a year later it's like, "Can you finally just buy into the fact that like, there are good places to work out there. Like, not everyone is out there to take advantage of an employee." So, I think that's also important to notate.

ASHLEY COX: It's so important. And I think what we also have to really be mindful of is that people have had these incredibly toxic workplace experiences for decades, decades. And we're also coming through new generations who are seeing work differently, who are thinking about work differently, who are thinking about work-life integration differently. 

You know, the boomer generation is, "I show up, I do the work I'm told to do, I stay as long as I'm told to stay, I stay longer than I'm told to stay because face time is really important. And I don't question it." And then you get the millennial generation, the Gen X and the millennials come along, and they're like rebels, and then saying, like, "Well, this is crap. I don't want to stay, you know, just to be at work. And I think this is, you know, bullshit. And I don't want to fall to this kind of expectation." And then we have this beautiful Gen Z coming through who are just like, "Yeah, I'm not here for any of that."

PATRICK CASALE: And that's a great point. And that's another misconception, though because I will hear this from colleagues that the newer generation of therapists, they just don't want to work hard. Like, they only want to work 10 hours and go home. Maybe some of that is true. Sure, absolutely. Like, I do think that we've swung work-life balance in the opposite direction because for so long, institutionally, there was no work-life balance. 

And again, COVID, as destructive as could be, really highlighted how short life can be, and how important it is to really be in alignment with your passions and your values. 

And, you know, you mentioned the boomer generation, like pensions and retirements, right? Like, those things don't exist really anymore in terms of working for a corporation. So, you've got to take care of your own self-interest as well. 

And I think, you know, I look at my role, my brain is diverging into a different pathway right now. But I look at my role, not as a boss or employer, but as a mentor and a guide. And if I can treat people well, and give them an experience where they feel like they're appreciated, and not taken for granted, and they get paid well, the odds of turnover being low is quite high. Like, that just increases. But ultimately, the relationships and the desire to be at work, and the desire to participate, and be a part of a team goes up too. And like, that's a hell of a lot easier to manage than, like, feeling like I've got to be authoritative, or like you mentioned, like helicopter boss or leadership style. Like, I feel like autonomy is crucial. We're working with adults. Like, micromanagement is not for me. So, I just think that ultimately, it really does allow you to have an outlook on things. 

And it's the same way that I looked at therapy when I was working as a therapist was like, I'm working myself out of a job all the time. That's the way I conceptualize therapy. And the same thing as a leader is like, I'm helping support development throughout people's careers. And do I expect people to work here for the next 20 years? Hell no, because I wouldn't do that. And that feels like very hypocritical and unrealistic to ask of someone.

ASHLEY COX: It does. And I think that if somebody gives you a solid three years, a solid five years, that's amazing. And if you can send people back out into the world better than when they came to you, you've done your job. 

And I think that's also where people don't understand building a pipeline of talent, right? They don't understand having people that are excited to come work for you before you're ever even ready to open the doors for an application. And that's because your culture isn't just something that you wrote down one day on a scrap sheet of paper and stuck on your TV or your computer monitor. It's something that you've integrated into every single fiber of your practice, of every single interaction with your team members. And so, they're going out there and they're saying, "Oh my God, if you ever get the chance, you want to work at this place." 

Even your interview process, let's even think about strangers on the internet. The way that you show up from a value-centered focus, and talking about, and really living out your culture is in your interview process. It's before you ever even meet this person, you know? So, it's do you follow up with people in a timely manner or are you ghosting people/ Because that goes both ways. It's not just, you know, potential candidates ghosting employers, but employers are notorious for ghosting candidates. And it happens in major corporations and it happens in small businesses all across the board. 

So, if your value is that, you know, we care for each other like a family, well, family doesn't ghost each other, right? So, how are you living those values throughout every aspect of your interview process to attract and excite people? 

And then how is that following through with orientation? With onboarding? Are you just saying, "Well, you're going to sink or swim? Good luck." Or are you cultivating a true onboarding experience where people feel embraced, and they feel supported, and they're getting the training, and they're getting the knowledge, they're getting the connections with the other team members. I mean, like, every single part of what you do with people has to be rooted in your values, and you have to be living it out, not just talking about how these are our values, we're so excited, let me put them on the website, let me make a cute graphic for it. But actually truly living those values every single day. And that's where most people get it wrong.

PATRICK CASALE: Yeah, yeah, for sure. And I was thinking about that the other day, you know, in our interview process because our three main populations that we support are the neurodivergent, LGBTQIA+, and the BIPOC communities. So, our values speak to those populations, and that's interwoven throughout our website language. But if applicants were to apply, and it just stopped there, like it was just lip service, and we're like, "Yeah, we don't do anything about it. We just say these things." Or like, "Yeah, we're allies." That doesn't feel good for me, and I'm sure it would not feel good for the potential applicants and employees. So, I think that means as the leader of the infrastructure, or the company, or the business you've got to be pursuing those opportunities as well. 

And if you want to attract, and I hear this all the time too, like, there's so much tokenism in this field of like, "I just want to have a BIPOC therapist on staff for pictures and like to show we're diverse." If you want to attract diverse applicants, you have to be really putting your money where your mouth is, and you have to be pursuing continuous learning, and education, and training from people of color, or from LGBTQIA members, or from autistic ADHD consultants. Like, you have to do the work. 

And I think that's where group practice owners get it wrong a lot of the time is because if you're so focused on profit margin, like I understand profit is important, I don't want to, like, minimize the fact that your business has to make money to survive, how much money do I need to make to survive? And I think that's important to realize and recognize because that's where a lot of frustration will happen in these group practices from the employee side is like, "I'm sick of the 60-40 split, I'm doing all the work." Or I am sick of making $23 an hour because I'm doing all the work." In a lot of ways, they are doing a lot of the work, if not all of the work. So, I think it's really important. 

And, you know, I've read studies, before becoming a group practice owner back in the day from like CEOs of tech companies in Seattle who are like really, really emphasizing profit or not profit, giving the profit back to the people who are working and really emphasizing the culture, and how that in the long run really works out. And I believe in that wholeheartedly. And that's why we're introducing profit sharing, that's why we're doing a lot of things that when we talk about them in the interview status, like people are really shocked. 

But I just think that you're going to get a healthier, happier, more content, more committed employee or staff member if you treat them well, and you go the extra mile. And it's worth spending more of the profit to do so because it just makes your company or your culture run like a well-oiled machine. And it doesn't really take a ton of effort or energy. 

Like, our practice is almost 100% virtual. We have clinicians who live in the Midwest and Florida. Like, all over North Carolina. We don't see each other's faces very often. But we have a connection, and culture, and a community, and a team where people feel like they have teammates, where they feel like even though they haven't seen each other's faces in a month since the group team meeting, that they have connection. And that took a lot to develop. But it was worth it in every sense of the word. Like team retreats, team outings, team events. Like, it's so much more than like the stereotypical lunch at the holiday party, you know? Like, show your appreciation to your employees, make them aware that you think about them, that you appreciate the work that they put in because it really is a win-win all around if you can really embrace that mentality and get out of the mindset of like, "Applicants are lazy, people don't want to work, there's no one applying, where do you even find applicants?"

Like, and all of the myths that we're discussing, but like it does take a lot of intentionality, and it takes a lot of energy, and you have to be committed to that. 

ASHLEY COX: Yeah, and I think something that happens a lot as solo practice owners grow into group practice owners is that they forget to take off that solo owner cap. And so that transition is really hard because they're trying to maintain all the things that they did before and now take on this new leadership role, right? And so, what happens is you get even more overwhelmed, you get even more burned down and burned out, and just burdened with having 57 jobs instead of, you know, only 32. 

And so, I think that part of this too, is that you have to, first, look internally and say, what do I want to put my energy, my hours, my effort, my time toward in this practice? You know, if I want to do therapy, then maybe staying a solo practice owner is the right choice for you. But if you want to really step into that leadership role, and you want to guide, and mentor, like you mentioned, other people and help them grow, and help them develop, you're going to have to probably take off that therapy hat more so than you maybe initially intended. 

And so, you know, maybe in the beginning, you've got two or three people on your team, you continue to practice therapy. But as you grow, as you get toward 10, 15, 20, 50 people, you know, depending on how big you want your group practice to be, your role is going to change significantly. And so, we have to really understand, do I want to be in that role? Where's that cap? And you don't have to have it decided today. But I think you have to be intentionally looking at what's the next step? And how does my role shift as I move into that role? 

And something else I wanted to speak to, Patrick, that you had mentioned, was, you know, as we are thinking about how do I create that culture that I want for my team? You don't have to be the one that comes up with every single great idea. Like, you've got team members to help you ideate and to think futuristically, and to, you know, create this culture together. And I think that we get really stuck in the trap of thinking, "I'm the boss, I'm the leader, I have to think of it all, I have to do it all, I have to be at all." And that's just such a big misconception. And I want you to get out of that rut if you think that you have to know it all, do it all, be it all, come up with every great idea because you will find so many more brilliant ideas when you tap into the collective of your team. 

So, it's okay to ask people, "Hey, what would make our culture better? What would make this a more fun place to work? What would make this a more, you know, exciting place? How would you feel you contributed in a more meaningful way?" It's okay to ask our people these questions, and especially, to say, "I don't have all the answers, that's why I hired you beautiful, brilliant people so that we could create this together."

PATRICK CASALE: Absolutely. And I think that's how you develop quality employees, and staff members, and teammates, and is asking for feedback, and figuring out ways to use the talents that they have because doing one thing over and over and over again, for some people that works. But for a lot of people, you want to use different parts of your brain, you want to put on different hats while you're at work. So, to be a part of, "Hey, help us plan the next team event or retreat. Hey, you're really good at whatever, EHR use. How would you like to be the onboarding clinician for people?" Like, give people opportunities to grow into roles because that's really important. 

And I think what happens to a lot of folks is they feel stagnant or complicit. And they're just like, "This is kind of boring me, I don't really see where this, you know, takes me in the next couple of years." 

And I ask people that in the interview process. Like, "You know, do you have an interest in leadership? Do you have an interest in training? Do you have an interest in A, B, C, D, and E?" 

Because I think, again, going back to hypocrisy, if you see that I have a podcast, and I do retreats, and I have coaching programs, and I have all these things that generate revenue, it'd be really hypocritical for me to not share that with them and say like, there are other possibilities to make money aside from one-on-one therapy, are you interested in doing any of these things? I can help support you along the way. So, I really think it comes back to that. And you're really helping just develop camaraderie, and cohesion, and connection, and it allows for accountability processes to be put in place, too. So, lots of things we could talk about with this.

Another myth and misconception and I think this is a good ending point after we talk about it because we could talk about all this stuff for days it feels like.

ASHLEY COX: For sure.

PATRICK CASALE: I don't do one-on-one coaching anymore. Post-throat surgery, I shut that down. But I have a lot of people who would ask me and still do ask me like, "Hey, I'm getting a lot of referrals. I want to refer in instead of out, I want to start a group practice." I always ask and I think this is paramount, "Do you want to be a leader? Administrator? A boss? Or do you just want to make more money? And if the answer is number two, I do not think group practice ownership is for you. And I really think that if you do say that's the reason you have to have a good leadership team in place if you do not want to be the boss, if you do not want to help develop people, if you do not want to deal with the onboarding. I see that far too often as if it's like this simple thing to say I'd rather just refer in instead of out. 

And I think it really does come back to your why and your values, to really aligning your business practices and your group practice culture with that answer. And it's going to show up. Like, when things get hard, when things are rocky, when there's conflict, like, that's when you have to default to the, "I want to be the leader here, I want to be the boss." And you have to wear that hat at times. So, just really acknowledging it's okay to want to refer in, it's okay to want to make more money. Those are things that are absolutely okay. 

But if you are like, "I don't really want to be a boss" Best thing to consider is, you know, you'll have to find someone to do the interviewing and the onboarding, and who deals with like, any sort of plans of action, or correction, or anything that comes up. So, I really do think that's important to think about as well.

ASHLEY COX: Absolutely. And I think I'll add one thing to that because I agree with everything that you said. I'll also add that at the end of the day, you are still the practice owner, and you may still get those highly escalated situations brought to you because, at the end of the day, the buck stops with you. So, if you don't want to deal with conflict, if you don't want to deal with pay conversations, if you don't want to, you know, handle, you know, interpersonal issues that happen amongst team members or whatever, you know, dream of your worst case scenario, do you see yourself handling that? Do you see yourself wanting to learn how to be more capable of handling those things? 

If you don't, if that scares the bejesus out of you, and you're like, "Oh, hell, no, this is not for me." You probably don't want to lead a team of people because I guarantee you, no matter how wonderful your people are, there will always be points of contention, there will always be conflict, there will always be things that they get upset about. 

And the beauty is, is that you get to choose whether or not you want to be part of that, and part of their growth and their development, and your own growth and development as a leader, as a boss, as somebody who's managing other people. Or you get to say, "No, I think I'm good as a solo practice owner." And all of these options are okay, and they're valid, and they're valuable, and they're so worthy in this world.

PATRICK CASALE: Absolutely. Those are great points. And I think this has been a really cool conversation, especially, for those of you who are questioning this or are just interested in group practice ownership, or a part of a group practice, or in this mental health space because I think a lot of these things are being talked about behind closed doors. And there's a lot of myths to bust. So, I appreciate you coming on and making the time Ashley, and please tell the audience where they can find more of what you've got going on.

ASHLEY COX: Thanks again for having me, Patrick. I really appreciate this conversation. And I'm glad that we were able to bust some myths down and really open up the door to some hard conversations that people kind of shy away from or they don't want to maybe have in a public forum. 

So, you can find me, I always say we're everywhere you go. So, Facebook, Instagram, our website, my email, everything. And we also have a fantastic podcast called The Impact Ripple, which we talk a lot more about these kinds of topics around, you know, hiring and leading your team, growing your practice. And so, I'd welcome you to come over there and tune in for our show as well.

PATRICK CASALE: And we'll have all of that information in the show notes, so all of you have easy access to all of Ashley's information.

To everyone listening to the All Things Private Practice Podcast, new episodes are out every single week on all major platforms and YouTube. Like, download, subscribe, and share. Doubt yourself, do it anyway. See you next week.


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