Building A Practice That Survives Medical Leave with Laurel van der Toorn

We talk with Laurel, an EMDR group practice owner, about the moment a sudden medical crisis forced her away from her practice for five months. We break down the real systems that kept her team supported, her clients cared for, and her finances stable so she could focus on healing. 

Connect with Laurel:

https://www.laureltherapy.net/

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*Intro/outro song credit:
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Transcript

Could Your Practice Run Without You?

SPEAKER_01 0:00

Could your practice survive without you? If something were to happen that took you out for a few months, what would happen to your business? Well, that's exactly what happened to Laurel back in 2024. And today I had a chance to interview her as she was taken away from her practice for five months, and she shares exactly what she learned from that experience and how you can prepare yourself so that if that were to happen to you, your practice could still thrive and grow. My name is Craig, and I'm the owner of Daisy Financial Coaching. Our team is on a mission to make your therapy practice permanently profitable. If you own a solo or group practice, we're here to help you build a business that creates more time, makes more money, and serves more people. This is the Therapy Business Podcast. All right, I have Laurel here. Thank you so much for joining. How are you doing? I'm great. Yeah, I'm glad to have you. Say, I I was we were just chatting about this before, but uh having therapists on here, you know, it's we don't get to do it too too often, but getting a peek behind the curtain, I know it's just relatable. People seeing how other therapists are running their practices. So uh I'm I'm excited to hear hear your story and hear all the the insights you bring in.

SPEAKER_00 1:16

Yeah, great.

SPEAKER_01 1:17

Well, good. Yeah. So let's let's just start with uh tell us a little bit about yourself. Who are you? What's uh what practice do you own? All that.

SPEAKER_00 1:24

Yeah, so I have a little group practice. It's me and three other clinicians. Uh I'm in LA, we're all virtual, and really our thing is virtual EMDR. We do a lot of other stuff too, some like burnout, recovery, couples therapy, but EMDR is our bread and butter. And um, and I I really love it. And I I think I have the best staff ever. So um, and uh, and the reason I'm here today, what I'm gonna talk about, is that I had a really um traumatic experience happen where I had to take emergency medical leave. And don't worry, I've done my own EMDR afterwards. Like, I'm good now, I can talk about this without getting all triggered. But um, that experience really highlighted for me uh how vulnerable a lot of therapists are, how vulnerable a lot of group practices are, because they often hinge on one person being okay. And I actually was very, very fortunate. Somehow I had subconsciously prepared to be away, and the practice continued on without much of a blip, other than my clients needing to see another therapist. So I want everyone listening to feel that they could do the same if they had to.

SPEAKER_01 2:44

Wow. Yeah, I think um you're you're hitting uh the nail on the head with the just the practice hinging on us. And you know, I'm not a therapist, but my business, you know, I've had the same concerns over the past year or two that it just kind of came to light that, you know, if something were to happen to me tomorrow, I don't even know that anybody would know how to get in contact with clients or would know what to do. The revenue source or the income source for my family would be just vanish. Um, so it's something we don't like to think about, but it sounds like we know it's important and it sounds like you were kind of forced into it. Is that right?

SPEAKER_00 3:17

I think I'm just a naturally um like I like to plan ridiculously far ahead. Like I'm already thinking about our summer vacation um like more than a year from now. So I think that that's just how my brain works and wanting to, I did have um a kind of a prolonged illness in my mid-20s. So I had this, and now I'm I'm just turned 40. So I I've always kind of known like, hey, medical issues can happen to any of us, the most healthy, or a lot of what I'm gonna talk about today also applies to a planned leave. Like if you go on parental leave or you want to take a sabbatical or something or something like that. Um so I think that I just kind of had a lot of systems and literal insurance in place that really came in handy.

SPEAKER_01 4:11

That's that's great. Yeah, it's um it's a good test to see how well, how sound everything is going. But I like that you're talking about even those planned leaves, because sometimes I think we feel like we can't leave because we don't uh again, the business just relies on us too heavily. And so uh talk talk to me a little bit more about that. Um the whole the the way you're able to do it or how you set it up. Um, I mean, you know the best launching point. So let us dig into

Laurel’s Five-Month Medical Leave

SPEAKER_01 4:35

it a little bit.

SPEAKER_00 4:35

I I want to share a little about my story first, just because I um storytelling is how we all came to this field. And um so I I I had, you know, my practice was thriving. We were doing you know, I was just really loving it, looking to scale. And then the the short version is in uh November, December of 2024, I developed um an acquired and pretty severe allergy to a common over-the-counter medication that I had been advised to take by a doctor. And weird stuff started happening. My face would swell up, it would be hard to breathe, I would pass out randomly. And that's traumatic and also like very anxiety provoking. And I was very fortunate that one of my early providers identified what was going on. She was like, Oh, this is a medication allergy. Um, but at that point, you know, the avalanche had already started down the mountain, and I um I needed to go on medical leave. And I was out for about five months. Wow. Um, just to get everything under control, get my nervous system regulated again so I could focus and function. All of this was um four months before my wedding, by the way. Oh my goodness. So, like suddenly I can't work, we don't know what's going on. My life is plunged into chaos. You know, I was I was 38. I had to temporarily move back in with my parents, which no one wants to do at 38, you know, especially when you're like a business owner, like doing your own thing. You're very independent. Um, and and that was probably the hardest part was losing my independence. But um, the the happy ending was the wedding happened exactly as we had planned. It was wonderful. Uh, and then I I was able to move back home um after the wedding and didn't have to go back to my parents. And really the hit to my business was pretty minimal for me being out for five months. I think the business lost about $10,000 in emergency savings, which I had saved for something like this.

SPEAKER_01 6:44

Love it.

SPEAKER_00 6:44

And I had to have someone come in and supervise my pre-licensed staff, and then I had to pay them for that. So that's actually most of what the $10,000 hit to the savings was paying for supervision. And um I, as far as you know, personal impact, I also had the right insurance lined up. I had, I was able to get state disability and I had a private disability insurance policy that paid out. So I had zero financial impact to me, despite not working for five months. And then, you know, I think the the things that I worried most about were like, oh gosh, I feel like I'm abandoning my staff. I feel like I'm abandoning my clients. And that is not how they felt at all. I think the most difficult part of any of this was the emotional part. Um, so, but but there are some very concrete, very kind of business-oriented things that I did again, subconsciously, so that enabled me to step out for five months. And I want people listening to know what those were so they can do them now, long before they ever need them.

SPEAKER_01 7:50

Love it. So, yeah, there's just uh that that was gonna be a question and it's ahead of time. You you didn't obviously you didn't know this was gonna happen, but if if I But I knew it could. It could. And so the emergency savings is huge. Yeah, uh, that gives you the peace of mind. Did you I mean, look go looking back in time, did you know, like if I were to ask you before all this happened, hey, can your team handle uh you being gone for five months? Would you have felt confident in that yet? Or is it just they were you wowed by it?

SPEAKER_00 8:17

I I think I probably would have said 75% they can if they have the right supervision. Right. I think that I think it was more guilt than doubt in their ability. They're amazing. They they they don't need me to be good therapists, right? They are their own beings, their own therapists, their own professionals. Um, but uh I and I did, you know, get them hooked up with the right supervisors for their temperaments. They had a great time with their temporary supervisors. Uh, I think it was just um it's very anxiety-provoking to step away.

SPEAKER_01 8:54

Yeah, absolutely. I can't imagine. Well, talk to me a little bit about the the systems that you, I guess, subconsciously had prepped and that we all it sounds like need to have in our businesses as well.

Getting Paid While You Heal

SPEAKER_00 9:07

So probably the the one of the big ones is actually your business structure because that affects how eligible you are for state benefits, right? I received around $20,000 in state disability benefits because I am a W-2 employee of my company. If I were a sole proprietor, I would have been SOL.

SPEAKER_01 9:31

Yeah.

SPEAKER_00 9:31

Right. And so you know the fact that I am a W-2 employee of my company allowed me to collect disability, state short-term disability, which luckily I was very fortunate to be able to access. I had a great team that was able to file a medical team that was able to file the state disability paperwork in a very timely manner. Uh, and then I also, a couple years prior, had taken out a private um long-term disability insurance policy. Uh, on an offhand comment, a friend of mine from college made. Um, this friend, her mom had a stroke a month after she graduated college. And she was like, Yep, everyone needs a long-term disability policy. And so I was like, Oh, yeah, you know, that's really good advice. So I had taken one out, and this was a nice supplement to the state disability that I received. So, you know, the last thing you need to be worrying about when you're not well is money. Yes. And of course, I can't say I didn't worry about money. Of course I worried about money, but I worried a lot less about money because I had those options. So business structure enabled me to access state benefits. And then also having taken out a private long-term disability policy a couple of years prior, um, they're they're really not that expensive. And I'll I'll plug here. Um, I had a fabulous experience with Northwestern Mutual. They don't pay me to say that. I just I felt very respected and like believed, which the system is built to reduce fraud. So of course, there's a process, there's lots of paperwork, but it was never like, well, we don't think you really need to be on disability. It was, it was a very positive experience. And um, so those are kind of the two most concrete things is like look at your business structure. And if you are a sole proprietor, maybe talk to someone about whether it makes sense, particularly if you are planning to have kids and you live in a state where um there is a state um parental leave program, you might want to a year a couple of years ahead of time restructure your business so that you can get those state benefits. Whereas if you're just a sole proprietor, you cannot.

SPEAKER_01 11:49

All right. So business structure is important. What what's what's some other things we need to consider?

SPEAKER_00 11:54

I mean, health insurance, right? That's not a given. Um, if you can offer health insurance through your company, um I believe that all you need is two non-spouse full-time employees. And I, you know, when I was getting benefits for my company, I did find a plan they were willing to provide benefits to employees that work 20 hours a week or more. Because not all therapists work 40 hours a week. I hope therapists don't work 48 hours a week, and some don't even work 30. So um, that's usually 30 is the cutoff point, but if you can negotiate and get a health insurance that covers um 20 hours a week. You know, that way you have an employee that sees 20, 22, 25. But then if they have cancellations or go on vacation, you're not running into any problems there. Um, you can also get a critical illness insurance. That would be for like um a heart attack or a stroke or something really major. Um, and that's usually just like a lump sum payout, and that's also very inexpensive to get.

SPEAKER_01 12:58

Good. That's great to know. Yeah. So health insurance is important. And again, I mean, if if you're getting it through the company for your team, that's just more benefits to attract you know, better uh team members potentially, or even just keeping uh clinicians or therapists on your team for longer if you offer those types of things. Uh, I know a lot of that can be enticing. So that's good to know also for ourselves as well as the owners.

SPEAKER_00 13:19

Yeah. Then the other piece is financial planning for this. I mean, I have always saved a certain amount per month in my practice, even it was just me. You know, I was like, well, either I'm gonna need this someday if I have a slow month, or I take a, you know, like I'm going on my honeymoon for a month and the practice won't have my income for a month. Um I that, you know, emergency savings, like that's not negotiable. And if you don't have a lot that you can put into emergency savings every month, still put something, like keep it rolling and automate it. But I actually think there are five bank accounts that all practices need, or especially group practices. And so you've got your checking account, that's where the bills are paid from, but you also have your um emergency fund, you have your

Building Emergency Funds And Bank Buckets

SPEAKER_00 14:10

sick pay savings, which is different than the emergency fund. So sick pay is um in California, we're required to offer sick pay to employees. So if, you know, let's say I have an employee who takes the afternoon off because she has a migraine and she takes sick time, it just comes out of that account. And I don't have to worry about it coming from checking um a vacation fund, but that would that would be more of a personal account for you so that you're, you know, because often as therapists, particularly sole proprietors, um, we don't get paid when we take vacation. So it kind of feels like a double whammy because there's the expense of going on vacation and the expense of not earning. And then you want to have your um your tax savings account. Um, if you're a sole proprietor, you know you're making those quarterly estimated payments. And if you're an S-corp, you never know if you're gonna have a bill. So you want to have money just in case. And then, hey, if you don't have a bill, you can reinvest that money back into the company, into new marketing effort. Maybe you need a website refresh. Maybe you want to hire a VA or something that you have that um kind of flexed as long as you don't have that tax bill. So um those those are the five essential bank accounts that I I recommend. Just so you know money is earmarked for certain things. Every dollar has a job and it's not all in one slush fund that you're hoping works out.

SPEAKER_01 15:32

Yes. Uh yeah, I'm I'm a big fan of that too. The dividing up and and just getting that clarity uh when you when you're looking at your accounts, and then money is um, you know, divide it up to where it's you don't feel like you have just one large lump sum of cash and are hoping that when the tax bill comes you have enough still, or yeah, one thing.

SPEAKER_00 15:49

You want to know you have enough.

SPEAKER_01 15:50

Yes, yeah. So perfect. And so emergency fund-wise, even before your medical emergency, did you have a set amount that you were aiming for, or did you do you just approach it the way of I'm just gonna save, keep saving a little bit and just let it grow and grow and grow?

SPEAKER_00 16:05

Yeah, just let it grow and grow and grow because maybe someday I do want to invest in a big project, or I I am actually going on my honeymoon at the end of this year, and like I I know I won't be there. So um I just have I think it's right now I have eleven hundred dollars every month that it just goes in there, and to me, it doesn't exist until there's an emergency. It just stays there, right? And similarly for tax savings and sick pay, I just have an automated transfer from the checking account to those accounts and it it just does what it needs to do. And that way, if if there is an emergency, if someone needs to step out, um, you know, I I um I anticipate at some point I'll have an employee that goes on parental leave. Um, that there's just a buffer so I don't lose sleep over is the practice going to be able to withstand this. You want to know it will.

SPEAKER_01 16:56

Yes, that's that's great. And for those who are not planners, you know, like myself, you talked about how you plan really far in advance. I tend to just wait till the last second. Um, I have a friend, we go on a we do a group trip to the beach every every summer, and she is a a planner months and months in advance. And I think I drive her crazy because it's she's trying to figure out dinner, and I'm like, well, just figure it out and like get there. It's fine. Yeah, um, but for those who are like that, is I love the the automating piece is is valuable in that you know that's just something we could do today. There's no yes, even if you just do a tiny little bit like you were talking about getting 200 bucks.

SPEAKER_00 17:29

Start with 200 bucks, yeah, a year a month. Perfect, and and just truly automate it because all the research says we're pretty bad at following through on something we say we're gonna do over months and years. And if it is automated and it actually is like you would have to go in and interrupt the automation, like you're much more likely to be in a good financial place if you don't have to think about it, if you don't have to take action.

SPEAKER_01 17:59

Yes, that's that's great. And yeah, and you won't catch yourself going in and then being like, Well, but I'd rather have that 200, like you know, deciding not to move it over. Um, it's just it's just happening, and then before you know it, uh that's building up. So that yeah, that's fantastic. Um, all right, so that that financial piece is is super, super important. Um, and any other things that you had you had to set up, whether on the finance side or or another system or yeah, yeah, uh everything had been set up, but I mean, we all know we're supposed to have a professional will, right?

SPEAKER_00 18:29

We but uh evidence says only 32% of therapists have a professional will. I personally know three people who found out their therapist had died by Googling. Oh wow, that's not good if you think about your clients who presumably care for you, are you know invested in the relationship with you and you know, vulnerable with you, and then they find out you die from the internet when you don't show up to a session. And this is three people who don't know each other and we're not seeing the same therapist. So kind of alarmingly common, right? And we have some research on this. There was a beautiful New York Times piece uh

Professional Wills And Trusted Executors

SPEAKER_00 19:18

about a year ago called The Ghost in the Therapy Room. And it's about um, it's about this, you know, clients that didn't know their therapist had died. Uh, and they felt newly distrustful of therapy. They were questioning the relationship. They were like, well, is therapy real? Like what I didn't even know my therapist was sick, or and they just felt totally abandoned and also like they couldn't go to a new therapist because the same thing might happen. Now, we're not talking about preparing for our own imminent deaths today, but the reality is something can happen to any of us at any moment. We could get hit by a bus. So all of us need to have that professional will. And you can find templates online. I'm sure that there's there's someone out there selling therapy, therapist uh professional will templates. It doesn't take very long to put together. It really doesn't. It's more of an emotionally daunting task. And then you have to identify two people that you would want to be the executors. Now, I did not have to enact my professional will. Luckily, I was able to get supervision set up for my employees and transfer my clients myself warmly over the phone, um, and to tell my clients what was going on with me, or as much as I knew was going on at the time. Um, but I took a lot of comfort in knowing it was there in case I needed to be hospitalized suddenly or something like that. So um having it there is honestly a lot more for your peace of mind and a standard of care for your clients. So I would say once you know who your executors are, it's gonna take max two hours to do this thing that will absolutely do right by your clients and provide you peace of mind.

SPEAKER_01 21:07

Yeah, that that's that's powerful. And with the executors, could do they have to be part of the company? Could it just be anybody? Can it be family, friends?

SPEAKER_00 21:15

No, if it is gonna be someone in your company, it needs to be someone you really trust. And it also would need to be a licensed provider because you're talking about them uh contacting your clients on your behalf and figuring out what's gonna happen to your caseload and to supervision of your pre-licensed employees, even some you know, financial management of the company, potentially. So um I uh I think that particularly if you have a large group practice, you actually should probably be talking more to a business estate attorney. If you're sole proprietor of a small company, you can do just fine doing a professional will. Um, but I I did uh talk. To a friend recently who has a decently large practice, and she was like, Yeah, we had to go through a whole basically a trust process um and identify who would be the the trustees and the um executors there. At least one of them absolutely needs to be a therapist. It helps if both your primary and your secondary executors are licensed therapists.

SPEAKER_01 22:23

That that's good to know. Yeah, that's I I know you're talking about the the difference between taking a leave and then also this is like the permanent leave that we don't want to think about. Um, but that's going back to kind of what we talked about uh earlier was if I if I were to die today, you know, it's it's those pieces of who's gonna go into my business and know who knows how to shut off auto billing and all those things uh that you know not only notifying clients but getting it to not charge their cards and totally and who has passwords to the accounts and access to your phone and your email, those things.

SPEAKER_00 22:59

So, and you know, we're not even talking about worst-case scenario here. We're not talking just about if someone dies, there's a clause in any good professional will for if you're incapacitated, meaning if you're in the hospital or you know, something like that, that you you can't work, but you want the business to continue, that they can kind of come in and they have there, it's very clear like when the professional will applies. And uh I was never hospitalized, therefore the professional will never activated. But I was like, but if I was in the hospital, it would have activated, and then I would have had the peace of mind in knowing that these two trusted people are in charge and they have access to everything they need access to.

SPEAKER_01 23:40

That's fantastic.

SPEAKER_00 23:41

Okay, so it's not only just for the death piece, but just yeah, if you're yeah, if you're really, really sick, or let's say you have a really uh complicated um pregnancy or complicated delivery, or or you need to there's so many circumstances under which it could activate, and you very much have a good prognosis and you will return. There's just needs to be this interim coverage.

SPEAKER_01 24:07

Yeah, absolutely. Okay, that's great sound advice. So uh doing the will, like you said, it doesn't take long once you identify those executors. So I think that's um probably a great quick small step action that people can do is get at least get that ball moving.

SPEAKER_00 24:23

Yeah, certainly less daunting than reconfiguring your business structure, I can tell you, is is writing that professional will.

SPEAKER_01 24:31

Yes, 100%. Okay, perfect, perfect. Um, anything else that you you had set up or that again subconsciously ready to go?

SPEAKER_00 24:40

I had uh written and cued all of our blogs and like marketing stuff for six months. I had done that before I was out for five months. So everything, and I have someone else that does social media, so everyone, everything was able to just carry on. And then I came back and I had to scramble and put together the next six months of blogs. But if you want to schedule stuff way out, then you know there isn't gonna be an interruption to your marketing efforts because it's also automated.

SPEAKER_01 25:09

Yes. So the people who are not your clients yet probably don't even know that you're gone because you know they're still seeing those blog posts or those YouTube videos or the emails coming out, um and just they just assume things are still trucking.

SPEAKER_00 25:23

Well, and I I would hate for my absence and me not engaging in marketing to mean that my team

Keeping Marketing And Referrals Moving

SPEAKER_00 25:29

gets fewer clients, right?

SPEAKER_01 25:31

And that was a concern I'm sure a lot of people have is if they step out, they're like, I'm the one who's who's generating leads and um maybe even the sales process and so uh all of that. So it sounds like with that marketing, um, and and you are a planner because that's that's awesome that you have six months in advance.

SPEAKER_00 25:47

It's like I'm it's a little extreme. I recognize maybe we do three months.

SPEAKER_01 25:52

I was like, I'm I struggle to get six weeks of it scheduled out. Um, but I used to do better. I would sit down and do the quarter, and so three months worth of of content I'd have batched out. Uh, but all that to say, um, having that stuff prepped can ease that that huge fear of what if business dries up while I'm gone, and then I come back and we're not getting any any new clients.

SPEAKER_00 26:13

Yeah, yeah. Well, and let me also speak to that because I had heard that any therapist that goes on a medical leave or parental leave, they come back and only half their clients come back. Now, obviously, it's gonna really depend on how long you're out, if it was planned and you kind of were able to wrap up with some clients beforehand. And um, all but two of my clients came back.

SPEAKER_01 26:35

Oh, great.

SPEAKER_00 26:36

And I was out for five months, right? So um it it really varies by clinician, by specialty, and you know, how you kind of frame it, but there was not as much disruption to my personal, you know, what I was bringing into the practice. Um, my long-term disability policy has a rider for income loss on it, which means like even when I'm ready to work, the clients aren't there because I was out, and that the in the disability insurance covered the difference, but I was only eligible for with for it for one month. Because you're never like I'm back in, I'm back in and I'm seeing just as many clients as I was before. Yeah. That's but that may not be typical, but it was better than I expected.

SPEAKER_01 27:20

That's yeah, that's unexpected for sure. And that's a testament just to the relationship you've developed. And so while you were out, did your team meet with your clients? Uh were they just yeah, just go without for five months and then jump back in?

SPEAKER_00 27:33

So legally and ethically, therapists are required to provide three referrals if they are discontinuing services for any reason. So I did, I provided three referrals, unless um there were some people that I could not find three referrals. I'm licensed in six different states, but I only really have connections in California. So I was like, I don't know anyone in Michigan. I'm so sorry. Um, here are some places you could look. Here, you know, here's a directory that is, you know, an EMDR specialty directory. Um, and uh, you know, I did the best I could. We we can only do the best we can. Um, and I would say I think five of my clients did opt to see someone uh while I was out, um, a couple of colleagues. Um, none of them saw my staff. I think my staff was either full or there was a conflict of interest or they weren't licensed in the right state or something. So um, but yeah, about five of my clients and and one of them actually liked her interim therapist so much she stayed with her. And I'm like, you know what? That's a win. That's a win. That's right. If I referred you to someone that you loved, then hey, good on me.

SPEAKER_01 28:49

Yes, there's the good referral source right there. Yeah, yeah. Um, so I mean, and I agree with you, the bigger picture is if she found someone, not that you guys didn't have a connection, but if clearly they found somebody who they really are clicking with and probably getting a deeper level of support, which is a huge win. Uh just in scheme of things.

SPEAKER_00 29:06

And had advanced training in a particular issue. I did not.

SPEAKER_01 29:09

Yeah.

SPEAKER_00 29:10

And great. Yeah.

SPEAKER_01 29:11

100%. Yeah. We've I've had clients before who um have gone to work with other coaches and to work on their finances and had huge success. And you know, there's there's sometimes it's just you don't even it's just there, it's just the right time, right person, right place. So I think that's a huge win. Uh what matters most is they get that level of support they need. So perfect. Okay, so the client base um coming back, that's that's a huge set a sign of relief. Yeah. Um yeah. Uh tell me tell me more. I'm curious of what else.

SPEAKER_00 29:42

Yeah, I think that um the the the last piece I'll speak to is that therapists are never really sure how much to share um with clients when they need to take a break. Now, let's say you need a burnout break. You may not want to share that with clients because then they're gonna be worried, they'll feel like they need to take care of you. Like, oh, well, was I too much? Like that one I would probably not share. But you know, let's say you're having uh surgery on your foot, I probably would share that.

unknown 30:16

Yeah.

SPEAKER_00 30:17

I'm gonna be out for a few weeks, I'm having surgery on my foot, prognosis is great. I'll see you in a month, you know. That that one, it if you can provide reassurance, absolutely give it. Um, be sure

What To Tell Clients And When

SPEAKER_00 30:31

to, if you're not gonna give much detail, but your condition is not life-threatening, please share that. Because we didn't know exactly what was going on, but we knew I probably wasn't gonna die. So I was able to tell my clients, like, hey, I'm I need to go on medical leave. We're figuring out what it is, it's not life-threatening. I will let you know when I'm coming back. And they were just like, oh, thank God it's not life-threatening. Because everyone goes to kind of a worst-case scenario. And am I gonna lose my therapist? So you know, therapists are all gonna have different um thoughts on how much self-disclosure they want to give. I would say give reassurance if you can. And, you know, whatever your kind of primary modality is, but then also think about what it would be like to be in their shoes and hearing, like, oh, I'm gonna be gone for three months. Okay. Um, you know, if it's a parental leave, they're like, oh yeah, I know what that is. That's fine. Like, I'm not anxious about it. Maybe they're anxious about not having therapy with you for a few months, but they're not anxious about your health and well-being. Um, and the other thing to consider is how fortified do you feel in handling their feelings about your leave? I probably could have done a better job with this when I came back from medical leave processing how my clients felt about me being gone. But I was just back on my feet and I finally felt like my nervous system was able to see clients, but I didn't want to talk about the fact that I'd been gone, which I really should have. Um, so I did it imperfectly, but I also knew that I wasn't quite ready to hold whatever they were feeling about it. Um, so you know, what we we call it a practice, not a perfect. So um, but yeah, consider how much you are able to hold their thoughts and feelings and reactions to your health issue when thinking about how much to share with them about why you are going on leave or were on leave.

SPEAKER_01 32:28

Yeah, that that's that's really insightful. And so uh I know you said that's kind of something maybe, and it sounds like you, it's not you we're not even sure if you would have approached that differently when you got to it. It's just um it's just now you're kind of aware of it, maybe holding space for their their feelings on that. Is there anything looking back over the last couple of years that you would do differently or that maybe you're set up differently so that if this were to happen again that you weren't for this first go around?

SPEAKER_00 32:52

Yeah. Um, I what would I do differently? I mean, I feel like I I kind of crushed it.

SPEAKER_01 32:59

Yeah, but it sounds like you crushed it.

SPEAKER_00 33:02

Um I'm processing with clients, my absence earlier. I mean, with most of them, there there came a time to process it, that it came up thematically and we were able to go back and do it. Um, I think I would have just been a little gentler and nicer to myself because the fact that I was so anxious and so worried did delay my healing.

SPEAKER_01 33:23

Yeah.

SPEAKER_00 33:23

You know, that like psycho-neuroimmunology thing is real. And the fact that I was so worried about the practice deteriorating meant that the energy wasn't going into the healing.

SPEAKER_01 33:36

Yeah.

SPEAKER_00 33:37

Um, so if you have these things set up, if you've got all the insurance and the business structure and the professional will and the trusted team and the executors and the plan and the marketing is automated, just focus on your healing. That's it.

SPEAKER_01 33:53

Yes. So I mean, you didn't really know fully that you were crushing it until you know you got to the end of it and back into business. And so uh now that you know you're sharing, here's what I did to crush it. And if I if I would have known then, so even now it sounds like if this were to happen again, you'd go in probably with even more peace of mind, knowing, okay, um, it was no big deal to first go around and here's why. So yeah, I love that. I love that. Um any action steps that you think listeners should do, whether that's getting in touch with you or whether that's doing uh implementing something, uh, what would you say is is a good first step?

SPEAKER_00 34:29

I am um I'm really happy to um work with people if they want like someone to hold their hand for like getting their practice ready for a parental leave. And you know, of course, there's no substitute for like consulting with legal professionals and like insurance specialists in your particular state, but I'm really happy to do that kind of like leave prep coaching. Um, but I have a quick checklist of six things, it's only six things. Love it. I mean, I'm sure there's a lot of bullets under each thing. So the one is like establish care with a PCP or specialist, like you need to have that medical professional that you can go to when you start to not feel right or something happens because that's the person that you want to have a relationship with. In California, they actually need to technically

The Six-Step Leave-Prep Plan

SPEAKER_00 35:18

need to see a provider within eight days of the start of a disability. Wow. So if I didn't, which like who can get an appointment within eight days? That's crazy. No, but if you can, you know. Um, so establish care, then consider your business structure, right? If you know you're having kids in two years, now's the time to restructure so you become a W-2 employee. I'm not quite sure how long you need to be an employee. Um one thing that I didn't mention that it is actually an option to pay into state disability as a sole proprietor, but it's about nine percent of your income, which is pretty high. You might just save that nine percent, right? Yes, which is also an option. If you decide you're not gonna restructure, you you can you can just save a lot of money that would protect you. Okay, so consider your business structure, get insurance coverage. So all the insurances we talked about, health insurance, disability insurance, like all of you know, all of those. Um, create and finalize your professional will or your professional trust. Um, build your essential accounts, those five bank accounts we talked about, and then nurture your professional network. You want to be able to have those three good referrals if you need to refer out, or people that could be an executor or someone that could come in and supervise your staff in your absence. And you want to have all those names in one place so that you could you when you're not feeling well and you're stressed and you're anxious, you're freaking out. Oh my God, I need to go on medical leave. You don't need to be like figuring out who you know. You need a document that has who you know in it. And then you can look down and be like, oh yep, Carrie, that's the one I'm gonna ask her to supervise. Right. Um, so those are really the six steps.

SPEAKER_01 37:06

Love that. And with that last one, uh, you know, question came to mind is uh did you have or do you I guess did you have ways or training or a way to document um again, going back to here's how you cancel some for for me, it's how you cancel somebody's recurring payments or how you um do X, Y, and Z on the logistic side.

SPEAKER_00 37:28

Yeah. Yeah. I so I had created an internal website that only my employees can access, and then I gave the people that came in to help cover for me access to it. And it had a lot of our systems and processes on there. Um, I uh into our consultation calls were being handled by staff already. So I just took myself off that schedule. Yep. And so there wasn't an interruption there. Um, I the only thing I did, the only thing I did the first four months I was out was log in every two weeks to run payroll. That was the one thing I didn't hand over because I was like, it takes me all of five minutes. I can do that. No matter how addled my brain is from this crazy allergy reaction, I can click around and run payroll. Um, but you know, there absolutely would be a way to deputize someone to run payroll. Um, and that should be in the professional will.

SPEAKER_01 38:25

Yeah, that's great. That's great. You know, and I'd heard somebody recommend, and I I've done it for a lot of our stuff. I probably need to go back and reorganize it and do it for more. But it's just when you go do some of these mundane tasks, just doing a screen record um when appropriate, when you're not, you know, on a screen that has you know sensitive information. Yes, yeah. Uh, but if you if it is um even just something on your CRM or your you know any kind of process, it's just hitting record, and while you're doing the thing you're doing, now you have documentation of how to do it. So if somebody needed to jump in and do it for you, they can then just watch that.

SPEAKER_00 38:59

Absolutely. And part of building the professional will, honestly, the most time-consuming part of the professional will, which again only takes two hours, is a list of passwords and logins to anything they would need. And now they're only instructed to open that document of passwords. And I just I snail mail it. That's the only way because I I don't want it being frowned. Um, but uh you know, they they do need to be able to access your systems, but these are trusted people that would never unless something had happened.

SPEAKER_01 39:32

Yes, 100%. Love it. Well, these are great insights. Um, Laura, it's been it's been so much fun just chatting with you. I'll link to your uh so people can get connected with you because I do think um having that uh unbiased third party just guide you through the process. Um, who you have nothing to gain from which insurance providers they do or which you know lawyers they use, it's really just a uh helping them with the process part, which to me is the biggest barrier for most of us is the actual getting started, taking that next step and doing all these things on that checklist uh to make sure it's getting done.

SPEAKER_00 40:06

I mean, this is something that you could knock out in one or two hours a week over the next few months.

SPEAKER_01 40:12

Yeah.

SPEAKER_00 40:12

So again, if you know you're gonna go on parental leave, if you're just wanting to plan for the future, if you have an aging parent also, like let's just like get some of these things going. Don't do it all this week. Like one of those six steps, focus on one at a time and take it from there.

SPEAKER_01 40:28

Love it. Well, thank you so much. Uh, it's been such a pleasure chatting with you and hearing your story and your insights on this. I know it's gonna be uh really, really helpful for for everyone, but I'm I'm certain there's somebody out there listening to this who's like, this has been on my mind and I'm committing to it. So thank you very much for being here.

SPEAKER_00 40:46

I'm I'm just wanting as many therapists as possible to think about this and to take steps so that if something happens, they're okay.

SPEAKER_01 40:55

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