The Private Practice Success Podcast

9: Dealing with the Stress of Running a Business

• Gerda Muller • Episode 9

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Join Gerda as she shares her personal experiences and insights on dealing with the stress of private practice. Discover how to build resilience and create a support system that empowers you to thrive in your role as a practice owner. Whether you're a solo practitioner or managing a team, this episode provides valuable guidance to help you navigate the complexities of business ownership with confidence.

What You'll Learn:

  • Common stressors in private practice and how to manage them.
  • Strategies for maintaining emotional regulation amidst business challenges.
  • How to build a support system for sustained success and well-being as a business owner.

Who This Episode Is For:

  • Private practice owners feeling overwhelmed by daily challenges.
  • Allied health professionals seeking strategies to manage business stress.
  • Business owners aiming to improve their emotional regulation and decision-making skills.

Connect with Private Practice Success & Gerda here:

 Hello there, amazing private practice owner. My name is Gerda Muller and you are listening to the Private Practice Success Podcast. And this is episode number nine.

The topic of today's episode is all about Dealing with the Stress of being an allied health private practice business owner. This topic was prompted by a lovely message that I got from a group private practice owner very recently. And she sent me this message on Facebook, and it basically said:

“Gerda, can you please give me any input you have to help me deal with the roller coaster that is this thing of trying to run my practice, because there is always something going on, and it seems like there's always something going wrong.”

So, reflect on whether this is the case for you. Some of the things that people tell me that often go wrong in their practice are cash flow difficulties, recruitment difficulties, client referral difficulties, dealing with team expectations, setting boundaries, customer service - and the list goes on and on.

Now, for this particular person, she mentioned that it feels like she's just in a constant state of stress, and is finding it really hard to step out of that. And I think a lot of us can probably relate to that. 

I know if I think back to my journey and my process, and all the years of being a private practice owner - where I was still boots on the ground, being the one having to manage all these fires as they pop up, and deal with all these very often unexpected operational crises - my experience of it was almost being triggered into dysregulation. Where something bad would happen, and I would have a really strong emotional reaction to it, and I would have to work really hard at managing that - at learning to park that - so that I can still deal with all the other stuff that I have to deal with, and also still be a psychologist, because for a long time whilst managing my practice I still had to see clients.

And if you’ve gotten bad news, you need to be able to park that - from a business perspective so that you can walk into the next session, and be an amazing psychologist, and forget about this business issue that has just arisen, so that you can be there fully - 100 percent mindfully there for the client.  So, I guess to some extent, it helps being a psychologist. I think I'm really good at compartmentalizing and doing that because my client work is so important. And I do think it has helped me, but I had to learn initially how to do that very consciously. 

When Making the Right Call has Challenging Consequences

So what are some of the things that have happened to me? I want to share that with you so that you maybe feel a bit less, “Oh, it's only me,” or, “When these things happen, it means I'm a failure.” These things happen. 

An event that clearly stands out in my memory is when I had to give my first ever written warning to a team member. And this was an administrative team member at the time. I'm not going to say a specific title, but it was an administrative team member. This person had made a significant error that had led to quite a big financial loss, and that impacted cashflow severely. So, I did my research, I got some advice, wrote up a formal written warning, had a meeting with this person. And of course, she totally lost it with me.

Long story short, she quit on the spot. She said, “I'm leaving, I'm resigning. This is not fair.” She stormed out of my office, slammed the door, went to the front desk - I could hear it was very noisy as she was packing up. I just literally stayed in my seat where I was the whole time. I didn't follow her out. Didn't do anything. Don't ask me why, but I think it was the right decision. So she packed up - and I will say that there were no clients at the time, so I was very clever - I did it during what would normally be lunchtime when I knew that there would be no clients there. 

She got all her stuff and then she walked back, came back into the room, and threw the keys at me. She turned around and as she turned around, she said, “You'll be hearing from Fair Work, because I will be reporting you.” And that was the trigger where you go - Oh my goodness, what does this mean? Have I done something wrong?

And immediately you start to question yourself. And then this threat hangs over you, especially if you've never been in trouble with Fair Work before and you've never had that experience. You don't know what's going to happen. And that was a really difficult day for me, but I knew I made the right decision. I knew I had to give this person a warning. They decided to resign - that's okay. They did end up reporting me to Fair Work. Long story short, Fair Work called me, and had an initial discussion. I told them what happened. They went back to that person because they told me that they are going back to them. And they told them that they are recommending they withdraw their report or their case because it was a frivolous complaint. 

And that was Fair Work's word, and I'm sure it's the first time I ever heard the word frivolous. It's an amazing word, and I've used it often in the future. And she withdrew her case and nothing came of it because I didn't do the wrong thing. But it's still stressful going through it. And even this year I've worked with people that had, for example, made team members redundant.

And again, there's those threats like, “You can't do this, and I'm going to report you and you're going to hear from my lawyer.” And that's so hard. And I totally get that it is not nice for the person that gets a written warning or who is being made redundant. But I also know that when practice owners do these things, a lot of thought has gone into it. And the majority of people I work with, have consulted HR providers, have even called Fair Work to make sure that they're doing the right thing, that they're following the right processes. They talk it through with me so that I can help and guide them from my experience. And still people take things in a bad way, which they can, and which is generally to be expected because they are humans, right?

And that's why when people react in these ways, I try to remind myself always that they are human, and very often when they do things where I go, “How can you do that?” I also have to remind myself that other people's values are very different from mine. And a lot of times when people feel that they got hurt, they become very combative. And when that happens, again, it's very easy for us as the business owner to be triggered into some state or level of dysregulation. And when this happens, it is so important to be mindful of  it, and to become conscious of it so that you can consciously step out of it because you can't deal with those types of issues when you are in dysregulation.

The most important piece of advice I can tell you if you ever need to reply to somebody, or to a third party like Work Cover, when stuff like this happens, is to never do it on a knee-jerk reaction. To always sleep on it. Always wait at least 24 hours. Even though you so desperately want to respond so that you can get that wave of anxiety under control. Never do it. And always read through everything going - How do I take the emotion out of this sentence? How do I take the emotion out of the next sentence? How do I not sound defensive? How do I stick to the facts?

Because the one thing I can tell you is the facts are always on your side, and the facts don't lie, right? And that's what you need to do at all times. 

Reaching Breaking Point

Another example that stands out in my mind of when I was triggered into such a state of dysregulation, was on a Friday afternoon, quarter to five - I got an email from my landlord giving me four weeks’ notice to move out. They had sold the building, and the new people wanted to have the place in four weeks’ time. Like how? How do they give people notice at quarter to five on a Friday. It should be freaking illegal. I clearly remember getting that, and I actually walked out of the house, my kids were still relatively young, and I sat on the driveway and I started crying, because I just went, “I can't do this.”

And of course, this was in the context of already being an overwhelmed practice owner. Already trying to juggle so many things, being there for the admin team, for clinicians, being there for my family - just juggling all the things. It was such a moment of overwhelm. But you know what? You do what you need to do. I contacted the landlord, and I actually managed to negotiate an extra two weeks, so I had six weeks’ notice, and I found an amazing new place, which was so cool. So, it turned out well. 

Shake It Off

And what a lot of these experiences have taught me is that I am very resourceful and that I can problem solve most things.

I can't problem solve everything by myself. That I also learned. Like, why would you not speak to somebody else that can help. Whether that's a business owner, like a colleague, a fellow practice owner that understands your situation. Your hubby, your wife, your partner, your accountant, your business coach and mentor, a local real estate agent? Speak to other people that could have the knowledge, the skills, and or experience to help you with that specific issue.

And in time, I have developed this underlying belief that I can problem-solve anything. I know I can - not necessarily by myself, but I can get there. That everything has some level of solution and that there is always an option. Doesn't mean I'm going to like the solution or the options that I have, but they're going to be there.

And then it becomes about how I'm going to manage those things. And that has really helped as well. So needless to say, these days when things happen - I’m not immune to being triggered into a state of dysregulation. It most certainly still happens - but I'm much more adept at stepping out of it, and I stay within that state of dysregulation for a much shorter time period.  Where sometimes initially when these things used to happen - I'm talking back in, 2008, 2009, 2010, when I was just starting to run my group private practice - I would be thrown for days at a time, something would happen and I would be thrown - always be there in the back of my mind, following me around everywhere.

Now I can, to use Taylor Swift's words, “Shake it off”, like in a manner of 30 minutes, and it's done. And I know what to do, and I know how to deal with it and handle it. So I can tell you, you will get there.  I don't know, is this the good news or the bad news? The more these things happen, the easier it becomes to navigate it.

And a lot of people get, for example, really stressed when they get their first bad or negative Google review. And I just go - well done. Big congratulations, that's a rite of passage. I've had many negative Google reviews on my private practice. And now you're probably going to want to go and look at what bad things they have to say.

But you know what it tells me? It tells me that we are reaching a lot of people. Because the more people you try and help, the more people are not going to be happy with, for example: your policies that you have at your practice - even though you've told them about it beforehand and they signed on the dotted line. When it doesn't suit them anymore, they're going to do a negative Google review.

That just happens. But it tells me that what we do matters. And that there's a lot of people that we are impacting. And I can tell you, once you've had your first negative Google review. Second one – okay, there it is again. Now we have a process for dealing with it. We've got a process for dealing with the actual complaint. With dealing with potential clients - If it's a current client, we know how to respond. Everything is systemised and now it's easy. 

So there is always good news when bad things happen in business in that you actually learn how to deal with it. How to make it easier next time. And that, you know what, it's not going to bury your business. Things would need to be really bad for it to bury your business. 

Three Must-Haves

So another thing that I also had to realise is that business is full of challenges. It just is what it is, but that's also why you have to be responsible by making sure that you are surrounded by people that can support you.

So coming back to the initial message I got that triggered this topic of discussion because I went... You know I'm sure a lot of people are struggling with this because I know I've been there.  My response to this person was as follows because I really like to give people a thoughtful, but thorough response and I said: “If you as a business owner want to deal with stress, right? There's three things that you need to make sure that you've got covered.” And then I will add a fourth thing as well by the end - which I didn't tell that person - but I'm going to add that here for you guys because I can, and I'm thinking of it now. 

Number 1: Have a Plan

So the first thing is you need to have a plan, okay.

Having a plan gives you a sense of control. And having a sense of control really helps to lower that stress levels and anxiety - because you have a plan. I'm not talking about a 20-page business plan, okay. I'm just talking about at the very least, “What do I want to do for the next 12 months?”

Yes, a lot of people are going to tell you, no - you need to think big. You need to think 10 years, five years, three years. Yes. Those things are lovely, okay, and wonderful.  But when you're feeling stressed and overwhelmed, you want to at least see the future 12 months ahead. So you want to have a bit of a plan. In terms of where do I want to be in 12 months’ time? What is that going to look like? How do I know when I'm going to get there? 

And then once you know that, then you want to ask yourself, “What is the right next thing? Just one right next thing that I need to implement, that's going to get me one step closer to the 12-month goal that I have within my business.” So, the plan, and then the plan leads to this one thing that I need to do.

Number 2: Clarity around the Right Next Step

And then the second thing that you need, of course, is the tools and the resources to implement that plan. Now that could be systems. It can be policies. It can be resources such as HR resources, like team members. Like what do you need to implement that? Is it job descriptions? Is it contracts to take on contractors in your practice? Is it a marketing plan that sets out all the strategies and tactics of how you're going to do your marketing?

You need the tools and the resources to implement your plan. And I find that a lot of practice owners are actually good at making the plan. They're even good at sourcing the tools and the resources that they go, “Where can I buy this? Where can I buy that? Where can I get this thing from? Okay, now I've got all the things - or maybe I can do a short course here, and a short course there. That's going to give me all this knowledge, or I'm going to ask questions in a Facebook group. I'm going to hear from people what they would do to take that step. And I'm going to do that.” 

People are very resourceful in finding things they need, but where they often fall down is with the third step.

Number 3: Implementation

And this is where implementation happens. I think as helping professionals, we always need to do CPD: Continuing Professional Development. We are always in learning mode. We are like these learning sponges that just want to go to the next workshop and learn the next thing. And it makes you feel really good because now you've got more tools to help your clients.

But we also start to do that as business owners and practice owners, we want to do this course and that course and learn all these things. And sometimes we buy things and we don't even do the learning. We just buy it and just sit there in our emails. No judgment. It happens to all of us, has happened to me. But the problem is that you probably need the most help with the third thing.

And that is during implementation. When you're actually taking the stuff you've learned - and you're going - Alright, let's do this shit. Let's implement. Let's take on board these new contractors. Let's roll out these new fixed term contracts for our contractors that are currently on percentage contracts. Let's change this policy. Let's implement pre billing in our private practice and change the way we bill for all these reasons that we've discovered pre billing works for.

And that is where people really struggle. And they generally tend to do implementation alone. Yes, with their team that they might have on site, whether that's a practice manager, reception team, maybe a clinical team leader, but they do it just with the in-house people.

And the problem is this - It is not a matter of if you're going to get stuck during implementation, it is a matter of when you get stuck. Because I can tell you, everybody gets stuck. Because if you do a course or you buy a policy - you still need to adjust that to your individual business. Yes, it might be 80 percent of the way, 90 percent of the way there, but you need to get it 100 percent of the way there. And when it is change that needs to happen, there are going to be struggles.

Team members are going to push back. You're going to start questioning whether you are doing the right thing. You're going to have to start to manage expectations. Then you're going to get stressed because you're going to start wondering, “Are they going to leave? And I need to retain these people. How do I do that? What's happening?” Now you start questioning yourself and then you might decide to backpedal and, that's when the pawpaw hits the fan. And that is when people generally don't make sure that they have the necessary support available. So that's the third part. And in my view, a really important part.

Building a Support System for Success

So part one, the first thing was to have a plan and know what your right next step is. Then the second thing was to make sure you've got the tools and the resources required to implement your plan. And then number three is to make sure that you have support around you to help you, not if - but when you get stuck.

And of course, that's what I do in my Private Practice Success Academy. It's a big part of why people join The Academy. Yes, a lot of times they join for all the amazing resources that's in there, but a lot of people stick around because of the help they get when they are implementing. Now, I'm not saying you need to join The Academy, though.

By all means, reach out if you're interested. What I'm saying is make sure you've got the support that you need. Do you need your own business coach and mentor? Is this a clinical supervisor for you? Who is this person? 

So ask yourself this -  what have you put in place to ensure that you have ongoing support - for when, not if - for when you get stuck. For when you have those moments of questioning yourself, of going -  am I doing the right thing? Is this the right thing to do right now because my team is pushing back? They're resistant. They're telling me all these things and I'm starting to second guess myself. That is when you need support, because very often people will go on a downward spiral, when this starts to happen. They stop making decisions, they backpedal, and then they've done all this work to make a plan, to get the resources, to learn new things, and it's all for nothing. 

And then 12 months down the track, they realise - I'm exactly where I was 12 months ago. What went wrong? I tried all these things and nothing worked. But the problem is you didn't really try all the things. You tried it not properly. And then you think that you've tried implementing this new policy, and you tell yourself it didn't work. But it's not that it didn't work. It's when you needed the support during implementation - you didn't give it to yourself. And yeah, you are the one that has to give that to yourself. You are the one, the only one, that can take the action to go – Who's going to be in my corner? Who's that person going to be that I can talk to during implementation? That's going to either provide me with coaching - if that's what I need, with mentoring - if that's what I need, or with consulting - if that's what I need.

So those three things are actually three different things. I should probably do a full podcast episode on that. But I'll give you a quick overview.

Which Support Do YOU Need?

Coaching is when somebody doesn't give you the answer or tell you what they would have done. That is when they ask you facilitative questions to help you get to the answer. So it's that whole approach of - you already know what the answer is, I’m just going to ask you a couple of questions to help you get there. That's coaching. 

Then there's mentoring. Mentoring is where you tell somebody, so when I was in private practice, this is what I did. This is how I manage that. So it's really mentoring somebody based on your own experience. 

And then consulting is saying - I think you need to do this, or I think you need to do that. So consulting is very direct problem solving.  

And depending on what is happening, you might need coaching or mentoring, or consulting. So it's also important for you to know that when you seek your own support, what do you think you're going to need most?

Do you want somebody that can offer all three of those for you? Or are you going to have one person for each of those things? Or maybe one person that can do coaching mentoring, and another that can do consulting? Because those are really three distinct things and there's a lot of business coaches out there that are just coaches. They don't really give you an answer. They haven't really run a private practice themselves. They don't really have that experience, but they are asking you the questions to help you get to the right answers - and if that works for you, that's perfectly fine. There's nothing wrong with that type of business coaching.

That's how most of them do it. But also ask yourself at times, “Might you need something else? Might you need that mentoring?” Very often you can get mentoring from, for example, a clinical supervisor that also has their own private practice. They can give you mentoring based on what it is that they've done and experienced.

But consulting is really a whole different level. Consulting is really going - it's based on my experience, but also based on a lot of additional knowledge and competency that has been built up over time.  I can do a whole episode on that. My message for you today is to make sure you've got some level of support.

Psychological Support

And then the fourth thing that I said I wanted to add was - don't forget about the support available to you by a good psychologist.  And yes, I'm going to spruik my discipline here because this is what we, as psychologists are there for.

Now, whether you're a psychologist or a different type of allied health professional, it's so important for you to also acknowledge when you might need somebody to talk to.

Not to do business coaching and stuff, but just to go to and be a person that you can talk to about your business problems, about problems in your relationships, about your worries about your kids, about your worries about your financial situation, about your worries about your own clients, about your worries about your team, about all your bloody worries, okay.

A lot of times we are so good at telling other people to get help, that we forget to also get that mental health, psychological health, that personal support ourselves. So, definitely consider that as well. Psychologists are really great at helping you learn how to engage in emotion regulation, how to calm yourself down when things get too much so you can step back into that place of making logical, rational decisions.

I'm a big believer that you do not need a mental health diagnosis to see a psychologist. You do not actually need any mental health symptoms in order to see a psychologist. I can take the most well-adjusted person off the street and I can bring them into the therapy room and I can do four, five, six sessions with them and they will leave having learned something, feeling more empowered and even better capable of pursuing their hopes and their dreams. That is what a psychologist can do for you.

So don’t think - not that there's anything wrong with having mental health concerns, that's not what I'm saying - but what I'm saying is, psychologists have got a lot to offer and why would you not make use of that type of help that is out there.

Just like, why would you not make use of an accountant to help you with your books? And why would you not make use of a business coach and mentor and consultant like myself to help you build your business, when these services are there? Just like how would you not make use of a lawyer, when you need legal assistance? That's just how it is. 

So allow yourself to access the help that you need. And that my friend, is how you deal with the stress of sitting at the helm of this business of yours called a private practice.

Alrighty. We're going to leave it at that. I would love to hear your thoughts. Please feel free to email me directly at gerdam@private-practice-success.com, just to share your thoughts on this specific subject. Or if you've got any other questions that you would love me to answer on this podcast, feel free to send those through as well.

 Okay, let's leave it there. I'm going to love and leave you and thank you so much for tuning in, and remember that I am here to help you build a practice you can't stop smiling about 😊

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Gerda Muller

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