00:00 Welcome Back and Life Updates
03:07 From Solo Practice to Business Coaching
04:03 Evolving Business Coaching Strategies
05:29 The Role of Social Media in Practice Growth
08:21 Leveraging Google Business Profile and SEO
09:49 Transitioning to Group Practice
11:50 The Importance of Hiring Admin Staff
13:49 Understanding Client Follow-Up Strategies
15:47 Navigating Employee Turnover and Retention
18:45 Acceptance of Turnover in the Therapy Industry
21:41 Building a Supportive Community for Therapists
22:19 Navigating Regulations and Marketing Challenges
23:14 The Importance of Investment in Business Growth
24:33 Maximizing Return on Ad Spend
26:11 Effective Marketing Strategies for Therapists
28:38 Building Relationships with Physicians for Referrals
31:05 Creating Connections Through Progress Reports
32:47 The Power of Relationship-Driven Marketing
36:07 Planning for Year-End and Future Growth
Dr. Jeremy Sharp (00:00)
All right, everybody. Welcome back to the Testing Psychologist podcast and another business episode here today. I have a returned guest, Nicole McCants. You might recognize her from the McCants Method. Nicole’s a psychologist, retired psychologist, turned business coach for practitioners who are scaling to a group practice. She expanded her private practice to 55 clinicians and multiple seven figures in three years with toddler twins at home.
and then sold her clinic in the fourth year and then retired in her fifth year. So she now teaches folks how to help more people make more money and have more freedom in her ⁓ proven method. you can find her at the McCants method or sorry, mccantsmethod.com. And like I said, Nicole is back. We are talking about lots of different things. ⁓ This is, it’s always fun to talk.
to Nicole, we chat about how we are kind of opposite in our styles. feel like she forces me to think quickly and bounce from topic to topic and cover lots of material. So she’s very high energy and has a ton of knowledge to share with us about a bunch of different things. But we focus on threads like marketing and why Nicole is pivoting away from social media and more into warm in-person relationships.
for referrals. We talk about predictions and sort of forecasting for 2026 and like how to navigate ⁓ an economic downturn when you’re a practice owner. We talk about the value of an admin and how administrative assistants can actually be revenue generating and many other things. Like I said, we touch on lots of topics and there are several just
little nuggets in here, you know, as far as building a practice and being successful. So glad to have Nicole back as always, and hope you enjoy this conversation.
Dr. Jeremy Sharp (02:02)
Nicole, hey, welcome back.
Nicole McCance (02:04)
Happy to be here. Thanks for having me.
Dr. Jeremy Sharp (02:06)
Yeah, definitely, definitely. How’s life been? I haven’t seen you. God, well, I saw you recently for your podcast, but you haven’t been here since maybe summer 2024. What’s been going on for you over the last year or so?
Nicole McCance (02:12)
Yeah.
Yeah.
Yeah, things have been amazing. Yeah, things have been really good. still, like we’ve got still so many practices that are thriving, which we’re going to talk about today.
Dr. Jeremy Sharp (02:28)
Yeah,
absolutely. Absolutely. That’s great. That’s good to hear. That’s good to hear. And just to remind folks, mean, at this point, you’re full-time business consulting, practice building, helping others, right?
Nicole McCance (02:39)
Yes, I can introduce myself real quick just for those who haven’t met me, if that works. Okay. Yeah. So I was in solo practice for 15 years and just became sick of hitting the ceiling in my income. So when I became pregnant with twins, that’s when I really realized, okay, I need to hire. And once I got a business coach, was able to scale to 55 therapists in three years. And in the fourth year, sold it to a psychiatrist. And then I was like, well,
Dr. Jeremy Sharp (02:43)
Yeah.
Mm-hmm.
Nicole McCance (03:07)
What do I do with my life? Why don’t I help my peers and I give them the map that got me there.
Dr. Jeremy Sharp (03:12)
Yeah, yeah, I hear you. Yeah, it’s a cool story. Cool story. It sounds like you were motivated by your kids like a lot of us are. It’s kind of an inflection point. You’ve talked about that a little bit, right? Like there’s sort of a moment where you realize that something needed to change for you.
Nicole McCance (03:18)
Yeah.
Totally.
Well, it was just me working evenings and weekends, you know, and spending a half an hour with them before they went to bed, because they went to bed at 730 and I worked until seven. Yeah.
Dr. Jeremy Sharp (03:31)
Yeah.
Yeah,
yeah, yeah, it’s kind of brutal when your kids are little. A lot of people describe that.
Nicole McCance (03:43)
Mm-hmm.
Dr. Jeremy Sharp (03:44)
So talk to me about your business coaching sort of strategy approach these days. I feel like all of us who sort of pivoted over the years a little bit in terms of what you’re advocating and supporting from a business standpoint. So maybe talk me through the evolution of your approach to practice growth and where you’re.
Nicole McCance (04:04)
Sure.
mean, and we talked before we hit record, so you’re specifically talking about the economy, like how coaching has changed. Honestly, the truth is, I have people in my program still hitting the seven figures, like growing. Do they have slower months? Yes. Is it harder than it was? Yes. Do we have to work harder? Yes. So I think that not everybody needed a business coach before. Now they do, unless they know business.
Dr. Jeremy Sharp (04:32)
Mm-hmm. Mm-hmm.
Nicole McCance (04:34)
And
if you’re not doing the right strategies, here’s the problem. Good therapists, it’s not that they’re not working hard. It’s that they’re working hard at the wrong things. That’s it.
Dr. Jeremy Sharp (04:46)
Okay, got to ask more about that. So what are the wrong things?
Nicole McCance (04:52)
I can tell you the right things. wrong things could be whatever that you’re getting. Social media? I would say social media would be, does it work? Yes. Is it the fastest? No. To bring in the leads, for example.
Dr. Jeremy Sharp (04:54)
Okay, great. Yeah, we can do that.
Nicole McCance (05:03)
What I’m talking about more these days is typically a lead that is warmer converts. I teach consult calls, like offering a free consult call for sure. think that’s so important. So strategies like if you’re in network or even out of network is connecting with family doctors and building those relationships. And I have a really cool strategy we can get into a bit later, but it’s just coming up, like really coming up with
Dr. Jeremy Sharp (05:13)
Mm-hmm. Mm-hmm.
Mm-hmm.
Nicole McCance (05:29)
what’s different and standing up from the crowd matters more than ever now. And it used to be easier. It just takes a lot more work.
Dr. Jeremy Sharp (05:35)
Yeah, yeah, I think this is super important. It mirrors a lot of what my own consulting clients are saying too. It just feels, it feels harder, right? The Instagram, well, you didn’t say Instagram, I don’t think, but social media, know, people jump on social media a lot. And I don’t know, I wonder if it is, it’s almost like a, like a double whammy, like where we’re all like,
more stressed and prone to spending time on social media, know, and like doom scrolling is a thing and people struggle with that. And so it’s, it feels like an easy thing to do for your practice. Like, my God, you know, I’m already on social media. Maybe I could just like post this thing and feel like I’m doing something for the business. But, I’ve never been a huge proponent of social media as a practice builder myself. I know. I there are folks out there who have, and maybe you have as well, but I don’t, it takes a long time to
Nicole McCance (06:03)
Mm-hmm.
Yeah.
Dr. Jeremy Sharp (06:26)
to make that happen as far as I can tell.
Nicole McCance (06:28)
Oh my
gosh, well, we hit the million dollar mark. had 400 unengaged followers. And it’s funny because the practices in my program that are really doing well, they don’t have a social media presence. Can you do it? Yes. Is it kind of like a full-time job? And like, I was so resentful of my tripod. Like, oh my gosh, tripods are getting better these days. But you know what I mean? And I didn’t personally find it fulfilling, like lip syncing and all the things I had to do back in the day.
Dr. Jeremy Sharp (06:33)
Yeah.
That’s interesting.
Mm-hmm.
Haha
Totally.
Nicole McCance (06:56)
And now
as a coach, I have a much bigger community on there because I’m just talking to them. I, I, here’s the thing. You were child struggling. Where do you go? Is it Instagram? No. Is it your best friend who helped your kid? Maybe. Is it your doctor? He’s not paying attention. He’s jumping all over the place. Or is it Google? It tends to be those top three things. It’s not going to Instagram. Yeah. Instagram we go to be entertained typically.
Dr. Jeremy Sharp (07:01)
Yeah.
Yeah, I think you’re right. think you’re right. Yeah. And the content, even though I feel like the good quote unquote mental health folks on there aren’t really like marketing mental health services. They’re like selling books or like doing speaking or I haven’t found a lot of like Instagram driven practice growth. I know. And I know they’re out there, but I just, I just don’t see it or hear the stories anyway. Okay. So it sounds like then are you kind of pivoting and like going more in on like SEO and
Nicole McCance (07:37)
Yeah.
Right.
I’m with you.
Dr. Jeremy Sharp (07:51)
website or Google ads you mentioned. mean, what are you seeing as the sort of top referral sources?
Nicole McCance (07:56)
SEO is the long game.
And because my program’s only six months, they want leads yesterday. I think people listening to this do, they’re like, I don’t have six months. Google Ads does work, but you have to pay to play. And a lot of people, as you mentioned, like if you don’t have the startup money, what is helpful right now is actually your Google Business profile. So there was a switch very recently as of the recording.
Dr. Jeremy Sharp (08:05)
Totally.
Mm-hmm.
Nicole McCance (08:21)
I’ll say the date if that’s okay, December 18th, because this could be a very different thing when they listen, ⁓ that now your Google business profile shows up before, so it’s typically after Gemini, but sometimes it’s before the sponsored ads now. I don’t know if you’ve noticed that on Google. We have an in-house digital marketing expert who’s telling us…
Dr. Jeremy Sharp (08:24)
Mm-hmm. Mm-hmm.
Nicole McCance (08:44)
to tweak the Google Business Profile. And I just love it because it’s free. Is it going to feed you all your leads? Absolutely not. But if it’s something that you can tweak, definitely get on that.
Dr. Jeremy Sharp (08:47)
Mm-hmm.
Yeah, and for folks who may not know the Google Business Profile, you can Google it. And it’s like a free listing essentially. And it’s basically like what drives the Google Maps listings. Like your business has to be on Google My Business to get on Google Maps.
Nicole McCance (09:03)
Exactly.
Yes. But what’s working right now, well, here’s the thing. There’s nothing new. Well, I’d love to hear your opinion. It’s not like I haven’t pivoted. The same foundational things work. And one thing I’ve always said that I’m talking more about is email marketing. Those people already know you, like you, and trust you. They haven’t seen you in six months. And now there’s an anti-spam law. So you want to know how to email market?
Dr. Jeremy Sharp (09:23)
Mm.
Mm-hmm.
Nicole McCance (09:32)
I have members, they’ll send an email out and get five clients. Now, because I teach people how to scale into a group practice, those five clients usually want to see them. So there’s like some, you know, I kind of train them in how to move their clients over to their people.
Dr. Jeremy Sharp (09:49)
Yeah, let’s detour for a second because people ask about that a lot. Like if you’re moving into group practice, there’s the whole like, I want to see the owner question. So yeah, how do you approach that? I’m guessing knowing you there’s a script or something that people can use. Yeah.
Nicole McCance (09:56)
Mm-hmm.
Yeah,
it’s not easy. I suggest hiring an admin when you can afford it and buying back your time and just delegating. Here’s the script that my admin would use. My rate, so I was 275 private pay and everybody else was 175. I do believe, and that’s one of the first things we do, is the clinic director should be more. So she would point out, number one, Nicole
Dr. Jeremy Sharp (10:09)
Hmm.
Mm-hmm.
Nicole McCance (10:29)
doesn’t work evenings and weekends. Let’s say we’re promoting Susie, but Susie does. Nicole’s 275, but Susie’s $100 less. But here’s the best part and what really moved people, Nicole supervises or trains, if you don’t supervise. Susie, every week reviews all the notes. You’re gonna feel Nicole’s presence in that session, even though it’s almost like you have two clinicians working on your case and they’re like, wait.
I save $100, I get the time I want, and I get access to Nicole. Yes.
Dr. Jeremy Sharp (11:00)
Yeah, I like that. The two for one. We use language like we do a team approach, you know, things like that. Yeah. And folks that, that certainly helps. And I experienced that too, when you talk about supervising and being part of the process. Yeah. Yeah. You mentioned an admin as well, like hiring an admin as soon as you can. People are hesitant about this. People say, I can’t afford it. And that kind of thing. Yeah, of course.
Nicole McCance (11:05)
Love it.
Totally.
Mm-hmm.
Yep. Can I talk about that?
And admin can be revenue generating. Think of somebody that you’re going to pay $22, $25 an hour first, but before I talk about how it will be revenue generating, because we don’t see it like that. First, I want to tell you who to hire. I’ve had the best admin that are psychology students, typically in third year, because they’re us. They want to be us.
Dr. Jeremy Sharp (11:45)
Mm-hmm.
Mm-hmm.
Nicole McCance (11:50)
That’s why they want to work for a clinic. So we’ve got them for at least four years if they do their masters. You’re three, you’re four, and two years in masters. So we’ve got them for a while, but they’re so bright. Here’s the thing, Jeremy. I feel like we’re just different humans. Like no one goes to school that long. You know what I mean? So if we can find versions of us that are really bright, really hardworking,
Dr. Jeremy Sharp (11:58)
Mm-hmm.
Yeah, totally.
Nicole McCance (12:14)
I find they’re the best admin and they want to stay because they just love being in the operations of a therapy clinic. So first it’s hiring them. Then I’ll tell you revenue generating. If you get them doing your follow ups, they follow up with every no show, every canceled, every person that did not convert on that consult call. And lastly, those who ghost you. You know those people halfway through therapy go on vacation, you never see them again?
Can you imagine your admin gets even two more in a week that pays for their full week?
Dr. Jeremy Sharp (12:45)
Yeah, yeah, that’s a good point. don’t think we, yeah, we don’t think about these little tasks that we don’t do most of the time as practice owners because we just don’t have time. Like we’re seeing people and doing other things, probably being on Instagram and you’re not following up on, but that’s true. and people, I don’t know, I can get on my soapbox about like the sales process of counseling and I don’t know that we recognize that it is a sales process. And when you look at sales literature, there is,
Nicole McCance (12:53)
Right. Exactly.
Yeah.
Mm-hmm.
Dr. Jeremy Sharp (13:12)
like the first call isn’t often the buying call. Like there is follow up that has to happen and we typically don’t do that. If people say no, then we’re like, okay, cool. But you can actually follow up and nurture them. Yeah. Yeah.
Nicole McCance (13:16)
Mm-hmm.
Yes. Can we talk about that for a second? I,
and correct me if I’m wrong, but the research I’ve done, that is such an important point that people don’t get. I’m going to say that again so they really, really hear it. When you’re on the consult call, the majority of people, it’s not a one and done. It’s not like a first call close as they call it. They have to think about it, get a babysitter, check their insurance and research shows.
that if you just follow up, you get a 20 % bump in yeses and in revenue. 20%. That’s worth it.
Dr. Jeremy Sharp (13:54)
Mm-hmm. Yeah. Mm-hmm. Yeah, that’s
huge. That’s huge. And you need somebody generally to help with that. mean, because that does stack up, you know, the time to do that kind of thing. Yeah. Yeah, I hear you. How do you just a quick kind of nuanced question about hiring students, which we have done and has been great, but how do you sort of deal with the turnover, I guess, you know, if they’re leaving?
Nicole McCance (14:04)
You’re right, exactly.
Dr. Jeremy Sharp (14:18)
Like every two to three years, maybe, I guess, maybe four years. That’s a little longer. But how are you working with like overlapping training and how to bring on someone new and that kind of thing?
Nicole McCance (14:29)
Honestly, in our day and age, I think four years is now long-term, don’t you? Like, I think turnover is much less. So I kind of planned it so I was very, I’m happy to have a superstar rock star for two years, two years flies though, so whenever two years goes by, I’m like, why did I sign up for this? Because it’s so hard when they leave. But really, I’ve seen people come into my life.
Dr. Jeremy Sharp (14:34)
Mm. Mm-hmm.
Hmm.
Yeah.
Nicole McCance (14:54)
improve my practice in so many ways and leave, but I’m like, my gosh, I’m so glad to have known you. Secretly, I want you forever. So it is hard and students are fickle because their schedule, like you have to be more flexible with their shifts, but they’re usually willing to work the evenings and weekends like we did. You know what I mean? Like they’re all over the place with their classes. So they don’t mind the chaos of our calendars, which is like evenings and weekends.
Dr. Jeremy Sharp (15:00)
Hmm.
Mm-hmm.
That’s a good point. Yeah. Yeah, I’m gonna think about that like four years is long term. I think you’re right. I think that has changed a bit, but it’s
Nicole McCance (15:29)
So sad. Oh my gosh.
Like, what are our children going to do? I swear to God. Like, everything is so, what in life doesn’t show up at your door instantly? So they just want new and better and change. And four years, yeah, is like a lifetime, I think, for the young ones. I’m 45, so I can say that.
Dr. Jeremy Sharp (15:34)
my gosh, yeah.
Mm-hmm.
That’s a good way to put it.
Yeah. Are you thinking about your employee? you know, employee, know, therapists, counselors, psychologists that way as well.
Nicole McCance (15:55)
I find, so I was strategic. I find that those who stay the longest are, if you get them early, I like to hire interns depending on where you live, California, you can’t, you know, they want to be under your wing. They just want to soak up all the training and they have to stay, which is kind of nice, up until they’re fully licensed. So you get that. Or later in their career, I don’t know if you’ve noticed this, but like,
Dr. Jeremy Sharp (16:05)
same.
Mm-hmm.
Nicole McCance (16:24)
I just want easy. I’m good. I don’t want to be in solo. I’m good. Yeah.
Dr. Jeremy Sharp (16:28)
Exactly.
I think you’re right. Yeah, that middle whatever midlife stage, that’s when I tend to lose folks. Like, yeah, they start with us, spend, gosh, if I’m lucky, you five, seven, eight years, but then like hit late 30s or 40s and they’re like, what am I doing? I need to do something different. My life is passing me by and then they take off. But then typically, you know, older folks are…
Nicole McCance (16:39)
Mm-hmm.
Dr. Jeremy Sharp (16:56)
I mean older, like, it’s so relative.
Nicole McCance (16:57)
No, exactly. They’re into like
just settling in and just want, you know what? Yes, a group works for me. I have to, you know, I just want to do therapy and go home.
Dr. Jeremy Sharp (17:05)
Yeah, yeah,
yeah, yeah, that’s a good way to think of it. I don’t know. Do you know Ken Clark? He’s another coach like in our space. has a, yeah, huge practice. I did some coaching with him a while back, but I think he was the one that said like shifting into this idea of like if we can give people the best like three to five years out of grad school, that’s a pretty big win. And then maybe they do go on to other things and that’s totally fine. You know, it’s just like
Nicole McCance (17:13)
⁓ yes, I think so.
Mm-hmm.
Yeah.
Dr. Jeremy Sharp (17:34)
development, but that kind of shifted my mindset a bit too from a
Nicole McCance (17:37)
You know, I
think that’s a really good point. Just, I had someone yesterday in coaching, she’s brand new to the program and she said, I’m so terrified. I haven’t even hired yet and I’m afraid they’re gonna quit. And I normalized that, because trust me, that was hard on me emotionally. became, I really took it so personally when they were leaving, almost like they didn’t wanna play with me in the playground anymore. You know, we can talk about that more in a sec. But I said to her,
Dr. Jeremy Sharp (17:54)
Mm-hmm.
Nicole McCance (18:05)
I want to tell you right now, it will happen. And part of it is just accepting. Like the industry standard, what is it? Like 20 % is turnover. Like that’s the industry standard. I aim for like 15 or less. So there is freedom in just accepting that, okay, you know, I’m going to try my best that we’re going to be together as long as we can. But acceptance rather than fear gives you so much freedom.
Dr. Jeremy Sharp (18:16)
Mm.
Mm-hmm.
Yeah. Yeah. I mean, I hear you. My head hears you. And I’m like the emotions of it. It is hard. It is hard. How did you get or how do you maybe coach folks to move from that fear to acceptance place? I think it’s important. It’s also hard.
Nicole McCance (18:45)
No, yeah, for sure. I think part of it is acknowledging like, okay, this is, it’s not me. I think the moment we take it personal, because we’re human, but knowing that, this is just something that happens, then it’s easier just to like understand that. And I can expect it in a way. And, and I think having a coach, like I will have a coach my whole life and a community that you just go to where people are like you.
Dr. Jeremy Sharp (18:57)
Hmm.
Hmm.
Mm-hmm.
Nicole McCance (19:14)
because
it is lonely at the top, for sure. That’s actually why I initially got that like the amount of pressure, normal people, we’re not normal. Normal people don’t like choose this, you know? So it is nice to have a community where you’re saying like, you know, I feel rejected because someone left and they get it.
Dr. Jeremy Sharp (19:16)
Yeah.
Yeah, is that what you meant when you said let’s come back to this like that feeling of rejection?
Nicole McCance (19:35)
Exactly, rejection.
yeah, it’s so interesting. You don’t expect, because I don’t know about you, but when, so I had 55 people, that’s a lot of interviews and so on. So when somebody would leave, I was often blindsided. Right? Do you notice that? And then actually sometimes they would say, oh, I actually, you know, I’m leaving because I want to do a hundred percent assessments. We did a psycho-eds, you know.
Dr. Jeremy Sharp (19:54)
Mm-hmm. Mm-hmm.
Nicole McCance (20:05)
And I was like, why are you leaving? You could have told me that. And I did talk them into saying actually two of them. So part, I would fight for my people. feel, you know, I’m like, wait, tell me why in my exit interview. And then I kind of wish they would have told us beforehand, but often when they leave, they have a whole new life set up and it just feels like what is happening? You know, how did I not know any of this?
Dr. Jeremy Sharp (20:25)
Mm-hmm.
Yeah, yeah. So validating. Yeah, I feel I’ve had that exact conversation a million times over the years. And but it does always feel the same. It feels you know, it’s so funny. It feels like the pair there’s like a lot of parallels to breakups, you know, I’m like, why didn’t you tell me like, why didn’t you talk to me before you went and like got a new apartment or whatever, you know?
Nicole McCance (20:47)
100%. Yes. It’s like,
I have a whole solo practice now. It’s like, what do you mean? What do you think that’s about? Like why? I think they trust us. Like I don’t think it’s that, but there’s something like when their decision is made up, they just don’t want to be talked out of it. So they don’t want to tell you before or something.
Dr. Jeremy Sharp (20:55)
Yeah.
Mm-hmm. Yeah, I think that people, I mean, there are lots of reasons, but people just hate ambiguity and like open loops, you know? And so like we move as fast as we can to certainty in one direction or the other. And when it’s something like this, yeah, it’s hard to like stay in that mess, you know, of like, do I stay, do I not? And so that seed grows of leaving and then it becomes a whole thing before they come and tell us.
Nicole McCance (21:18)
Yeah.
That’s it.
Yeah,
I found a community is just so important to have to make it easier.
Dr. Jeremy Sharp (21:41)
Mm-hmm. Yeah. What kind of community are you a part of? It sounds like you have, is this like a small group for, you know, entrepreneurs or what’s your community look
Nicole McCance (21:50)
So
I started, when I started, I wasn’t aware of therapists who were business coaches. This was many years ago now, 2018, 2018. There were people around, I just didn’t know them. So I had to find a group of just business people that weren’t therapists. And I loved it, but I also, one of the downfalls is we’re so unique, our industry, there’s so much
Dr. Jeremy Sharp (21:57)
Yeah. Yeah.
Mm-hmm. Yeah.
Hmm.
Mm-hmm.
Nicole McCance (22:19)
Two things,
we’re so highly regulated and terrified. We’re terrified, like of our board, like what, you know, I feel like I’m, wanna be this ethical all the time, but I’m scared because there’s so many rules. And then because of that, there’s so much marketing that I’m not allowed to do. No testimonials, can’t message people on the DM, can’t do packages, or at least Ontario is highly regulated. So I…
Dr. Jeremy Sharp (22:23)
Mm-hmm.
Mm-hmm.
Nicole McCance (22:47)
That’s why I created a therapy one, because I’m like, you know what? I feel like we’re different.
Dr. Jeremy Sharp (22:51)
No, I think that’s very true. Have you, it sounds like you personally are part of groups with other businesses though, or other businesses. Can you think of, I think that’s super valuable by the way. Do you, are there any, I don’t know, nuggets, like things you picked up over the years just from being around like other types of business owners that has stuck with you?
Nicole McCance (22:59)
Exactly. Entrepreneurs last.
100%. The very first thing I learned, I think it was the key to everything. I mean, that’s such a big statement, but I think there’s some mind shifts that once you have them, you just can’t not be successful. And what it was, which may surprise you, is spending money. There’s so many people that are afraid to spend money because of childhood, right? I’ve got my own stuff.
Dr. Jeremy Sharp (23:38)
guys.
Nicole McCance (23:38)
It feels like a loss.
What if, you know, I coach this all day long in my program. but I heard this, she was talking to the coach and she was like, it’s like a bit of a formula. And I was listening, I’m like writing notes and it’s investing though in advertising because if you don’t advertise, how can people find you? And there’s so many therapists with beautiful websites, but no traffic to it.
Dr. Jeremy Sharp (23:52)
You
Nicole McCance (24:04)
but they just don’t know that three networking events isn’t gonna bring all the clients that you need, you know? So that stuck with me. So I was like, all right, let’s go. I’m getting it. I’m gonna invest in a business coach, in Google ads, and I’m just not gonna question it, and I’m gonna invest a lot if it takes that.
Dr. Jeremy Sharp (24:09)
Mm-hmm.
Mm-hmm. Are you still a fan of that? I know you were kind of talking about marketing at the beginning, but investing in marketing and playing the long game with Google Ads and Search Engine and that kind of thing.
Nicole McCance (24:33)
Yes.
So Google ads don’t work if you have a website that doesn’t convert, right? Like you really, I just had, like we do this, immediately we’re changing people’s websites because therapists don’t know what converts. They think pretty works. Pretty does work, but it’s more than just that, right? And working with a company that, there’s a lot of elements working with a company that knows what they’re doing. But my goal is to get
Dr. Jeremy Sharp (24:40)
Yeah.
Hmm.
Yeah.
Mm-hmm.
Nicole McCance (25:00)
members up to like four times a ROAS return on ad spend. that’s, or like six, seven. So there are therapists in my program that are struggling and here’s why. Typically, it’s perfect back to what I just said. They’re not spending enough. Here’s what I mean. I live in Toronto. It costs $100 to bring in a client. Okay. Then it’s my job to retain that client lifetime value to be as high as possible.
But let’s say you live in California, it’s even more. That feels really expensive and it is, and it’s scary because you also aren’t doing the treatment now. You’re relying on another therapist too, which is even more scary. So they don’t spend. So they only spend, let’s say $1,000 and maybe some months get less than 10 clients and they say it’s not working and they stop, right? So they’re not willing to spend $100 for a client. But those who do, I just see them grow.
Dr. Jeremy Sharp (25:59)
Mm-hmm.
Nicole McCance (25:59)
As long as
they have a good website, good company, know, no other. Yeah.
Dr. Jeremy Sharp (26:04)
Yeah, it’s all got to connect for sure. Where else do you advocate people spending money or time, I suppose, on marketing?
Nicole McCance (26:12)
Not Facebook. Facebook’s really good for me. Like we’re very niche. So I love it when a therapist scrolling around and I’m like, Hi, are you looking to be in a group practice? So therapist works for us as coaches. But for therapy, like, unless you’re very, very niche, it absolutely works. So not Facebook. Honestly, they, I mean, soon chat to PT ads, I cannot wait. Like, when are they going to come out? I’m to be the very first to do that. Bring me back and I’ll tell you all about it.
But it’s posting on Indeed, like sponsoring the post, and it’s investing in the website. But really, there’s nothing else to spend money on that works in terms of advertising over and above Google or Facebook, if you’re niche.
Dr. Jeremy Sharp (26:49)
What do you think about?
Yeah, yeah, that makes sense. What about like Psych Today or other directories? you?
Nicole McCance (26:58)
I don’t really count backs. like 30 bucks. we could, So, I mean, should we say it out loud? I mean, they’re a big company. I don’t want to get sued. But I just find that there, I give away a free template. I really try to help people with the wording and it does help them. But my gosh, it’s a different world. It used to be that psychology today was amazing. Like you have a, I’ll tell you this, because I work with every single state, I have noticed
Dr. Jeremy Sharp (27:00)
Okay. Yeah.
Mm-hmm.
Nicole McCance (27:25)
that the therapists in the East do better than the therapists in the West. And Psychology Today is in New York. I don’t know if they’re just, I have no idea. But it doesn’t work, but it’s so cheap that I say, pay the 30 bucks, just test it. If you bring in one client, it’s worth it.
Dr. Jeremy Sharp (27:30)
Interesting.
Yeah. Yeah.
Yeah, I say the same thing, especially with testing. If you get one evaluation from it, that pays for it for five years or something. So yeah.
Nicole McCance (27:49)
my gosh, that’s amazing.
Well,
yeah, how much is a typical assessment that you do?
Dr. Jeremy Sharp (27:55)
Yeah,
I mean, it depends on geography, but let’s just say on the low end, it might be a thousand in a super rural, like low income area all the way up to like 14,000 in LA or New York, you know.
Nicole McCance (28:07)
wow, okay. Good to know.
Dr. Jeremy Sharp (28:08)
Yeah, so there’s a but like if we
want to take like maybe the mean or whatever, let’s call it 2500 to 4000.
Nicole McCance (28:15)
I would say that’s the price here. Yeah.
Dr. Jeremy Sharp (28:17)
Yeah, yeah, it pays for itself. But I did want to circle back though. You mentioned something kind of like throw away at the beginning that feels pretty important, which is connecting with physicians. And I would love to hear how you do that or coach people to do that. Because this feels like, especially for us, it’s kind of like the holy grail of referrals if you can get in with physician practices.
Nicole McCance (28:20)
See ya.
Sure. And are you in network or out of network or both? Okay. No, they are. are. Yeah. Yeah. Yeah. I would say 60 % of the people I work with are. So even better, because it’s easier to find a doctor that’s in network. That’s why I asked. Okay. So we’re going to talk about a progress report strategy that
Dr. Jeremy Sharp (28:42)
We personally are, yeah, and a lot of practices are, but that is a variable for sure.
Mm-hmm.
Hmm.
Nicole McCance (29:03)
Well, first we’ll talk about the first, the most obvious strategy that I did. And then I’ll tell you why I switched it. Calling them. It’s cool calling. It’s scary, but there you need a script. And the script is don’t talk to the gatekeeper because they can’t help you, which is the person who picked up the phone typically. And ask for the clinic manager. They might say, you know what? Michelle’s only in on Thursdays. Perfect. time? I’ll call back. Then I get to Michelle.
Dr. Jeremy Sharp (29:21)
Mm-hmm. Mm-hmm. Mmm.
Nicole McCance (29:31)
and I name drop. Why is it important to name drop? I’m dropping. You’re saying like doctor, psychologist. Why is that? Immediately you want to create, I’m one of you. You trust me. You work with doctors. I’m not trying to sell you samples or whatever. Because I think a lot of therapists don’t do this because they’re worried like, my God, like this is selling. It’s not. They’re looking for you. That’s the reframe.
Dr. Jeremy Sharp (29:44)
Mm-hmm.
Nicole McCance (29:59)
You are providing a service to help them, especially for you, Jeremy. my gosh, the doctors here are so hungry for those who do assessments. ADHD, autism, all the things. And the goal of the call is getting in the EMR because yeah, have you ever seen your doctor and you’re like, have this, I need to see a dermatologist, let’s say. What do they do?
Dr. Jeremy Sharp (30:08)
Mm-hmm.
Yes.
Hmm. Yeah, what do mean by that?
Nicole McCance (30:25)
They say, okay, I’ve got your address here. Perfect. Here’s three referrals. And immediately the EMR is there. Everything’s electronic, right? So if they add you to the EMR, the next patient that says, my kid is struggling. I don’t know what’s happening. They’re going to put you in there. Not you, sorry. They’re going to put the address and you’ll pop up. So I just found that was an easy way to access all the doctors.
Dr. Jeremy Sharp (30:34)
Mmm.
Nicole McCance (30:53)
because here I am in the EMR and every single one of them is I’m going to pop up now.
Dr. Jeremy Sharp (31:00)
I like that. Yeah, it’s their list, essentially, their referral list when they’re just quick in the appointments. Yeah. So let me go back and try to connect two key pieces here. What do you say to the clinic manager or referral coordinator, whomever it may be, what do you say when you get them on the phone? Hey, I’m Dr. Nicole and.
Nicole McCance (31:05)
Exactly. Yes. Yes.
Yes. Okay. So don’t hate me.
This is what I say. And I’m curious your thoughts about this guys. I first say, yes. So your name drop. And then you say, first, I want to thank you for the referrals. Okay. Just hear me out. will. some of my members are like, what are you fibbing? You haven’t even met this person yet. Well, I don’t know. I’m in Toronto.
Dr. Jeremy Sharp (31:33)
Yes.
Nicole McCance (31:42)
Probably, we’re a big clinic, 55 people. They probably sent us referrals. They don’t ask because it’s private, but I say, thank you so much. We’re really enjoying this relationship. I wanted to let you know we just brought on a new psychologist that now does X, Y, and Z. So you immediately want to thank them and then tell them what is different. It’s not like the other things that they hear all the time. I’d be happy, know, let me know if you prefer referral pads or if you want to add me to your EMR.
They’ll tell you some are old school still and they want a referral pad. And you can even offer to do a lot of my members do this lunch and learn happy to come in and chat with you guys about trends we’re seeing right now with kids in school.
Dr. Jeremy Sharp (32:14)
Mm-hmm.
Mm-hmm. Mm-hmm. Yeah, yeah. I love all of that. It’s funny. I mean, you’re like, don’t hate me. But I did literally that exact same thing. Like, in the beginning, when I was trying to get in, I did the exact same thing. Called. Thanks for the referrals. Hey, I just saw a patient of y’all’s. I’ll send over some notes. And there was some truth. Like, at some point in time, I had seen a patient from that practice. ⁓ But I think that does help, for sure, to bridge the gap.
Nicole McCance (32:30)
Amazing.
Yes!
Yes.
100%.
And then I want to tell you about progress reports, if that’s okay. ⁓ Because nobody was calling. I gave my members the script. did all the, I even gave them, I’m not lying, a playlist. I have a Spotify playlist. We should add it to your show notes. It’s really fun music that I, that I like kickbox to you that you can get pumped up before you call. They still didn’t call. So instead, what if you started sending with the client’s consent, progress reports?
Dr. Jeremy Sharp (32:54)
yeah, yeah.
Nice. Okay. Scary.
Mm-hmm.
Nicole McCance (33:19)
So that
means in your consent form, you would start asking, this is a free service, we send progress reports, all we need is your doctor’s information. And about 50 or 60 % of clients will say yes, especially if they’re highly symptomatic or on medication. And now these are like little sales letters. Of course it’s about high client care, but you’re also top of mind for all of those doctors.
because they’re seeing the amazing work you’re doing.
Dr. Jeremy Sharp (33:47)
Mm-hmm. Mm-hmm. This is great. Yeah, this is super cool. Our version of that that I talk about is the continuity of care facts, you know? So as soon as somebody comes through our door, we get a release to talk to their physician. And we just send like a one page is basically just a cover page, but it has our logo and, you know, letterhead and all that. And just says like, thank you for the referral. We’re seeing this patient will be in touch with updates as the evaluation wraps up. And it just we just shoot it out.
Nicole McCance (33:55)
Hmm.
Love it.
Dr. Jeremy Sharp (34:14)
Yeah, it’s just it keeps you top of mind. It has brand recognition, you know, with the logo. Super easy. There’s a template. Yeah. yeah.
Nicole McCance (34:20)
A lot of people don’t do this. And your admin does most of it. Like your therapist helps with,
yeah, like it can really be streamlined and you can scale it.
Dr. Jeremy Sharp (34:27)
Yeah.
Yeah. Yeah. I like this. Yeah. I, you know, the more, I don’t know, the more I do this, I think it’s hard for folks, but I’m a big fan of relationship driven marketing, like versus like Google ads and SEO and all that. I mean, that stuff’s important, but I really, I like the warm kind of in-person, like those relationships. Those to me are like the real flywheel, like the engine that kind of drives referrals long-term.
Nicole McCance (34:45)
Mm-hmm.
Totally.
You got it.
Dr. Jeremy Sharp (34:52)
Because once you build
good relationships, they kind of operate on their own. You know, they keep going. They’re self-sustaining.
Nicole McCance (34:56)
Definitely.
And they’re much warmer. So research does show not only will they convert higher on that consult call, because they come in with some borrowed trust, if you will, because their doctor knows you. So I’m probably going to like you too. But research also tells us that their retention is higher, I think, because engagement. They’re walking in more open.
Dr. Jeremy Sharp (35:11)
Mm-hmm.
No, I think that’s true. That’s so true. And I think it’s funny, you mentioned referral pads. I wanted to come back to that. My admin kind of like forced me to print out referral pads so we could distribute them. And I was like, OK, here we go. I was like hesitant. But I swear, people love these things. Like we just like drop them off around town. And I’m like, nobody hand writes anything. what are we? Nobody’s going to But people love these things. Like we get these.
Nicole McCance (35:37)
Mm-hmm.
Yes!
Dr. Jeremy Sharp (35:43)
do referral pads and go drop them.
Nicole McCance (35:45)
Yeah, it is old school and
it’s faxing. we’re still getting referrals via fax. Like they write it down and fax it. Yeah, it’s smart.
Dr. Jeremy Sharp (35:52)
Yeah, yeah, it’s
kind of wild anyway. we’re heading into 2026. Do you do any kind of or coach your folks to do any kind of year end review or, you year end like kind of planning? Like, how do you sort of look ahead to a to a new year?
Nicole McCance (36:07)
I love that. Yeah, I’m doing a whole podcast episode on this actually. It’s so important, I think. ⁓ I do. Okay, so first, before I answer that, I want to point out that I notice that those who are the most successful at anything actually focus. I find that therapists and human beings get bored and I’m one of them. ⁓
Dr. Jeremy Sharp (36:12)
nice. Yeah.
Mm-hmm.
Nicole McCance (36:33)
And so they end up doing the spaghetti on the wall, even though it’s working. They’re doing something that’s working, but somehow that feels too easy now and I have to do something else, right? Even though we all say we want freedom, I just watch them and the moment it’s kind of easy and flowing, they’ll like do something else because we get bored. So part of reviewing the year is looking at what actually worked and then 80-20 rule, literally letting go of the busy work.
Dr. Jeremy Sharp (36:42)
Hmm.
Nicole McCance (37:01)
of the 80%. Like they’re half writing a book, they’re half doing a podcast that they stopped. It’s like all these things. So number one is where you go though is the data. And what I mean is pulling it from your EHR and looking at, I don’t know if simple practice or therapy notes, but I love Jane, let me know if the other ones, because it tells you where they came from. So if you can pull like your referral report and then just do more of that.
Dr. Jeremy Sharp (37:01)
Mm-hmm. Mm-hmm.
Mmm.
Nicole McCance (37:30)
But pay attention, of course, to the trends because there’s ups and downs, Slow months, et cetera.
Dr. Jeremy Sharp (37:34)
Yeah, yeah,
yeah, of course, of course. Yeah, I like that. I love data, obviously, and anything. Yeah, I think you’re right though. People do get bored and want to do a bunch of different things, but most of the time…
Nicole McCance (37:40)
Mm-hmm. ⁓
And me too, like every
day I’m like, Nicole focus, you know? And I’m proud that I only have one program and I only, I only help people scale into group practices or help group practices. Yeah.
Dr. Jeremy Sharp (37:49)
Mm-hmm. Mm-hmm.
Ha ha.
Yeah,
it’s true. Yeah, focus is important. And just to highlight, I’ve been on this big 80-20 rule kick for the last six months or so where I feel like I see it everywhere. in this case, maybe it’s like 80 % of your clients come from 20 % of your referral sources or something. like zero in on the 20 % that are actually making a difference and try to increase that.
Nicole McCance (38:06)
That’s so cool.
Mm-hmm.
Yeah.
Dr. Jeremy Sharp (38:19)
What else do you have people do? December is weird. People kind of freak out in December and January. It’s like kind of slow, the holidays. How do you, I don’t know, work with people through that and see like income dips maybe in December? Yeah.
Nicole McCance (38:28)
Yeah, I have lots to say about December. Yeah.
So I learned the hard way that we did neurofeedback at my clinic too. We did everything basically. And in, it’s different here. mean Canada, that we have benefits. So we have like $1,500 towards therapy. If you don’t use it, you lose it and it restarts though. Okay. So we were quite, you can be quite busy now in the States is different. it ebbs and flows.
Dr. Jeremy Sharp (38:37)
Okay.
Nicole McCance (38:54)
Typically, December is weird because it’s a very stressful time. Maybe people are coming in, but it’s a very expensive time. Maybe people aren’t coming in. But on top of that, and this is why I want people to hear this, I underestimated the amount of vacation my therapist would take in December. So there was a month.
Dr. Jeremy Sharp (38:59)
Mm-hmm.
Mm-hmm.
Nicole McCance (39:16)
that we had the clients, because it’s a stressful time, but we did not have the therapist, which was a stressful time for me. So it’s so important to have an approval process where, yes, please take your vacation, but we need to be better and two months ahead, plan this so we have people actually working. That’s number one. Number two, because you guys have lots of W-2s, if people, if you,
Dr. Jeremy Sharp (39:23)
Yes.
Nicole McCance (39:43)
In Colorado, do you have to pay PTO? You call it PTO. Is it required or no?
Dr. Jeremy Sharp (39:46)
Mm-hmm.
It’s murky. No, it’s not required in every state for…
Nicole McCance (39:50)
Not required.
no, but there’s some states it’s required. Mine is required. ⁓ so also I would put a reminder for this upcoming October. Number one, plan vacations, you know, ask everybody plan it well. Number two, if, you have to pay vacation sick time, AKA PTO and they don’t take it, then you have to pay it out. They double check what it says in your contract and that’s
Dr. Jeremy Sharp (39:55)
Yeah.
Mm-hmm.
Nicole McCance (40:17)
that ends up being a really low cashflow month in the business. So you want to be on top of this and have them take their vacay. People don’t think of this and then they’re like, my gosh.
Dr. Jeremy Sharp (40:28)
Absolutely. Yes. I am with you. Great. We’ve hit a lot of topics today, which I love. This is your vibe. We can bounce around and talk about all kinds of things. Anything else exciting on your horizon? Things you’re thinking about, talking about that you want to get on my listeners’ radars?
Nicole McCance (40:32)
you
Yeah, totally.
Lots. mean, I think therapists
are so hungry for marketing right now. I think that it, like we said earlier, it’s just getting less easy that we really need to work a little bit harder and work with people who actually know the marketing that works, which, back to our initial discussion, is not Instagram. I believe it’s email marketing. I believe it’s connecting with family doctors.
Dr. Jeremy Sharp (40:51)
Mm.
Nicole McCance (41:08)
I mean, another one of my favorite strategies is my waitlist strategy. So here it is. Ready? So you go on to Psychology Today and let’s say you’re an IFS therapist. Guess what? There are IFS therapists in your community with a waitlist. It’s going to say it. You’re going to compile them. Then guess what you’re going to do? My people love this. You’re going to email them.
because that IFS therapist, because I actually do my own IFS therapy and she stopped seeing me. What did she do? She gave me, because she worked, she reduced her hours. She gave me three names because she had a wait list of other, that’s free marketing. So you contact the people with a wait list. They want names. They feel so bad that they can’t see these people. It’s like such an easy strategy, but again,
Dr. Jeremy Sharp (41:43)
Mm-hmm.
Nicole McCance (41:59)
It’s slightly uncomfortable. Calling the doctors are uncomfortable. Calling the waitlist people are uncomfortable. And that’s in an economy like this, we just have to do those who will win, do what’s uncomfortable. And not everybody will do it.
Dr. Jeremy Sharp (42:12)
Hmm. Those who will win will do what’s uncomfortable.
Nicole McCance (42:16)
Yeah, that was like my motto because I’m like, you know what? I feel like most people aren’t going to do this. So like, I’m going to do it. Which was get a business coach. Most people won’t do that. So I’ll be the one.
Dr. Jeremy Sharp (42:22)
Mm-hmm.
Mm-hmm.
I like that strategy line, the weightless strategy. This is good. This good. Well, you have a lot of knowledge. Thanks for sharing all this with us. ⁓ Yeah, yeah, definitely. I’m sure we’ll talk again sometime, but yeah, in the meantime, thank you. Is there anything, you know, folks want to find you, do your thing, you know, where…
Nicole McCance (42:33)
Yeah, I love this combo.
Yeah, so I have a podcast. If you like podcasts, I have one, The Business Savvy Therapist. I’m also on Instagram. I think there’s 73,000 of us over there. Come, it’s a party. If you’re doomscrolling, like you said earlier. And I also have a free master class every week, How to Build a Seven-Figure Group Practice. I’ll give you the link.
Dr. Jeremy Sharp (43:06)
Nice. Yeah. And we’ll put all that in the show notes. Of course. So yeah, good to see you. Thanks for coming on.
Nicole McCance (43:09)
Awesome, thanks for having me.
Yeah, thank you.
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