Dr. Sharp: Hello, everyone. Welcome to The Testing Psychologist podcast. I’m your host, Dr. Jeremy Sharp, licensed psychologist, group practice owner, and private practice coach.
Many of y’all know that I have been using TherapyNotes as our practice EHR for over 10 years now. I’ve looked at others, and I just keep coming back to TherapyNotes because they do it all. If you’re interested in an EHR for your practice, you can get two free months of TherapyNotes by going to thetestingpsychologist.com/therapynotes and enter the code “testing”.
This episode is brought to you by PAR.
The new PAR training platform is now available and is the new home for PARtalks webinars, as well as on-demand learning and product training. Learn more at parinc.com\resources\par-training.
Hey everybody, welcome back to the podcast.
Today is a business episode. It’s an example from a real-life situation in my practice that happened recently, and I wanted to turn that into a bit of an episode here.
As you can tell from the title, I had a recent experience of freaking out a little bit when our intake calls dropped and I had no idea why. This is just a story, I suppose, of how I investigated that and used some of the metrics that we track to dial back the anxiety and get a clear handle on what was happening. So if you are out there and you’ve experienced a drop in your intake calls, I have heard this from several practices around the country. I don’t have a great idea of what’s going on. I have some thoughts I’ll go into in the episode, but if you’re in that group, this might be the episode for you.
We’ll talk about what happened, how I investigated it, some of the metrics that helped me in the situation, and then the action that I took and that I think you could probably take as well if you are wrestling with a drop in call volume or bookings here lately.
Let’s get to this episode talking about the importance of metrics and not freaking out.
All right, folks, here we are back talking about a real-life example from my life where metrics came in handy.
Let me dive into it. This is going to be a relatively short and to-the-point episode, but like many episodes, this came from a real example in my practice. I thought I might share some of this experience with you.
3 to 4 weeks ago, we noticed that we had a relatively sudden drop in our incoming calls. As I talked to folks around the country, I was hearing this more and more. I heard it locally as well. I still am not totally sure what happened or what is going on right now with the drop in calls. I have theories. I know that was right around the time that the stock market started to tank. There is, I think, increasing uncertainty at the federal government level, and I don’t know, people are maybe just holding on to their money and focusing on essential things right now. Unfortunately for many folks, psychological or neuropsychological testing would be considered non-essential. That’s my guess. I combine that with the fact, especially locally, that our schools started to go on spring break, and presumably, people are out of town and not concerned about booking a neuropsychological evaluation.
All that said, though, something happened 3 to 4 weeks ago where we had a very sudden drop in our intake calls. So I freaked out.
Now, we’ve been very fortunate. I’ll set the scene here. We have been very fortunate over the years that we are pretty consistently booking anywhere around, let’s just call it 50 intake calls a week. So we have 50 incoming inquiries, and we have a pretty good conversion ratio that sits around 75 to 80%. That has been consistent over the years despite any number of factors. And so, it stood out to me when I noticed that the calls were dropping.
And so, like I tend to do, like I said, I got really anxious and freaked out at first. I was worried that something had changed, like we were doing something wrong, that something was broken on the intake booking side. Any number of thoughts ran through my mind. Of course, I catastrophized and thought about whether I need to fire everyone and downsize to a solo practice or maybe get out of business entirely, because clearly we were failing. Just a simple catastrophic thinking pattern.
When all that settled down, though, I took a step back and I started to rely on the metrics. I’ve talked about metrics on the podcast before, of course. And so that is the first point to highlight right off the bat. Before we get into any specific metrics or process that I went through to ease some of my anxiety, specifically, just the idea that we have metrics is what allowed me to catch this problem in the first place. And I caught it really early.
I’ve talked before about metrics on the podcast. One of the things that we track is incoming calls. We track all of the booked intake calls that we conduct each week. And so I knew within a few days that there was a big drop. And so that’s the first thing to highlight, that, if nothing else, just tracking that number allowed me to catch it quickly and take some action on it. We’re going to get into some more details about exactly what action I took and the outcome here.
Let’s talk about metrics just a little bit.
I’ve talked about metrics and KPIs, or key performance indicators that are relevant to private practice, in previous episodes. So you can go back, you can check out. I’ve done more deep dives on KPIs. So, I’m not going to go into a ton of detail about KPIs and what those are. The short story is that KPIs or metrics are a short list of numbers that you are keeping track of that will instantaneously give you a sense of the health of your practice.
The things that we track in our practice are booked intake calls, conversion ratio for those intake calls, absolute number of intakes booked each week, and actual evaluation intakes. We track our income each week, our gross revenue. We track our insurance aging and our patient aging- how much patients owe us and how much insurance owes us at any given moment. We also track our profit percentage each month. We track the number of billed hours each week, and we track the number of outstanding notes that are older than a week old.
That’s a brief window into the key performance indicators of the metrics that we are tracking every week. When I say tracking every week, I mean myself, my admin lead, and my office coordinator get on a meeting. It’s an hour long. We go through these numbers at the very beginning, and we talk about whether they’re on track or whether they’re off track. That gives us insight and lets us do things about it if we need to.
That’s the brief recap of key performance indicators or metrics that you might want to track in your practice. But in this case, there were a few things that I looked at very specific to this particular problem. I dove a little deeper into the metrics that could help tell the story about this downturn in screening calls. I looked at things like our website traffic. I looked at how many people were clicking our booking link on the website. I looked at how many people were submitting our booking form. And then, of course, I looked at the actual booked screening calls. Those are the four things that I looked at.
Being able to look at these things, again, helps you get a firm handle on what’s actually going on instead of living in that anxiety and just wondering what’s happening. I run into this a lot with folks that I consult with, and clearly, like I shared, I do it myself even before I rely on the numbers.
I run into this dynamic a lot where folks will say, “My referrals are down.” I’m like, “Oh, what do you mean? How much are they down?” And then folks typically don’t have a great idea of what that even means. It’s just like, things just seem really slow, or nobody’s calling or nobody’s booking or I’m not as busy as I want to be, or any number of variations on that theme.
My first question is always, well, what does the data say? In the majority of cases, folks are not tracking that data. And so at that point, we’re living in no person’s land. Without data, it’s really hard to know anything. In some cases, it’s hard to gather data. I get that. But for these particular metrics, especially with our EHRs and other software, it’s pretty easy to track the things that I’m talking about. So this is a small call to action to track as much as you can, or at least learn what you could track within your EHR and your website portal, and that kind of thing, admin portal.
Short story, metrics help us catch problems early, and they give us a good sense of what’s happening instead of forcing us to rely on our feelings, guesses, and intuitions, which are often wrong.
What we know from research, too, just to throw this in there, is that practices that use KPIs and regular tracking tend to outperform those that don’t, at least in the financial sense.
Okay, so what did I do? Let’s talk about that; my specific experience in systematically investigating this.
Let’s take a break to hear from a featured partner.
Y’all know that I love TherapyNotes, but I am not the only one. They have a 4.9 out of 5-star rating on trustpilot.com and Google, which makes them the number one rated Electronic Health Record system available for mental health folks today. They make billing, scheduling, note-taking, and telehealth all incredibly easy. They also offer custom forms that you can send through the portal.
For all the prescribers out there, TherapyNotes is proudly offering ePrescribe as well. And maybe the most important thing for me is that they have live telephone support seven days a week, so you can actually talk to a real person in a timely manner.
If you’re trying to switch from another EHR, the transition is incredibly easy. They’ll import your demographic data free of charge so you can get going right away. So if you’re curious, or you want to switch, or you need a new EHR, try TherapyNotes for two months, absolutely free. You can go to thetestingpsychologist.com/therapynotes and enter the code “testing”. Again, totally free, no strings attached. Check it out and see why everyone is switching to TherapyNotes.
I’m excited to tell you about PAR’s all-new PAR training platform, an elevated online learning environment with everything you need in one place. This is the new home for PARtalks webinars, many of which offer APA and NASP-approved CEs, and also houses on-demand learning tools and PAR product training resources. Best of all, it is free, totally free. To learn more, visit parinc.com\resources\par-training.
All right, let’s get back to the podcast.
I’ll do a quick little sidebar. This is one of my curses and blessings. I am relentlessly curious about something that’s not working. For example, when I see that our calls have dropped, I immediately switch into research mode, and I will not stop until I figure out what exactly is going on. And so that’s what happened. I had a lot of avenues to pursue to see what was going on.
The first thing I did was I checked the website traffic. You can get this through Google Analytics. Some hosting platforms will give you this. But this number should be pretty easy to find for you as long as you know how to log into the backend of your website or Google Analytics. So I looked at our website traffic and found that website traffic was consistent. Okay, good. So it was not a matter of people not searching for us or not finding the website. So I could wipe that off the screen in terms of a potential driver for this drop in calls.
Next, I looked at our calls to action on the website. We are relatively militant about only having one call to action on the website. I don’t mean just one button. I mean, all the calls to action throughout the website go to the same place.
I’ve talked about this with Brie Chrisman and other folks, I think Uriah Guilford. I think it’s very confusing for clients and introduces a lot of friction if you have multiple means of contacting your practice, if you have a Call Now, or an Email as this, or a Submit This Contact Form.
I like to focus on one single call to action and one method of contact. For us, every call to action on our website directs us to have clients submit a form, basically an inquiry form that then allows them to book a screening call with our scheduling team.
I checked the buttons, made sure that all the buttons were working, first of all. I wanted to make sure that the link didn’t break or something like that. None of the links were broken.
Then I looked at the click rate on those buttons. Now, this is a little bit more advanced. We have it set up where those buttons are mapped to a specific, unique link that I can track. So I know every time someone clicks on that button. I went and looked at the history and found that we were getting just as many clicks to the call-to-action buttons as we typically had. Now, there was a very small drop, I’m talking like less than 10%, let’s say, it was about 5%. There’s a very small decrease from month to month in the calls to action. So that wasn’t enough for me to be concerned about that.
When I was confident that we had about the same number of people clicking those calls to action, then I went to the next step in the process, which is submitting that inquiry form. This is where things got interesting.
What I was finding was that we were having fewer people submit the intake form or the inquiry form than we previously had. And so, I dug in and looked at the intake form, and I found, I’ll just call it a little error in the intake form. There was a little problem with the formatting. I still do not know how it changed or what introduced that error. So that’s still bugging me, but I did figure out that there was a little problem with the intake form that introduced a step in the process that made it slightly tougher for people to submit the form and then subsequently book their intake screening call.
And so, walking through this process was super helpful for me. At each stage of that process, I was looking at the specific numbers involved in each stage of client conversion, which allowed me to take some action.
I fixed the inquiry form and then double-checked the whole process. I looked at the people who submitted the intake form, how many close the loop by booking the screening call, which is the last step in the process. What we found there is fewer people were submitting the form and booking the screening call.
Again, going step by step helped. It also reassured me because, to me, it’s almost a bigger problem if we were getting less traffic to the website or fewer people clicking on the booking link or the call to action. So this told me, okay, this is a very specific problem with this form. Let me see what I can do to fix the form and increase the booking of the screening calls. So instead of reveling in that anxiety and spiraling down into more and more panic, I got a little reassurance and got to stop guessing. Maybe the most important thing is that it gave me clear next steps in terms of how to optimize the booking process. I didn’t have to take any huge steps as far as revamping marketing or something like that, which I maybe would have if I didn’t have the data and the metrics to guide the decision-making process.
Now, to close the loop on all of this, on the backend, I also found that, again, going back to the beginning, since we track screening calls that are booked each week, all I had to do was wait a week and find out how many calls we had booked for that week. And the calls went back up. Now, they’re still not, I’m going to be transparent, they’re still not at the same level that they were 4, 5, 6 weeks ago prior to this drop, but they are increasing.
What I’m going to do is continue to track this metric. I’m going to look at these screening calls every week and see if they’re trending upward and returning to normal or if they’re staying a little lower. Over time, let’s say 2, 3, 4 weeks after, for me, I’m going to wait till the spring break passes and parents are getting back to school, and kids are getting back into the classroom, and we’re doing parent teacher conferences and that kind of thing. So I’m going to give it a little time and see where the numbers are trending and then possibly make another decision based on those metrics.
The cool thing about all this is that I was able to come back to that metric and realize, Hey, it’s actually not as bad as I thought it was. Even though we have fewer calls booked, we’re still booking more intake appointments than I thought we were. So the absolute number of intake appointments was less than before, but it was more than I thought it was. And it is actually more than we have capacity for. So we were still booking a solid number of intake appointments, and that gave me some reassurance as well.
Just to recap a little bit. Metrics are important. I gave you a decent list of the metrics that you could be tracking in your practice at the beginning of the episode and in previous episodes.
What I would encourage you to do is to take a simple step is either figure out what metrics you could track. So that would be looking at your website analytics. It would be looking at your call volume. That would be digging into your EHR and seeing what data you can you can pull from it and just start tracking one thing.
Try to pick one thing that you think is important to you. Maybe it’s incoming calls. Maybe it’s the absolute number of appointments you book. Maybe it’s the conversion ratio. It could be any number of things, but just start a tracking process. It does not have to be fancy. You can do it on a Google sheet or an Excel sheet. You can do it on a piece of paper if you want to and make tick marks, but think about one metric that you could start to track. This is a step in the right direction. It’s super easy, and it starts to build that muscle.
If you’re wrestling with which one to track and which one is important, I fall back on words that were shared with me by our EOS consultant over the last few years. The way he framed it is, what number or numbers would you want to know? If you were on the vacation of your life and you had a series of numbers or set of numbers you could look at that would give you an idea into the health of your practice, which ones would you want to know that would tell you whether you could continue to hang out on this amazing vacation and order another drink, or if you need to get on a plane immediately and fly home. Figuring out which of those numbers feels most important. And like I said, you can pick one or two to start. It can be pretty straightforward.
I hope this is helpful to you. If you are wrestling with the numbers or metrics or trying to figure out what to do with this, happy to jump on a strategy session with you. You can go to thetestingpsychologist.com/consulting and book a strategy session right there. It’s an hour. We’ll jump in, talk about numbers, get a tracking sheet going, and I’ll try to send you away with some pretty concrete helpful info.
That’s it for today, folks. I love numbers, I love math. In this case it benefited me and my practice so that I was not freaking out and making people do all kinds of crazy things to get our intakes up. All right, thanks as always.
All right, y’all, thank you so much for tuning into this episode. Always grateful to have you here. I hope that you take away some information that you can implement in your practice and your life. Any resources that we mentioned during the episode will be listed in the show notes, so make sure to check those out.
If you like what you hear on the podcast, I would be so grateful if you left a review on iTunes or Spotify, or wherever you listen to your podcasts.
If you’re a practice owner or aspiring practice owner, I’d invite you to check out The Testing Psychologist mastermind groups. I have mastermind groups at every stage of practice development: beginner, intermediate, and advanced. We have homework, we have accountability, we have support, and we have resources. These groups are amazing. We do a lot of work and a lot of connecting. If that sounds interesting to you, you can check out the details at thetestingpsychologist.com/consulting. You can sign up for a pre-group phone call, and we will chat and figure out if a group could be a good fit for you. Thanks so much.
The information contained in this podcast and on The Testing Psychologist website is intended for informational and educational purposes only. Nothing in this podcast or on the website is intended to be a substitute for professional psychological, psychiatric, or medical advice, diagnosis, or treatment.
Please note that no doctor-patient relationship is formed here, and similarly, no supervisory or consultative relationship is formed between the host or guests of this podcast and listeners of this podcast. If you need the qualified advice of any mental health practitioner or medical provider, please seek one in your area. Similarly, if you need supervision on clinical matters, please find a supervisor with expertise that fits your needs.
Click here to listen instead!