Hiring a psychiatrist for your therapy practice with Dan King

Dan King: [0:00] I want to do a quick episode for you about how to add a psychiatrist to your Dan King: [0:04] therapy practice because this is often a huge struggle. Dan King: [0:07] I was with a practice owner last night who was telling Dan King: [0:10] Me about a group conversation she had with other therapy practice owners who are very, very smart. Dan King: [0:15] Seven or eight, I think, Dan King: [0:16] Practice owners who are all looking to add a psychiatrist and really struggling to do it. Dan King: [0:21] So I wanted to give you a Dan King: [0:22] Couple of suggestions here as well. Dan King: [0:24] As talk a little bit about the benefits of why you would want one. Some of them are going to be obvious, Dan King: [0:29] Some of them may be a little less obvious. So let me start with five benefits I've written down here, and then I'm going to get into three or four creative approaches to hiring a psychiatrist. Dan King: [0:40] So on the benefits, they are helping patients in more ways, Dan King: [0:44] Improving your margins, attracting more therapists, more high-quality therapists to your practice, ensure negotiating leverage, and the value of your practice at sale. So number one, you all know that medication management and prescribing are opportunities that you're just not. Dan King: [1:01] Going to have Dan King: [1:02] With a pure therapy practice. So being able to serve your patients in more ways. Dan King: [1:07] Especially in ways that are in demand, Dan King: [1:08] Can be super valuable for your practice overall, for clinical outcomes, etc. Probably don't need to convince you of this. Number two, margins. You can charge more for medication management and psychiatry. Dan King: [1:21] So, you're able to not only get reimbursed by insurers at higher rates, but when it comes to cash pay, you can charge more. Dan King: [1:30] So, that's a huge benefit. Number three, a lot of the best quality therapists want to work with prescribers. Dan King: [1:36] Want to work with psychiatrists, nurse practitioners, etc. So, and I think a lot of the really good quality Dan King: [1:42] Psychiatrists and prescribers and nurse practitioners want to work with good quality therapists too. So, quality attracts quality. And if you're able to get prescribers in your therapy practice when few other practices nearby can get them, you can attract a lot of the higher quality therapists who want to learn from psychiatrists and vice versa. Number four, think about an insurance company. Think about how you can get negotiating leverage against them. Most group practices, because they don't have prescribers, are going. Dan King: [2:09] To be less Dan King: [2:10] Valuable to an insurance company than a practice that does have prescribers. You can serve a wider variety of patients. probably. Dan King: [2:17] They're going to have Dan King: [2:18] Members of their network who really really need medication management need psychiatry if. Dan King: [2:24] They can't get that elsewhere Dan King: [2:25] You have a lot of power if you would have threatened to leave the network they're going to stand up and take notice because you would be leaving their network you would be working with competitors and you could serve, those patients of competitors better. Dan King: [2:39] They're really, really going to be frightened by that. Dan King: [2:42] So it gives you a lot of negotiating leverage. Dan King: [2:44] And then number five, Dan King: [2:45] Your practice is more valuable with prescribers. It just is. An acquisition firm, an investment firm. Dan King: [2:50] Like ours is really going to take Dan King: [2:52] Notice of a therapy practice that has been able to add psychiatry. Dan King: [2:56] You will be more valuable in the market because you have a rarer commodity. So let's talk about the how-to now. Dan King: [3:01] It's all well and good. Dan King: [3:02] You're probably convinced of the benefits. How do you add a psychiatrist? Dan King: [3:06] How do you add a prescriber or multiple prescribers to your therapy practice? I think at the core of this is that you want to build a therapy practice that delivers excellent client outcomes. You need to be worthy of prescribers. Dan King: [3:18] And this isn't to say that prescribing is more impactful or important in the mental health landscape than therapy. Dan King: [3:25] I don't believe that. But we do want to build a therapy practice that delivers excellent clinical outcomes. Dan King: [3:31] Because that's going to be Dan King: [3:32] Attractive to prescribers. High quality prescribers. Dan King: [3:34] Are going to want to know Dan King: [3:35] That you're good at what you do. The reality is there is a hierarchy. It's not necessarily fair, but psychiatrists see themselves, maybe arrogantly, but they see themselves at the top of a hierarchy and they will sort of sit in judgment, even some of the ones that you would want. Dan King: [3:50] To work with. And so you should do the same to them, Dan King: [3:53] By the way. You should judge them. You should do due diligence on whether they're able to produce good client outcomes. Dan King: [3:58] The reality is they can very often on their own command more obvious business opportunities Dan King: [4:04] They offer a higher margin service than therapy typically. Dan King: [4:07] Is and so that ability to generally if they're somewhat entrepreneurial build a business on their own gives them a lot of leverage so there's the the status hierarchy and then there's the financial aspect of things and they often just have a lot of power so They'll need to be convinced, and they also are not always fair in how they judge therapists. Dan King: [4:28] So at the core of what you want to do is build a therapy practice that delivers excellent, demonstrable clinical outcomes so that you can make a case to a psychiatrist. Dan King: [4:37] Thought number two I have for you. You may not actually need to hire a psychiatrist at all or right away. You could potentially just hire a nurse prescriber. The laws vary from state to state about whether you can do this or how to do this. Some. Dan King: [4:50] States are going to require that Dan King: [4:52] A psychiatrist supervise in a relatively close way, a nurse prescriber, a nurse practitioner, excuse me. Other states will not. Other states, you can pretty much just hire a nurse prescriber and a psychiatrist could supervise from a distance. Dan King: [5:05] Nurse practitioner lobbies are fighting more and more aggressively across the country to get independent prescribing rights. And so that battle is ongoing. And you may in your state just be able to hire a nurse prescriber where the economics are often better. Dan King: [5:16] It's often easier to make the case to them than trying to hire a psychiatrist so you could explore whether you could just hire a nurse prescriber. Dan King: [5:23] Rather than a psychiatrist. But let's say you really, really want a psychiatrist. Dan King: [5:28] It has to be a psychiatrist in your state. How do you do that? So I'm going to give you. Dan King: [5:33] I'm going to give you three approaches. Dan King: [5:36] Actually, I'm going to give you four approaches. The first is to add a psychiatrist advisor to your practice. The second is to find a psychiatrist with a small practice. The third is to hire one right at a school. And the fourth is to work with a firm like ours, an investment firm that. Dan King: [5:50] Has credibility and has either Dan King: [5:52] Connections with psychiatrists or the expertise and knowledge and credibility to add a psychiatrist. So those are four approaches. Let's start with the first, adding a psychiatrist advisor. You know, maybe you find a psychiatrist who is retired. They're not able to come on board full time. Dan King: [6:07] They don't actually want to see patients, Dan King: [6:08] But they still want to work. Dan King: [6:10] They want to keep their hands a little bit dirty. Dan King: [6:12] They want a side gig. They want, you know, to bring a sense of purpose and contribution to their lives. Dan King: [6:17] Find a Dan King: [6:17] Retired psychiatrist in your. Dan King: [6:18] Area and bring them on board as an advisor. Dan King: [6:20] Maybe you pay them a little bit. Dan King: [6:22] Maybe you don't. Maybe you give them some equity in your business, Dan King: [6:25] Right? But a retired psychiatrist can give you credibility, can also help with legal compliance where in certain states. Dan King: [6:31] If you want to bring on a nurse practitioner or a psychiatrist, Dan King: [6:36] You may need to have a medical entity, may need to be owned by a psychiatrist. They could serve that purpose for you. Dan King: [6:42] You're going to definitely want to know the law in your state around what's Dan King: [6:46] Required to bring in a psychiatrist. If you don't, I can introduce you to the right lawyer. Dan King: [6:50] You can also start out with ChatGPT, but you're going to want probably the right lawyer to help you out here. Just write me an email, dan at firesidestrategic.com. I can probably make an introduction for you, and you're going to want to have the legal side really, really buttoned down. Dan King: [7:04] But a psychiatrist advisor can help with the credibility, find the right psychiatrist. Dan King: [7:09] And even if you find the psychiatrist Dan King: [7:10] And they don't, they can bring credibility into the conversation. If you go into the conversation with a psychiatrist who really. Dan King: [7:16] Knows their stuff, Dan King: [7:17] That could impress the psychiatrist that you want to hire, right? Dan King: [7:20] So that's thought one. Bring on a part-time advisor, Dan King: [7:23] Someone for credibility boosting. Number two, find a psychiatrist with a small practice. Maybe it's someone. Dan King: [7:30] Maybe it's a woman psychiatrist who is raising a family for a few years and wants to get back to the workforce. Maybe it's someone in an unconventional situation who hasn't quite found the right fit. Dan King: [7:40] A psychiatrist with a small practice. Dan King: [7:42] You know, may not be the most entrepreneurial. They may actually want to be an employee, just like a lot of the right clinicians that are going to be with Dan King: [7:49] You for a. Dan King: [7:50] Long time and have an employee mindset. Dan King: [7:52] Find a psychiatrist who's maybe a little less entrepreneurial. Dan King: [7:54] Who just wants a job, doesn't want to Dan King: [7:56] Be bothered with any of the paperwork. Dan King: [7:57] Want to be bothered with the admin. Dan King: [7:59] Number three, take a look at psychiatrists who are just graduating. Dan King: [8:03] From school in your area. Dan King: [8:05] Hiring someone right. Dan King: [8:06] Out of school who's able to be molded, who may be a bit more humble, they're probably more likely to be a little bit more open-minded. Dan King: [8:13] Try to build a pipeline. Take a look at the school, the medical schools in your area. Look to hire someone right out of school. Dan King: [8:19] And I think if you did the first Dan King: [8:20] Suggestion of a psychiatrist. Dan King: [8:22] Advisor, Dan King: [8:22] That could be a really powerful pitch to someone who's right out of school, who's open-minded, who really wants to learn from therapists. And. Dan King: [8:29] Then the fourth Dan King: [8:30] Concept is work with a firm like ours. So we have credibility here. Dan King: [8:35] You know, we know psychiatrists, Dan King: [8:36] We work with excellent psychiatrists. Dan King: [8:38] And we're able to, you know, in conversations with psychiatrists, we're able to be credible. That really matters. And we have the expertise to know how to create interdisciplinary partnerships between Dan King: [8:50] Psychiatrists and therapists, between nurse prescribers and therapists. Dan King: [8:54] Not everyone has that expertise or that knowledge. And as investors, if we invest in a company, Dan King: [8:58] We have every incentive to grow it. That incentive to grow it often means adding services. So it could mean adding psychiatry. Dan King: [9:06] Adding nurse prescribers. It could mean adding psychological and neuropsychological testing. It could mean adding Spravato, Dan King: [9:11] TMS. All of these services are. Dan King: [9:13] Within our wheelhouse. And our incentive to help you add services is very, Dan King: [9:18] Very strong if we invest. And. Dan King: [9:20] Probably there are other investment Dan King: [9:22] Firms out there that do something similar to what we do. So working with a firm like ours is a way to both get. Dan King: [9:28] An investment as a Dan King: [9:29] Financial investment as. Dan King: [9:31] Well as bringing on Dan King: [9:32] A psychiatrist. Typically. Dan King: [9:33] Now this is the Dan King: [9:34] Self-serving portion of the episode. Dan King: [9:36] We will typically buy a majority of practices, Dan King: [9:39] Of therapy practices. Dan King: [9:40] And we buy that majority. Dan King: [9:42] And so the cash associated with that purchase. Dan King: [9:45] Most of it you get to keep because in general, the mental health business is not a very cash-intensive business. Dan King: [9:51] It doesn't require a ton of cash to grow businesses. So most of the cash that we use to buy a. Dan King: [9:57] Stake in your practice, you get to keep. Dan King: [9:58] So you get to keep, you get to take chips off the table. Dan King: [10:01] And at the same time, you bring on an investor who is motivated to help you grow. Dan King: [10:05] And part of that motivation. Dan King: [10:06] As I say, is going to be adding services. So we have some very sharp people who know how to add services. And typically for us, Dan King: [10:13] Medication management and psychiatry are at the top of the list. We see just a ton of demand across the country. We're very motivated. Dan King: [10:20] To bring our Dan King: [10:20] Expertise to bear to help you find the right psychiatrist who's a good culture fit, as well as a good fit to serve your patients. Those are some of the benefits of hiring a psychiatrist. Dan King: [10:30] And those are Dan King: [10:31] Four unconventional approaches to hiring a psychiatrist because you may be struggling at the moment. Dan King: [10:37] You may really want to do it, but you may be struggling to bridge that credibility. Dan King: [10:41] Yeah. So those are some ways to go about doing it. I wish you the very best of luck with your practice. And shoot me an email anytime at dan at firesidestrategic.com. Dan King: [10:51] That's dan at firesidestrategic.com. Dan King: [10:54] Have a great day. Take care. Bye.