Mission clarity in group practice with Dr. Ryan Duckworth

Dan King: [0:00] It is a pleasure to have Dr. Ryan Duckworth, clinical psychologist and founder and owner of Hope and Wholeness Psychology Center in the Grand Rapids, Michigan area. Ryan, welcome. It's so good to see you again. Dr. Ryan Duckworth: [0:12] Yeah, thanks so much, Dan. Thanks for having me on the podcast. I'm excited to chat with you. Dan King: [0:16] Great. So please tell our audience the basics of the practice. Tell us about size, number of clinicians. Dr. Ryan Duckworth: [0:23] So I started this practice about eight years ago, a little bit sooner in my career than I thought I would, but I found myself praying for 12 clients a week that first year. We've grown now over the past eight years to having six locations and about 36, 37 clinicians right now and talks about a seventh location as well. So a lot of fun, a lot of work, pretty crazy journey for sure. Dan King: [0:47] Well done. And if you were to look back on this journey now, all those years ago, what would you have told yourself was the biggest challenge in getting to this point? Dr. Ryan Duckworth: [0:56] I know exactly what I would say, actually, because I've thought about it. I would say, be clear about your mission and your vision. Be clear about the foundation that you're building your business upon. Because I think that I did have a mission and vision statement, and it hasn't changed much over the last eight years. But I do now feel sometimes like I'm a little bit stuck with the mission and vision that I have. I don't have this specific idea of what I would change it to, but I know the type of practice we've built. And it's very difficult to change the culture, to change the mission and the vision, you know, eight years in when you've got 30 people that are not actually employees, they're contractors. And so you are a leader, but it's also kind of a contractual relationship more than an employee, you know, employer relationship, a lot of dynamics there. And so I would say, really think about your mission and vision. And as hard as it is, think five years down the road, think 10 years down the road, and think, what is this going to be like if I grow and hire based on this foundation? What do I imagine this will look like? And is that what I'm looking for? I think I did pretty good. I really love where I'm at in life. I have a great life. I have a great practice. I love all the clinicians. You know, my practice manager is amazing. But I think that there are some things that I'm thinking about. If I were to, even right now, if I were to sell my practice and start another one, I know it would be a little bit different. I don't even know exactly what I would choose, but I know I'd choose something a little bit different to grow it on. Dan King: [2:17] So how would you articulate? I mean, listeners can read the website, but sitting here talking, how would you articulate the mission and the vision originally? And can you sort of walk us through some of your internal conversations around roughly like what the change might look like? Dr. Ryan Duckworth: [2:33] Absolutely. So the current mission and vision, not verbatim, is to provide compassionate, effective, research-based, psychological intervention for anybody from any background and to be part of the healing ministry of Jesus. Dr. Ryan Duckworth: [2:46] The vision is really a community where anybody from any background can come to hope and wholeness and know that they're going to be loved, they're going to be accepted, they're going to be treated with dignity and respect, and that we are going to create a plan for reaching their goals that they're involved in. That's the basics of the mission and vision. And again, I don't know how I change it, but kind of like one of the main things that I've batted around in my head about the mission and vision is, do I want a practice that has the same Christian faith as me? Or do I want people who have a different faith? And if they have the same faith, how much difference am I going to tolerate or be okay with? I also would have considered more that I'm going to attract people who are similar to me pretty much in every way. Can you hire people who are different from me? 100%. But who am I going to connect with? Who's going to trust me? Who's going to feel comfortable with me? That's something to consider as well. I think the first four or five people I hired were fairly well aligned with me. Now, actually, a couple of them have, I would say that they're still aligned with me in terms of compassion and love for other people. But I would say in terms of the expression of that, it's slightly different, which I think is good. It's fine. But I think that those first few people I hired really determined the direction and the type of culture that we established in our practice. And I don't think I realized at the time the significance of that. So I think that I would have put a lot more thought into the types of people that I hired first. And if I wanted to have a practice that was really, truly diverse, I think I would have put more effort into hiring some people who were distinctly different from me in the beginning. Dr. Ryan Duckworth: [4:13] And not that I even intentionally thought about exactly who I was hiring, but the for two people, I was like, wow, they're a Christian, they believe in God, and yet they have love for everybody. Dr. Ryan Duckworth: [4:22] You know, they're going to be welcoming to racial, sexual minorities. And I guess to put it plainly, I would just say to have more purpose, intentionality, and direction about the type of people that I'm going for initially, because that's the foundation upon which we're going to attract and build other people. Does that make sense? Dan King: [4:39] That's such a rich answer. Thank you for that. There's eight different follow-up questions I could add. Where I'm going to go next is, and one of the things that's come up in a number of podcast interviews so far is that importance of distinguishing yourself. So the fact that your Christian message is at the core of what you wanted to build, that's distinct. There are definitely other practices like that, but the majority are not. And if I'm a clinician and I'm deciding, or I'm a patient, I'm deciding where to go, that gives me a really distinctive opportunity to decide, yay or nay. So that's important. And we see this, especially for attracting clinicians, which is one of the biggest challenges most group practice owners have. Creating a distinct brand that is true to who you and the core people in the practice are, that's important. But similarly, so is diversity of thought. You know, there's all different kinds of diversity. There is pretty strong evidence that diversity of thought, which can come from people who take many different forms, a diversity of thought when you're dealing with complex challenges, people's lives come up in therapy all the time. They're pretty damn complex, right? Dr. Ryan Duckworth: [5:44] Yeah. Dan King: [5:44] But how do people create a distinct brand? How do they balance creating a distinct brand with the importance of diversity of thought, especially in a complex field like therapy? Dr. Ryan Duckworth: [5:54] Yeah. Well, unfortunately, you're probably going to get a long winded answer to that big question. But I would say that also our practice is definitely built on the foundation of my love for other people, my care for other people coming from my faith and coming from how I believe Jesus loves people. And that's a distinct thing much more in my personal practice or my personal, I guess, belief system than it is in others. But it is something to definitely consider because although I'm a unique individual, people see our website, they see that we're that we have the healing ministry of Jesus in our mission and vision. They think a lot of different things about that. they are going to interpret that through the lens that they've personally lived, that culture gives them to look through it. And so there's a lot of pros and cons to that. But in terms of kind of your question, yeah. So I would say that, you know, those two things are definitely compatible. But like I mentioned already, the part that can be difficult is that your mission and vision is going to be pretty specific. It's going to distinguish. And it's also probably going to attract people who are similar. And so I think that having something in your mission and vision statement and in the way that you practice that also values diversity is really important. So it was only a couple of years ago that we put a diversity inclusion statement on our website. We put quite a bit of time and energy into creating it because this was something that kind of, we weren't going to change our mission and vision, but we wanted it to distinguish ourselves and really kind of clarify who we are as a group. And in some ways, how our Christian foundation is now involved in kind of, Dr. Ryan Duckworth: [7:24] Forming the culture of our practice. So I'm just going to read it. Our goal is to be a place where anyone is welcomed and supported on their journey towards hope, healing, and wholeness. We know our commitment to diversity and inclusion is central to being able to achieve this vision of welcoming everyone. We work hard to foster a culture where love and care for others is authentic and automatic. Dr. Ryan Duckworth: [7:43] We understand that unique perspectives generate better ideas and improve our ability to help the people we serve. We realize that welcoming everyone is a lofty goal because of the polarizing differences in our culture, but this is part of what makes it a goal worth striving for. We believe in creating a safe space for all communities and people, regardless of race, ethnicity, sexual orientation, gender identity, religious beliefs, disability, or socioeconomic status. I almost love that as much or maybe even more than our mission and vision statement. And I feel like this really gives people the kind of the information that they need to know that we do value your distinctive beliefs and that you need to be a distinct person in private practice to be successful. And you're going to find that I'm a distinctive person and I'm going to be my authentic self. And you're going to hear about my spiritual beliefs, but you're going to hear about them in the context of love and respect and not what some of our culture kind of perceives as the negative things about anybody who has strong convictions. Because anybody with strong convictions can very easily cross that line into disrespect, in my opinion. So we want to tell them exactly who we are. And so that actually, I probably didn't think about this much until you asked me, but I think that that probably has improved. I think the last several people that we've hired, they don't have, you know, maybe as much difference for me as I would like, but we are hiring some different people, that's for sure. And I think that meeting with me, knowing that that's on our website provides them a little bit more clarity and a little more confidence in choosing where they're going to be employed. Dan King: [9:10] Well, I salute what I think is really your courage in standing for what you believe, right? But in also staying true to the core of what you're here to do. Love has to be at the core of all therapy. It has to be at the core of how we care for our teams, right? All the people around us. I think you're courageously standing for both. You're right that anyone with strong convictions, like any practice, you know, I interviewed a gentleman named Eric Arzubi, who runs a psychiatry practice, which is devoted to providing telepsychiatry to very remote communities in Alaska, Montana, Idaho. And that's a very distinct message. He's standing for something. Not everyone agrees that telepsychiatry is what we should be doing in remote communities, right? And so when you stand for something, you do attract some level of controversy Dan King: [9:55] and there's a courage inherent in. Dr. Ryan Duckworth: [9:57] Yeah, I totally agree with that, especially in our culture and our society. I say it is a lofty goal to have all those differences in the same room, especially with people with the strong convictions that they have these days. It's even scary sometimes, that's for sure. Dan King: [10:11] Does this make for different interviews, perhaps, than you might see with other group practices, where in standing for what you stand for, but in an inclusive, loving way, do you still find that that makes for some pretty vulnerable job interviews with clinicians? Dr. Ryan Duckworth: [10:25] It does. There have been several, several job interviews where I've been able to, you know, basically have a corrective emotional experience with people, you know, interacting with a white male in my position of power in a practice like that. Christian person? Absolutely. There has been some really cool, and I preach this a lot as well, is that love is our primary motivator. And the reason is because love, I believe, is what changes people. It's an experience that changes people. People don't get changed usually by logic. I can present you an argument, Dan, but I don't really think that you would be totally changing your beliefs from one side to the other because I gave you a logical argument. But if I invite you into my home and I give you an experience of what it's like to live this other logical argument that I'm making, you're going to be far more impacted by that. And that's how I was impacted even in graduate school with loving other people who are different from me. It's like, I met these people and I was like, wow, I'll be honest with you. I was like, wow, you're gay? I like you. You're a good person. And they're like, you're a Christian and we're hanging out. And I'm like, you know what I mean? And so we both had this experience of love that changed us. And honestly, my beliefs moved towards theirs and their beliefs moves towards mine. We moved closer as a result of the experience, not of any type of logical argument. Dan King: [11:47] I love your answer about love. Are you able, and if not totally cool, are you able to share a story or two on a no-names basis about a job interview with a clinician where, you know, the power of love was an animating force. Dr. Ryan Duckworth: [11:59] Yeah. Um, I could share. Dan King: [12:01] This could be really helpful for practice owners, right? Who are thinking about how they interview. It's so important. Dr. Ryan Duckworth: [12:07] Yeah. You know, I'm going to do my best. I remember one in particular with a person that we were looking to hire and, uh, we were sharing and talking, you know, typically interview and I'm a little bit more like down to earth, both in terms of my genuineness in relating to others. I'll wear a collared shirt, but I'm generally speaking just a little bit less professional. I tell people straight up, I'm straightforward. I'm transparent. I'm honest. I'm going to ask you all the questions you have the right to ask me, all those questions right back. I pretty much say that every interview. And I ask people very specifically, what are your spiritual beliefs and how do those impact your practice? Because in my opinion, everybody has spiritual beliefs and it is a sign of growth as a clinician to be able to know how those spiritual beliefs impact the therapy room. I mean, it's not a question of discrimination of this or that. It's anybody needs to know how what you're bringing into that room is affecting your client. And so I ask him that. I say, you know, tell me about a time that you worked Dr. Ryan Duckworth: [12:56] with the client was different from you. And it was hard because everybody, in my opinion, should have that experience in their clinical training. But it came about that she had told me that she had had, I believe, a child die before. At a very young age if i remember right and um and she had said something like you know it's just i'm i'm okay with it now god god has shown me that how he's you know brought good out of it and how you know he he caused it to happen for a reason i think is what she said he made it happen for a reason and i in my typical style use socratic dialogue i'm like oh where did that thought come from you know and like where did that belief come from and who told you that where did you see that in the Bible? Dr. Ryan Duckworth: [13:36] You know, just really honest, genuine questions to get her. And by the end of the session, she was like, in tears, she's like, oh my gosh, it wasn't God who caused this. It was the devil who caused this. I'm like, yes. You know, the devil is the stealer of life and the author of bad things. And she was able to have kind of a corrective experience of God in an interview with me of not blaming God for something bad that happened or having to accept something that God did that was, that was bad. And I didn't even put that thought in her head because I don't really believe in me telling somebody what my opinion is, but helping somebody kind of get to a conclusion on their own, that's going to kind of be helpful for them. I'm all about that. You know, and some people would definitely not be that bold. And some people might even disagree with how I do an interview and I'm totally okay with that. And I'll be like, Hey, you have some, you have some legitimate concerns about that. But that's how I am. And I remember another experience was with a lesbian woman that had had some kind of relationship trauma and had definitely had bad experience with Christians before. Dr. Ryan Duckworth: [14:40] And again, I apologize. I don't remember all the details, but I was in tears. I was in tears apologizing to her for how she had been treated. And she did not end up joining our practice. And she was transparent with me that it was going to be a real stretch for her to be an environment where at least 50% of the people were Christians and she wasn't sure how they were going to take her. And I said, I 100% hear you and you do not have to take shoulder all that responsibility in our practice. You know, some of that is on me. Like I can't be a gay woman in our practice and be that person. But if you don't want to be that person, I 100% support you. Dr. Ryan Duckworth: [15:14] And I remember the practice that she joined. I said, that is going to be great for you. And I'm so pumped for you to be in a place where you're going to be at your best because where you're at your best, you're going to do your best work. Your clients are going to get the best outcomes. I'm almost tearing up right now. I love that person. I wanted her at my practice. We had such a good time together. Yeah, I love it. Dan King: [15:34] Now that is raw and real. Thank you so much for sharing those stories. I think that's going to provide great fodder for other group practice owners who are doing these interviews who perhaps haven't built the same distinctive brand that you have, right? And you're honoring your brand, right? You're being both Christian, but also loving. That's who you are. That's what your brand is, right? Dr. Ryan Duckworth: [15:56] Yeah, and not controlling too. Not controlling. I don't want to control people. I want to help people live their best life. Dan King: [16:01] Yeah. And you're not attached to the outcome. You did want her at some level, but you also appreciated that her decision might have been, there may be another environment that's a better fit. Dr. Ryan Duckworth: [16:11] And it totally made sense. I mean, if somebody is telling me something that's totally illogical, I'll be like, help me understand this, you know, but most of the time that's not the case. Dan King: [16:19] Yeah, no, I love the raw honesty, which in our conversation so far, Ryan, you are, you are such a champion. So I so appreciate that quality of you. Dr. Ryan Duckworth: [16:28] Thank you, Dan. I appreciate that. Dan King: [16:29] And I imagine your clinicians do as well. Dr. Ryan Duckworth: [16:32] Yeah, I hope so. I believe they do. Dan King: [16:34] Yeah. So you guys also do testing. Yes. Dr. Ryan Duckworth: [16:38] Yes. Yeah. Dan King: [16:39] Tell me about that element of the equation. Dr. Ryan Duckworth: [16:41] Yeah, to be totally frank, we have an amazing limited licensed psychologist that does 90, probably 90%, 95% of our testing. And I have no question that she is smarter and knows more about testing than me, even though she only has a master's degree. And she is really the champion of our testing program. I did start it and I still do a couple cases a month. Just like I've kind of always done. I enjoy that. But it's been really rewarding also to work with her. Her name is Kara and just talk about cases together. I love looking at the data. I love figuring things out. I love giving people at the end of their testing when I'm giving them feedback. I like to give them a new perspective or a new lens to look at their life and their issues. Not just here's your diagnosis. Here's some recommendations. Go do CBT. You know what I mean? I think it's about how the best thing that I can give them is a different angle on what they already know is happening within them. And if a diagnosis helps them put words to it, great. But between you and me on a more philosophical level, I don't really believe in diagnosis. People have issues. They come in and I work with them to address their issues and it's never the same. I don't give the same antibiotic to every person. I'm so glad that the medical field has that. But that's just not how psychology and therapy works. We have to get paid. So we have these clusters of symptoms that we say is this, but every person is so different. And it's all this continuum of things. That's our testing program. We test about probably about 15 to 20 people a month between Kara and I. Dr. Ryan Duckworth: [18:06] And that definitely keeps us busy. Dan King: [18:08] Such an interesting point you make and maybe a subject for another conversation, but it's an interesting point about what is it about mental health and psychology that are different, right, from perhaps other medical domains where diagnosis is a bit more the norm, right? And that's a whole interesting conversation. I think it's neat that you do offer testing because few practices do, right? At their core, most outpatient practices are therapy focused. So I think there is good evidence that that testing can make the therapy more effective. Dr. Ryan Duckworth: [18:37] Absolutely. Dan King: [18:37] Tell me just a little bit as we start to come towards the end of our time together. Tell me about what the future of the practice holds. So you've built this to this point where it's more than 35 clinicians. You've got six locations, a seventh on the way. What are you building towards? Dr. Ryan Duckworth: [18:52] My personal mission has been statement that I don't actually have it written down in its current form, but I created it. I remember I was in high school. I might have been in ninth or 10th grade. And I told the Lord, I said, God, I just want to make a bigger impact. I just want to do something bigger than me, you know, more than I can just do on my own. I just want to do something that's, I didn't say this, now I would. I would say multiplication. I don't want to do addition. I want to do multiplication. I want to do something more powerful to impact people. And I saw, I didn't really want to go to college. I ended up going to college. Didn't really want to go to grad school. Ended up going to grad school because I knew what I needed. And then God helped me to see what I would need to make the impact I wanted to make. And I thought that, honestly, I thought that group practice was it. I remember my third year thinking, I've arrived. I have a house. I have a family, a beautiful family, beautiful children. I don't even know how, Lord, I don't even deserve this, but thank you. You know, and my group practice is great. Dr. Ryan Duckworth: [19:42] You know, I'm making six figures and paying all the bills. Sweet. And then I kind of like, it wasn't a specific moment, but I kind of had this realization like, oh, wait, this isn't where it ends. This isn't the Christian lifestyle just to arrive and have a family and live in West Michigan and, you know, own a house. It's like, there's a lot more to it. And I was like, okay, let's do this group practice thing. And let's, let's grow. Let's have a bigger impact. And now, looking forward from where I'm at now, I haven't, a lot of these extra locations and extra clinicians, I have to be honest, I haven't worked super hard for them. There's been some that I have worked hard for, but a lot of them just happened organically or naturally. I say God brought them into my life. And some of them say the universe brought them into my practice. That's great. You know, we're growing, we're having an impact, but I am, and my clinicians know this too. Dr. Ryan Duckworth: [20:27] They know that I'm always thinking bigger. And I don't have a specific vision of what that is right now, Dan, but I know, and you know this about me, that I'm always looking for what's next. And I'm not spending a ton of time and energy just seeking out every little thing, but I've got my eyes open. I live life with my eyes open. And I evaluate opportunities all the time. And I do hope and believe that there will be another opportunity where I can use the gifts and talents that God has given me and the resources that he's given me to do something with an even greater impact that doesn't involve just adding another location. As much as I love helping therapists, I'm not going to stop doing that. I don't plan on selling my practice anytime soon. But if God asked me to, I wouldn't hesitate in order to, because sometimes something has to die for a new life to come out of it. I love talking about that. I think it's a biblical principle, but I think it's a life principle that you don't really get something greater unless something else dies. You have to sacrifice something to get to the next level or to get to where you want to be. And so I'm ready to basically do that. And I don't think that that's going to include selling my practice. I don't feel like that right now. It could change. But I do feel like once some things come together in other realms of business and personal, I think this year or early next year, I'm going to be doing something a little bit different, a little bit bigger. Dr. Ryan Duckworth: [21:39] And I pray that the Lord will have his hands on it. And that'll be having a positive impact on it. Dan King: [21:43] Very cool, Ryan. None of that surprises me, knowing you a bit. Dr. Ryan Duckworth: [21:47] Yeah so Dan King: [21:48] When you're not doing this important work when you're not growing your group practice i know that you do real estate on the side but when you're when you're Dan King: [21:56] not working as hard as you do what do you what do you do outside of work for fun. Dr. Ryan Duckworth: [21:59] Yeah i i'll tell people that there's you know aside from my love for the lord i i love two other things i love my family and i love mountain biking you'll see me on the floor being a three-year-old with my three-year-old and getting in trouble my wife yelling at us that it's past bedtime and we're still giggling laughing and wrestling those are probably some of the funnest times of the day for me and i also get out and and ride the trails some at least a couple times a week and try to stay in fairly good shape i'm actually doing like 10 mountain bike races this year which i'm i've been really excited about that i'm kind of a team that i'm kind of hanging out with those guys so that's what i'm doing outside of here and as kind of another little quick side note about psychology practices i tell all of my contractor is that this is the life that I want all of them to be able to have to manage their own schedule, to work hard and play hard and live well. So that's kind of my mission vision for growing a practice is to have a practice where there's all sorts of different therapists, one for every client, and all the therapists are doing their best work because they're where they're called to be. Dan King: [23:03] You couldn't agree more with that idea, Ryan. Thank you so much for sharing your wisdom. Thank you so much for sharing your distinctiveness. Dr. Ryan Duckworth: [23:10] A Dan King: [23:10] Rich conversation as I knew it would be so. Dr. Ryan Duckworth: [23:13] Yeah thanks thanks for asking the good questions dan those were good