Private pay group practice growth with Stephanie Korpal
In this episode (quick summary):
Private pay group practice growth depends on aligning marketing, intake, clinician training and client retention. Stephanie Korpal explains how Marble Wellness identifies performance gaps, prepares clinicians for the early stages of therapy and builds a connected culture across a remotely led, in-person team.
TL;DR:
More enquiries do not create sustainable growth unless the practice can consistently convert, engage and retain the right clients.
What you’ll learn:
- How to market a general therapy practice built around specialist clinicians.
- Why private-pay clients evaluate therapeutic value differently.
- How a live 12-week training programme strengthens client retention.
- Which marketing and intake metrics practice owners should understand.
Stephanie Korpal’s quote: “This work is too important for those sessions to not go well.”
Best for: Group practice owners, clinical directors, supervisors and therapists building or improving a private-pay model.
Key terms: private pay group practice growth, client retention, therapist onboarding, clinician training programme/program, counselling/counseling practice, organisation/organization culture, intake conversion, therapy marketing, client care
Private-pay group practice growth: fixing the gaps between marketing and retention
“This work is too important for those sessions to not go well.”– Stephanie Korpal
Stephanie Korpal, founder of Marble Wellness, joins Dan King to explain why private pay group practice growth depends on much more than attracting new enquiries. Marble Wellness operates two locations in the St. Louis area, serves clients aged three and older, and brings together clinicians with advanced specialties across couples therapy, maternal mental health, trauma work, EMDR and play therapy. Stephanie also leads the in-person team remotely from Chicago, making clear systems, shared expectations and intentional culture essential to the practice’s performance.
A central challenge is marketing a broad practice without diluting the value of specialist care. Marble Wellness adapts its message across Google Ads, service pages, social media and email. Some channels lead with a modality or specialty, while others begin with the client’s problem and then connect that need to the right clinician. This creates a “boutique therapy experience” in which the practice brand opens the door and the intake process helps the client find an appropriate clinical match.
Stephanie argues that private-pay clients evaluate value differently because they feel the full cost of every appointment. A sustainable practice therefore has to communicate that therapy can create meaningful, lasting change rather than offering only surface-level symptom relief. That promise also creates an operational obligation: the experience delivered by the intake team and clinicians must match the confidence communicated through the marketing. Strong practice growth comes from aligning the promise, the clinical work and the client journey.
That alignment became especially important when Stephanie compared enquiry logs, EHR appointment reports, cancellations and session counts. Marble Wellness had strong call volume and conversion, yet revenue and total sessions were not matching the apparent marketing success. The missing piece was client retention. In response, the practice created a live 12-week retention training series for every new clinician, including experienced therapists who are new to private-pay work. The programme covers how to structure early sessions, summarise the work, establish direction and pace the therapeutic process without appearing passive or overwhelming the client.
Live delivery is deliberate. Stephanie wants to hear where clinicians resist discussions about money, value, micro-skills and therapeutic pacing. She can then coordinate with supervisors, identify patterns early and provide more focused support before six months of weak retention data accumulates. Training is also distributed across several team members, helping new clinicians form relationships beyond their direct supervisor. In this model, private pay group practice growth is tied directly to onboarding quality, clinician wellbeing, team connection and clinical leadership.
Stephanie also encourages owners to understand the indicators behind their marketing spend. Website traffic, bounce rate, time on site, Google Ads performance, call volume, lead quality, conversion and retention all help reveal where the system is working or leaking. The point is not to become a marketing technician, but to know enough to evaluate partners and make grounded decisions. Her experience shows that private pay group practice growth becomes more sustainable when owners combine measurable systems with professional community, shared resources and trusted relationships with peers who understand the realities of leading a mental health organisation.
Takeaways
- Track enquiries, conversions, cancellations and session counts together so retention problems are not mistaken for marketing problems.
- Train every new clinician on the private-pay client experience, regardless of how many years they have worked in the field.
- Give clients clarity in the first session about what therapy will involve and what should happen next.
- Use live training to uncover resistance around money, value, pacing and therapeutic confidence.
- Distribute onboarding across the team to build relationships and culture beyond the supervisor-clinician pairing.
- Treat private pay group practice growth as one connected system spanning marketing, intake, clinical quality and retention.
Transcript: private pay group practice growth with Stephanie Korpal
“This work is too important for those sessions to not go well.” — Stephanie Korpal
Read the full transcript
Dan King:
[0:00] Hello, everyone. I am looking forward to a Friday. We're recording this on a
Dan King:
[0:04] Friday, which means the vibe is going to be very Friday with Stephanie Korpal. She is the founder of Marble Wellness. Welcome, Stephanie. We'd love to hear the basics about you and your practice.
Stephanie Korpal:
[0:15] Thanks, Daniel. Happy Friday to you, too. There definitely is something in the air when you wake up on a Friday, even if it's a work day, isn't there? Yes, my name is Stephanie Korpal. I am a group practice owner in St. Louis, Missouri. We actually have two locations about 40 minutes away from each other. So we are a team of 13. We have about 12 therapists right now. As most group practice owners know, there's always somebody shifting somewhere, you know, an onboarding person about to come on, a clinician maybe in their last week or two before they exit. But we are a team of 15, private pay. We are a group of specialists, but a general practice. So we see ages three and up. We see teens. We have a maternal mental health specialty. We see couples. We do EMDR, trauma work. And so we serve almost everybody in the community, but everybody in our practice has an advanced specialty. We've been around since 2018 when I was a solo clinicianer and started our transition to becoming a group practice at the very end of 2020. And another interesting asterisk next to how our business runs is that I am a remote owner to an in-person team. So I actually live in Chicago and my whole team is in St. Louis. So that was a very interesting hurdle and challenge to navigate when we were first getting off the ground, though it certainly has less of an impact now.
Dan King:
[1:37] That is some very good raw material to dig into. There's a few different avenues to dig into, but I think I'll start with you talk about how each of your practitioners has some kind of advanced specialization. How does that play into your marketing, which is always a challenge with a private pay practice, right? How do you market that?
Stephanie Korpal:
[1:55] It's actually really hard because coming up with a newsletter approach, even, you know, email marketing or how we choose our blog strategy, we have to look at so many different factors. And you have to look, you know, ahead of the game. And you're also evaluating who needs clients, but what seasonal impacts you're absorbing right now. And so what we really try to emphasize is that if you call us, we will figure out who to partner with. So we do like to use a lot of words like a boutique therapy experience. We do have specialists, even if your needs feel general and will help you take it from there to what specialty makes sense for you. But people really, you know, consumers are getting, not necessarily, they've always been smart, but they are more educated on what to look for in therapy. And so I think it makes sense that we already have specialties because you even get people on the phone asking for what trainings people have. You know, they're using things like, do you have a Gottman couples therapist? Do you have someone that does EMDR? Do you have a registered play therapist? And so it's almost now something that people are bringing to us as a question and not even something we have to go out and educate the community on all the time.
Dan King:
[3:16] So if I'm hearing correctly, it sounds like you're mostly marketing marble rather than individual clinicians. However, customers will pick marble and then request often someone with a specific skill set.
Stephanie Korpal:
[3:29] Yes, it kind of depends on what marketing channel you're talking about. You know, as a private pay practice, we work Google ads a certain way. We work our specialty pages on our website a certain way. We do social media a certain way. We do email newsletter marketing a certain way. And so some of them we may be more forward about the specialty from the beginning. And others we're just talking to what are the common problems you're experiencing? What's the pain point you're experiencing? And then we'll get to the point that we have a specialist at the practice who can help with that.
Dan King:
[4:03] Did you, okay, so you're really building a whole ecosystem.
Stephanie Korpal:
[4:06] For sure, we have to.
Dan King:
[4:08] How would you describe, and I've been to your website, so having done that, maybe let me ask, what is sort of the central brand message that your ecosystem is conveying to a potential customer?
Stephanie Korpal:
[4:19] Because we are private pay, I think people want more from a private pay clinician because they're evaluating value differently. And I don't mean that people want less from insurance-based practitioners at all. That is not at all what I'm saying. However, once anybody gets connected to a therapist and there's enough of a connection that you keep going, you don't want to switch. Nobody wants to start over. People like that their therapist knows them. But if it is a $20 copay.
Stephanie Korpal:
[4:47] Every time. It's probably often like, this is working well enough. If it is $160 out of pocket, even if your budget can afford that very easily or it's something you are prioritizing, you are still evaluating the worth, very differently with a private pay practice is what I've sensed and had communicated to me over time. And so I do think that we are trying to tell people that the work that you can do with us is really deep. It is actually going to be the difference you are looking for in your life. It is not just symptom resolution. It is not just some of these tweaks that will lead to only surface level bettering of your day-to-day, though that is important. But it's really people long to know themselves better and how to get out of their own way. And so many people realize there's something I can't get over this habit. I can't break this pattern that keeps coming up and is leading to friction in my relationships or friction in my functioning. I know I can thrive, but why am I not thriving? And so what we try to say is we can help you get there. We can help you do that deep work. And so I think we do try to aim for that in our newsletters, in our blogs, in how we talk to people on the phone when they call looking for a therapist.
Dan King:
[6:09] I think you have to be in business sustainably as a private pay practice. You have to convey value, you have to convey confidence that, hey, if you're ready for deep work, you can come and get it here. And that's part of why I've seen a lot of private pay practices that break this cycle that you see more often in the insurance world of, you're going to be in therapy forever, right? You can be a client for 10 years. It's pretty rare that someone's going to be a private pay client for 10 years with the same therapist and just repeat, repeat, rinse, repeat, right?
Stephanie Korpal:
[6:42] Yeah. It's not uncommon for us to have people in therapy long, but they get to those maintenance sessions, you know. So people will come for maybe a year or two years at a very regular pace because they are getting that deep work done. And it's hard, but it feels good, you know, like a really good workout. You know that you are straining against your limitations, but you also recognize all of the benefits that are coming from that. I think a lot of our clients that do commit to that deep work are experiencing that same thing, but then they get to the point that monthly or six weeks for between appointments is really good. Because we do have a lot of longstanding clients, certainly not more than half by any stretch, but we do the kind of work where then people do come back because they wanted, a new tweak or a check-in on this thing, but they already have made that very significant transition to a new way of functioning.
Dan King:
[7:40] I think that's a fantastic segue to another subject we decided we would talk about before hitting record, which is retaining patients in practice in a private-paced setting. Tell me about your approach there.
Stephanie Korpal:
[7:52] Yeah, so we recognized a couple years ago, I would print out all of these reports and I would have to cross-check our inquiry log with appointment reports from our EHR and things like that. And I would sit down and count a number of sessions that clients would attend, total them, look at cancellation trends, and then look at that for each therapist. And it was really illuminating as to why, oh my gosh, we have all these calls and our conversion rate is so high. So this isn't a marketing problem and this isn't an intake coordinator problem. Why do we not have the session count that we need to? Why is our gross revenue not seeming to add up with how successful our marketing is? And we realize that a lot of times that there's leaks in...
Stephanie Korpal:
[8:40] Retention, client retention. And so what we do at our practice, we have designed a 12-week series on retention training that every new clinician gets from their second week with us. And that's regardless of if they are a new graduate or they've been in the field for 15 years. Because we've especially noticed that even if you've been in the field for 15 years, 16 years, if you're need to do a private pay, private practice, there's still a lot that you have to learn. There's money mindset you have to adjust to. There's an understanding of how clients come in evaluating your services. And you just kind of have to frame things out differently. Now, I think there's a lot of just general foundation to how you frame things out, regardless of type of practice you're in. Not only insurance-based or private pay, but also community mental health, all of that.
Stephanie Korpal:
[9:33] So we work really hard on this is what a first session should feel like. This is how it should be summarized at the end. This is how you start session two, session three. By session four and five, this is what you should be getting into and helping clinicians really understand sessions one through four in a certain way and then sessions five through eight in another way. And then, of course, helping them continue to do that deep work. So we train really hard on that. But then we also have a whole retention improvement plan that gets activated if we notice people still struggling to retain clients. And that may include that we have clients sign off on permission to record sessions so a supervisor can listen to the clinician session and see what's going on. We may have them sit in with a clinician who has really strong retention because, you know, unfortunately, our master's training programs don't do a ton of that really live learning. And sometimes you can only learn so much without seeing what good looks like. And so we just like to expose people to that. But we take retention very seriously. You know, most clients spend six months in the pre-contemplation phase before they'll even reach out to start.
Stephanie Korpal:
[10:48] So I feel so connected to making sure that effort isn't squandered by clinicians then not knowing how to take care of those first couple of sessions. Because if they're lost in those initial sessions, I recently don't, I don't remember the statistic, but it's really high that a client will never go back to therapy at all if that doesn't go well at the beginning. This work is too important for those sessions to not go well. And I think those sessions are pretty easy to train how to do well.
Dan King:
[11:19] I can hear the conviction in your voice as you say that. Yes. Without thinking about it too much, what's the biggest reason why clinicians struggle to retain patients.
Stephanie Korpal:
[11:28] I think that there is a lot of imposter syndrome and I also think a lot of clinicians don't know how to pace appropriately. So they don't do nearly enough in session one to frame out what's coming next. It's a little too laissez-faire from the clinician or they feel like they have to prove their worth so much that they throw so much at the client that they overwhelm the client more than what the client was already feeling coming in. So it's Kind of like Goldilocks is porridge, you know, they can't find that sweet spot all the time. Yeah.
Dan King:
[12:01] Yeah. So 12 weeks, have you found that the training has measurably improved retention results?
Stephanie Korpal:
[12:06] Yes and no. I would love for it to be this magic wand of, you know, so everybody comes in and nobody struggles with retention. But what it has allowed us to do is open conversations really early. Instead of waiting six months to see somebody's retention trend, we're already in there with Here's some pitfalls you're going to experience over the next couple weeks. And then I refuse to put that training into recordings because I want it to be a live conversation because I want to experience where the clinician is going to meet me with resistance.
Dan King:
[12:40] So it's always live.
Stephanie Korpal:
[12:42] Yes. Yes. Because I want to feel them when we talk about the money stuff. I want to feel them when I talk about micro skills versus modalities. And I also want them, when we are on week five of the training or week seven of the training, talking about how they're already using it with their clients so I can see how they're connecting the dots and I can start to experience their conceptualization. And then we can coordinate with their supervisor on what themes need to be continued in supervision to be explored, enhanced, or if they are already getting it, how to really put a strong foundation and cement it.
Dan King:
[13:23] When the money stuff comes up, how does it feel?
Stephanie Korpal:
[13:25] It's so hard because I had my own money stuff, so I totally get it. As the owner, as a leader, as a supervisor, I can't communicate necessarily how much I get it because there's going to be a subconscious permission structure that they get from that. And so there's a really hard person-to-person element of that where I have to talk differently with them about the money stuff. And internally, I'm screaming because I get it. I have some bad stories about some sliding scale spots that I gave my first whole year in private practice, maybe even two years. And so I want to be relatable to them and I want them to learn from some of my stories. But I also have to talk so differently, understanding that my influence is going to be landing in their fertile ground and I need it to grow a certain way. So if I'm validating, validating, validating, I'm kind of saying like, I understand and I just need you to not do it that way. I need to help their feelings change so I can't validate too much.
Dan King:
[14:35] You know, there's definitely a balance there. People need to feel held and understood and challenged at the same time.
Stephanie Korpal:
[14:42] Yes.
Dan King:
[14:42] So that's very interesting. And I think other practice owners will be, I think, inspired by what you're doing. But also I think that you do it live is not an element I was counting on because I've definitely heard about trainings that folks do, but that tend to be recorded right. So that's such valuable data that you get live. Let's say it was a 50 or 60 person practice. Would you still do it the same way or would greater scale require recording?
Stephanie Korpal:
[15:08] It's a great question. I think that goes to culture of your practice. And there's obviously a time efficiency, time maxing consideration, especially for your leaders, especially if you are onboarding that much. However, there's in a world.
Stephanie Korpal:
[15:25] Where so much is automated? Are you losing an opportunity to go directly against that? And against that fatigue too, by not figuring out how to continue to do it live. And my clinical director and I have talked a lot about onboarding because onboarding is one of my least favorite things. It has been one of my least favorite things in any job, in any sector. I find it so tiring. It's nice for the relationship building, but then you go back to your computer at the end of an onboarding day or onboarding week and all of your job is still there. But for us, at least, it is such a culture boom to be able to do it live because we also spread out a lot of our onboarding and a lot of our retention training across the team. Because a lot of times what happens is somebody comes in and they just get to know their supervisor. And then it takes a really long time to know the rest of the team beyond a staff meeting. And so by doing a lot of our training live were able to say, you're going to sit with so-and-so for this, and you'll sit with so-and-so for this, and so-and-so for this. And now they've been exposed and able to build a relationship with five team members in two weeks versus just, one in-depth relationship with a supervisor and then a slow build everywhere else. So for our culture, it works. And I think we would figure out how to keep it live. Even if we were really big, we would just have a lot more trainers.
Dan King:
[16:49] So in the private pay world, marketing is even more important. You have to drive results. And so one of the things that I see a lot of practice owners struggle with is how to evaluate marketing. I keep hearing the phrase, I hired a marketer and I set a lot of money on fire. So I'd be curious to understand how you've had some success with marketing and how you've been able to really evaluate whether the marketer that you've hired is good.
Stephanie Korpal:
[17:13] I think there are two avenues here that are really important. One is something else that we've touched on before we hit record, which is I do think group practice owners need to come a little bit more around to the idea of it takes money to make money. You have to spend money to get people to even know you exist. You have to spend money to get people to call you. You have to spend money to have somebody in the seat of answering the phones, you know, so you definitely have to put money there. And just by putting money there, it doesn't mean you're burning it.
Stephanie Korpal:
[17:46] But the other thing that's really important as a group practice owner is you have to be educated enough to know what the KPIs for good marketing are. So you have to remain educated enough on what are good Google analytic returns, right? So this is for the size of your practice and for the area of the country you're in, how many visitors to your website should you have? What is a good bounce rate? What is a good time on site? All of those other things, and you have to maybe once a year do another training, read a little bit to see if that's changed from five years ago. Same with Google Ads, right? There are ways to know if Google Ads have a return. There are Google Ads calculators that help you know if you are getting a good return on investment. Google profile hits. You know, you can feel more confident about your marketing decisions if you know the metrics your marketer should be hitting. And of course, those aren't hard and fast rules. Of course, there are ranges. But I think not enough people also know how many calls should I be getting per therapist in my practice. If you don't even know that number, it is hard to gauge marketing. So from my understanding, and I think this is updated enough, you should have between eight to 12 calls per month per therapist. You may need to increase that if your conversion rate is low.
Stephanie Korpal:
[19:14] You may be able to decrease that a little bit if your conversion rate is high or your retention rate is off the chains. People say between a 20 and 40 percent conversion rate if you're a private pay practice. I don't think that's enough. I think you should aim for 50 percent conversion rate if you're a private pay practitioner. We have had that the whole time we've been in business. So it's doable. It should be closer to 80 percent if you're an insurance based practice. So you need to know some of those targets so you can know what your marketer is aiming for and you feel better about that spend or about that partnership.
Dan King:
[19:48] I wonder if that really high levels of scale, whether the 50 percent is realistic. That's an interesting thought. And I don't know the private universe as well as the insurance based universe.
Stephanie Korpal:
[19:59] Well, what I like about that number is and there are obviously ways to dig in. So I want to make sure that people know I'm not talking about warm lead 50 percent conversion. That's an all lead conversion rate. Right. So but if you if it's way lower than that, we definitely need to be talking to our intake coordinator and really evaluating what's going on in those communication channels. Or we may need to be significantly tweaking marketing because why are so many people calling that aren't a good fit?
Dan King:
[20:27] 100 percent. What I'm curious about is how you got up to speed. So I agree with you. It's important for practice owners, especially private pay, to get up to speed. Would you say that it was mostly learning through experience? Was there a specific course you took? Did you consult with someone? How did you get up to speed?
Stephanie Korpal:
[20:45] Great question. So, you know, I became a group practice owner in COVID. And so I cut my teeth during a time that it was kind of easy to grow, so to speak. But I also cut my teeth during a time that everybody was looking for community. And I was very fortunate to land in a lot of different groups. And when I tell you that my first two, maybe three years of group practice ownership, I attended everything I could. I'm not joking. I would show up to the free webinars about insurance-based practices just so I knew what was going on in the landscape and I could think about how that would impact private pay practices. And because I was in those groups, I made really good relationships with colleagues who are now really good friends. And so now I still have the support. I still have the insight. I still have the people to bounce ideas off of because I made those relationships. And what was also beneficial about those relationships is that there's so much shared resourcing that goes on there, which is both, hey, here's who redesigned my website. They were awesome.
Stephanie Korpal:
[21:56] And it takes away hours of you having to do your own research because now you have a really good referral. Two things like, here's my employee handbook. Don't start from scratch. Just use this and then make it what you need to in yours. So for anybody starting or anybody who feels like they're stalled, find a group to be a part of because that is absolutely life-changing because it also eliminates stress. So you're also walking away from work less stress. So your personal life is different. It truly is the best thing you can do is find a couple colleagues out there that get it, you feel simpatico with, their practice does not need to look like yours, but they know the lingo, they know the rhythm, they know the headaches, and you just feel so seen and heard. And it is so emotionally helpful, but also, like I said, resource helpful. It has saved me a ton of money, a ton of time. So that's how I got scaled up as community.
Dan King:
[22:56] Super interesting. Super interesting. Stephanie, as we come towards the end of our time together, I'd love to end on a human note and ask, when you are not growing marble, you're not managing marble, what do you do for fun?
Stephanie Korpal:
[23:08] Yeah. So, I mean, I'm in Chicago, so I've got right out the door a ton of stuff to do. I live in Restaurant Row. I like going to a lot of stand-up comedy concerts, you know, Broadway musicals. I've got several theaters not even a mile from me. So I just try to enjoy the city as much as I can, which is a nice rhythm change from group practice ownership.
Dan King:
[23:29] Maybe some of that's translatable to therapy. Who knows?
Stephanie Korpal:
[23:32] Yes, I agree.
Dan King:
[23:33] It was a pleasure to have you on. Pleasure to meet you. Thanks for your insights. Super, super helpful, Stephanie.
Stephanie Korpal:
[23:38] I appreciate the opportunity. I always love conversations like this. So thanks for having me, Daniel.
Transcript: private pay group practice growth with Stephanie Korpal
“This work is too important for those sessions to not go well.” — Stephanie Korpal
Read the full transcript
Dan King:
[0:00] Hello, everyone. I am looking forward to a Friday. We're recording this on a
Dan King:
[0:04] Friday, which means the vibe is going to be very Friday with Stephanie Korpal. She is the founder of Marble Wellness. Welcome, Stephanie. We'd love to hear the basics about you and your practice.
Stephanie Korpal:
[0:15] Thanks, Daniel. Happy Friday to you, too. There definitely is something in the air when you wake up on a Friday, even if it's a work day, isn't there? Yes, my name is Stephanie Korpal. I am a group practice owner in St. Louis, Missouri. We actually have two locations about 40 minutes away from each other. So we are a team of 13. We have about 12 therapists right now. As most group practice owners know, there's always somebody shifting somewhere, you know, an onboarding person about to come on, a clinician maybe in their last week or two before they exit. But we are a team of 15, private pay. We are a group of specialists, but a general practice. So we see ages three and up. We see teens. We have a maternal mental health specialty. We see couples. We do EMDR, trauma work. And so we serve almost everybody in the community, but everybody in our practice has an advanced specialty. We've been around since 2018 when I was a solo clinicianer and started our transition to becoming a group practice at the very end of 2020. And another interesting asterisk next to how our business runs is that I am a remote owner to an in-person team. So I actually live in Chicago and my whole team is in St. Louis. So that was a very interesting hurdle and challenge to navigate when we were first getting off the ground, though it certainly has less of an impact now.
Dan King:
[1:37] That is some very good raw material to dig into. There's a few different avenues to dig into, but I think I'll start with you talk about how each of your practitioners has some kind of advanced specialization. How does that play into your marketing, which is always a challenge with a private pay practice, right? How do you market that?
Stephanie Korpal:
[1:55] It's actually really hard because coming up with a newsletter approach, even, you know, email marketing or how we choose our blog strategy, we have to look at so many different factors. And you have to look, you know, ahead of the game. And you're also evaluating who needs clients, but what seasonal impacts you're absorbing right now. And so what we really try to emphasize is that if you call us, we will figure out who to partner with. So we do like to use a lot of words like a boutique therapy experience. We do have specialists, even if your needs feel general and will help you take it from there to what specialty makes sense for you. But people really, you know, consumers are getting, not necessarily, they've always been smart, but they are more educated on what to look for in therapy. And so I think it makes sense that we already have specialties because you even get people on the phone asking for what trainings people have. You know, they're using things like, do you have a Gottman couples therapist? Do you have someone that does EMDR? Do you have a registered play therapist? And so it's almost now something that people are bringing to us as a question and not even something we have to go out and educate the community on all the time.
Dan King:
[3:16] So if I'm hearing correctly, it sounds like you're mostly marketing marble rather than individual clinicians. However, customers will pick marble and then request often someone with a specific skill set.
Stephanie Korpal:
[3:29] Yes, it kind of depends on what marketing channel you're talking about. You know, as a private pay practice, we work Google ads a certain way. We work our specialty pages on our website a certain way. We do social media a certain way. We do email newsletter marketing a certain way. And so some of them we may be more forward about the specialty from the beginning. And others we're just talking to what are the common problems you're experiencing? What's the pain point you're experiencing? And then we'll get to the point that we have a specialist at the practice who can help with that.
Dan King:
[4:03] Did you, okay, so you're really building a whole ecosystem.
Stephanie Korpal:
[4:06] For sure, we have to.
Dan King:
[4:08] How would you describe, and I've been to your website, so having done that, maybe let me ask, what is sort of the central brand message that your ecosystem is conveying to a potential customer?
Stephanie Korpal:
[4:19] Because we are private pay, I think people want more from a private pay clinician because they're evaluating value differently. And I don't mean that people want less from insurance-based practitioners at all. That is not at all what I'm saying. However, once anybody gets connected to a therapist and there's enough of a connection that you keep going, you don't want to switch. Nobody wants to start over. People like that their therapist knows them. But if it is a $20 copay.
Stephanie Korpal:
[4:47] Every time. It's probably often like, this is working well enough. If it is $160 out of pocket, even if your budget can afford that very easily or it's something you are prioritizing, you are still evaluating the worth, very differently with a private pay practice is what I've sensed and had communicated to me over time. And so I do think that we are trying to tell people that the work that you can do with us is really deep. It is actually going to be the difference you are looking for in your life. It is not just symptom resolution. It is not just some of these tweaks that will lead to only surface level bettering of your day-to-day, though that is important. But it's really people long to know themselves better and how to get out of their own way. And so many people realize there's something I can't get over this habit. I can't break this pattern that keeps coming up and is leading to friction in my relationships or friction in my functioning. I know I can thrive, but why am I not thriving? And so what we try to say is we can help you get there. We can help you do that deep work. And so I think we do try to aim for that in our newsletters, in our blogs, in how we talk to people on the phone when they call looking for a therapist.
Dan King:
[6:09] I think you have to be in business sustainably as a private pay practice. You have to convey value, you have to convey confidence that, hey, if you're ready for deep work, you can come and get it here. And that's part of why I've seen a lot of private pay practices that break this cycle that you see more often in the insurance world of, you're going to be in therapy forever, right? You can be a client for 10 years. It's pretty rare that someone's going to be a private pay client for 10 years with the same therapist and just repeat, repeat, rinse, repeat, right?
Stephanie Korpal:
[6:42] Yeah. It's not uncommon for us to have people in therapy long, but they get to those maintenance sessions, you know. So people will come for maybe a year or two years at a very regular pace because they are getting that deep work done. And it's hard, but it feels good, you know, like a really good workout. You know that you are straining against your limitations, but you also recognize all of the benefits that are coming from that. I think a lot of our clients that do commit to that deep work are experiencing that same thing, but then they get to the point that monthly or six weeks for between appointments is really good. Because we do have a lot of longstanding clients, certainly not more than half by any stretch, but we do the kind of work where then people do come back because they wanted, a new tweak or a check-in on this thing, but they already have made that very significant transition to a new way of functioning.
Dan King:
[7:40] I think that's a fantastic segue to another subject we decided we would talk about before hitting record, which is retaining patients in practice in a private-paced setting. Tell me about your approach there.
Stephanie Korpal:
[7:52] Yeah, so we recognized a couple years ago, I would print out all of these reports and I would have to cross-check our inquiry log with appointment reports from our EHR and things like that. And I would sit down and count a number of sessions that clients would attend, total them, look at cancellation trends, and then look at that for each therapist. And it was really illuminating as to why, oh my gosh, we have all these calls and our conversion rate is so high. So this isn't a marketing problem and this isn't an intake coordinator problem. Why do we not have the session count that we need to? Why is our gross revenue not seeming to add up with how successful our marketing is? And we realize that a lot of times that there's leaks in...
Stephanie Korpal:
[8:40] Retention, client retention. And so what we do at our practice, we have designed a 12-week series on retention training that every new clinician gets from their second week with us. And that's regardless of if they are a new graduate or they've been in the field for 15 years. Because we've especially noticed that even if you've been in the field for 15 years, 16 years, if you're need to do a private pay, private practice, there's still a lot that you have to learn. There's money mindset you have to adjust to. There's an understanding of how clients come in evaluating your services. And you just kind of have to frame things out differently. Now, I think there's a lot of just general foundation to how you frame things out, regardless of type of practice you're in. Not only insurance-based or private pay, but also community mental health, all of that.
Stephanie Korpal:
[9:33] So we work really hard on this is what a first session should feel like. This is how it should be summarized at the end. This is how you start session two, session three. By session four and five, this is what you should be getting into and helping clinicians really understand sessions one through four in a certain way and then sessions five through eight in another way. And then, of course, helping them continue to do that deep work. So we train really hard on that. But then we also have a whole retention improvement plan that gets activated if we notice people still struggling to retain clients. And that may include that we have clients sign off on permission to record sessions so a supervisor can listen to the clinician session and see what's going on. We may have them sit in with a clinician who has really strong retention because, you know, unfortunately, our master's training programs don't do a ton of that really live learning. And sometimes you can only learn so much without seeing what good looks like. And so we just like to expose people to that. But we take retention very seriously. You know, most clients spend six months in the pre-contemplation phase before they'll even reach out to start.
Stephanie Korpal:
[10:48] So I feel so connected to making sure that effort isn't squandered by clinicians then not knowing how to take care of those first couple of sessions. Because if they're lost in those initial sessions, I recently don't, I don't remember the statistic, but it's really high that a client will never go back to therapy at all if that doesn't go well at the beginning. This work is too important for those sessions to not go well. And I think those sessions are pretty easy to train how to do well.
Dan King:
[11:19] I can hear the conviction in your voice as you say that. Yes. Without thinking about it too much, what's the biggest reason why clinicians struggle to retain patients.
Stephanie Korpal:
[11:28] I think that there is a lot of imposter syndrome and I also think a lot of clinicians don't know how to pace appropriately. So they don't do nearly enough in session one to frame out what's coming next. It's a little too laissez-faire from the clinician or they feel like they have to prove their worth so much that they throw so much at the client that they overwhelm the client more than what the client was already feeling coming in. So it's Kind of like Goldilocks is porridge, you know, they can't find that sweet spot all the time. Yeah.
Dan King:
[12:01] Yeah. So 12 weeks, have you found that the training has measurably improved retention results?
Stephanie Korpal:
[12:06] Yes and no. I would love for it to be this magic wand of, you know, so everybody comes in and nobody struggles with retention. But what it has allowed us to do is open conversations really early. Instead of waiting six months to see somebody's retention trend, we're already in there with Here's some pitfalls you're going to experience over the next couple weeks. And then I refuse to put that training into recordings because I want it to be a live conversation because I want to experience where the clinician is going to meet me with resistance.
Dan King:
[12:40] So it's always live.
Stephanie Korpal:
[12:42] Yes. Yes. Because I want to feel them when we talk about the money stuff. I want to feel them when I talk about micro skills versus modalities. And I also want them, when we are on week five of the training or week seven of the training, talking about how they're already using it with their clients so I can see how they're connecting the dots and I can start to experience their conceptualization. And then we can coordinate with their supervisor on what themes need to be continued in supervision to be explored, enhanced, or if they are already getting it, how to really put a strong foundation and cement it.
Dan King:
[13:23] When the money stuff comes up, how does it feel?
Stephanie Korpal:
[13:25] It's so hard because I had my own money stuff, so I totally get it. As the owner, as a leader, as a supervisor, I can't communicate necessarily how much I get it because there's going to be a subconscious permission structure that they get from that. And so there's a really hard person-to-person element of that where I have to talk differently with them about the money stuff. And internally, I'm screaming because I get it. I have some bad stories about some sliding scale spots that I gave my first whole year in private practice, maybe even two years. And so I want to be relatable to them and I want them to learn from some of my stories. But I also have to talk so differently, understanding that my influence is going to be landing in their fertile ground and I need it to grow a certain way. So if I'm validating, validating, validating, I'm kind of saying like, I understand and I just need you to not do it that way. I need to help their feelings change so I can't validate too much.
Dan King:
[14:35] You know, there's definitely a balance there. People need to feel held and understood and challenged at the same time.
Stephanie Korpal:
[14:42] Yes.
Dan King:
[14:42] So that's very interesting. And I think other practice owners will be, I think, inspired by what you're doing. But also I think that you do it live is not an element I was counting on because I've definitely heard about trainings that folks do, but that tend to be recorded right. So that's such valuable data that you get live. Let's say it was a 50 or 60 person practice. Would you still do it the same way or would greater scale require recording?
Stephanie Korpal:
[15:08] It's a great question. I think that goes to culture of your practice. And there's obviously a time efficiency, time maxing consideration, especially for your leaders, especially if you are onboarding that much. However, there's in a world.
Stephanie Korpal:
[15:25] Where so much is automated? Are you losing an opportunity to go directly against that? And against that fatigue too, by not figuring out how to continue to do it live. And my clinical director and I have talked a lot about onboarding because onboarding is one of my least favorite things. It has been one of my least favorite things in any job, in any sector. I find it so tiring. It's nice for the relationship building, but then you go back to your computer at the end of an onboarding day or onboarding week and all of your job is still there. But for us, at least, it is such a culture boom to be able to do it live because we also spread out a lot of our onboarding and a lot of our retention training across the team. Because a lot of times what happens is somebody comes in and they just get to know their supervisor. And then it takes a really long time to know the rest of the team beyond a staff meeting. And so by doing a lot of our training live were able to say, you're going to sit with so-and-so for this, and you'll sit with so-and-so for this, and so-and-so for this. And now they've been exposed and able to build a relationship with five team members in two weeks versus just, one in-depth relationship with a supervisor and then a slow build everywhere else. So for our culture, it works. And I think we would figure out how to keep it live. Even if we were really big, we would just have a lot more trainers.
Dan King:
[16:49] So in the private pay world, marketing is even more important. You have to drive results. And so one of the things that I see a lot of practice owners struggle with is how to evaluate marketing. I keep hearing the phrase, I hired a marketer and I set a lot of money on fire. So I'd be curious to understand how you've had some success with marketing and how you've been able to really evaluate whether the marketer that you've hired is good.
Stephanie Korpal:
[17:13] I think there are two avenues here that are really important. One is something else that we've touched on before we hit record, which is I do think group practice owners need to come a little bit more around to the idea of it takes money to make money. You have to spend money to get people to even know you exist. You have to spend money to get people to call you. You have to spend money to have somebody in the seat of answering the phones, you know, so you definitely have to put money there. And just by putting money there, it doesn't mean you're burning it.
Stephanie Korpal:
[17:46] But the other thing that's really important as a group practice owner is you have to be educated enough to know what the KPIs for good marketing are. So you have to remain educated enough on what are good Google analytic returns, right? So this is for the size of your practice and for the area of the country you're in, how many visitors to your website should you have? What is a good bounce rate? What is a good time on site? All of those other things, and you have to maybe once a year do another training, read a little bit to see if that's changed from five years ago. Same with Google Ads, right? There are ways to know if Google Ads have a return. There are Google Ads calculators that help you know if you are getting a good return on investment. Google profile hits. You know, you can feel more confident about your marketing decisions if you know the metrics your marketer should be hitting. And of course, those aren't hard and fast rules. Of course, there are ranges. But I think not enough people also know how many calls should I be getting per therapist in my practice. If you don't even know that number, it is hard to gauge marketing. So from my understanding, and I think this is updated enough, you should have between eight to 12 calls per month per therapist. You may need to increase that if your conversion rate is low.
Stephanie Korpal:
[19:14] You may be able to decrease that a little bit if your conversion rate is high or your retention rate is off the chains. People say between a 20 and 40 percent conversion rate if you're a private pay practice. I don't think that's enough. I think you should aim for 50 percent conversion rate if you're a private pay practitioner. We have had that the whole time we've been in business. So it's doable. It should be closer to 80 percent if you're an insurance based practice. So you need to know some of those targets so you can know what your marketer is aiming for and you feel better about that spend or about that partnership.
Dan King:
[19:48] I wonder if that really high levels of scale, whether the 50 percent is realistic. That's an interesting thought. And I don't know the private universe as well as the insurance based universe.
Stephanie Korpal:
[19:59] Well, what I like about that number is and there are obviously ways to dig in. So I want to make sure that people know I'm not talking about warm lead 50 percent conversion. That's an all lead conversion rate. Right. So but if you if it's way lower than that, we definitely need to be talking to our intake coordinator and really evaluating what's going on in those communication channels. Or we may need to be significantly tweaking marketing because why are so many people calling that aren't a good fit?
Dan King:
[20:27] 100 percent. What I'm curious about is how you got up to speed. So I agree with you. It's important for practice owners, especially private pay, to get up to speed. Would you say that it was mostly learning through experience? Was there a specific course you took? Did you consult with someone? How did you get up to speed?
Stephanie Korpal:
[20:45] Great question. So, you know, I became a group practice owner in COVID. And so I cut my teeth during a time that it was kind of easy to grow, so to speak. But I also cut my teeth during a time that everybody was looking for community. And I was very fortunate to land in a lot of different groups. And when I tell you that my first two, maybe three years of group practice ownership, I attended everything I could. I'm not joking. I would show up to the free webinars about insurance-based practices just so I knew what was going on in the landscape and I could think about how that would impact private pay practices. And because I was in those groups, I made really good relationships with colleagues who are now really good friends. And so now I still have the support. I still have the insight. I still have the people to bounce ideas off of because I made those relationships. And what was also beneficial about those relationships is that there's so much shared resourcing that goes on there, which is both, hey, here's who redesigned my website. They were awesome.
Stephanie Korpal:
[21:56] And it takes away hours of you having to do your own research because now you have a really good referral. Two things like, here's my employee handbook. Don't start from scratch. Just use this and then make it what you need to in yours. So for anybody starting or anybody who feels like they're stalled, find a group to be a part of because that is absolutely life-changing because it also eliminates stress. So you're also walking away from work less stress. So your personal life is different. It truly is the best thing you can do is find a couple colleagues out there that get it, you feel simpatico with, their practice does not need to look like yours, but they know the lingo, they know the rhythm, they know the headaches, and you just feel so seen and heard. And it is so emotionally helpful, but also, like I said, resource helpful. It has saved me a ton of money, a ton of time. So that's how I got scaled up as community.
Dan King:
[22:56] Super interesting. Super interesting. Stephanie, as we come towards the end of our time together, I'd love to end on a human note and ask, when you are not growing marble, you're not managing marble, what do you do for fun?
Stephanie Korpal:
[23:08] Yeah. So, I mean, I'm in Chicago, so I've got right out the door a ton of stuff to do. I live in Restaurant Row. I like going to a lot of stand-up comedy concerts, you know, Broadway musicals. I've got several theaters not even a mile from me. So I just try to enjoy the city as much as I can, which is a nice rhythm change from group practice ownership.
Dan King:
[23:29] Maybe some of that's translatable to therapy. Who knows?
Stephanie Korpal:
[23:32] Yes, I agree.
Dan King:
[23:33] It was a pleasure to have you on. Pleasure to meet you. Thanks for your insights. Super, super helpful, Stephanie.
Stephanie Korpal:
[23:38] I appreciate the opportunity. I always love conversations like this. So thanks for having me, Daniel.