Building a Group Therapy Practice for College Students with Dr. Jennifer Contarino Panning

Dr. Jennifer Panning [00:00:00]:

We're not easy to be in relationships with, right. Because we, I think, need a lot and we give a lot. But I also think, you know, there's a lot of, a lot of people can't handle or would want to be in a relationship and partnership with a therapist because sometimes we give in at the office and we come home and we don't have a lot to give.

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Michael Fulwiler [00:00:23]:

This is Heard Business School, where we sit down with private practice owners and industry experts to learn about the business of therapy together. I'm your host, Michael Fulwiler. Starting your own therapy practice and growing it from a solo to group practice is a journey filled with learning and adaptation. Today my guest is Doctor Jennifer Contorino Panning, a licensed clinical psychologist based in Evanston who has successfully navigated this path and now shares her expertise with fellow therapists. Doctor Contorino Panning started her private practice in 2004 right after her postdoctoral fellowship with a focus on serving college students. Over the years, she's expanded her solo practice into a thriving group practice with twelve clinicians providing a range of mental health services for the northwestern community. I met Doctor Contrino Panning through a program I offered called consulting for therapists and I'm a huge fan of her work. In our conversation, she discusses the initial challenges she faced when starting her practice, such as struggling with insurance.

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Michael Fulwiler [00:01:29]:

She also shares the mistakes she made, including getting behind on finances. Along with the valuable lessons learned from these experiences, we explore how Doctor Contorino Panning's practice has evolved, particularly through the pandemic and the impact of her participation in the Goldman Sachs 10,000 small businesses program. Here's my conversation with Doctor Jennifer Contarino Panning. Enjoy. Doctor Jennifer Contorino Panning, welcome to the show.

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Dr. Jennifer Panning [00:01:58]:

Hello. Thank you for having me.

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Michael Fulwiler [00:02:01]:

Very excited to have you on. You took my consulting for therapist program, which is how we know each other.

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Dr. Jennifer Panning [00:02:07]:

Yes. That was 2021. Seems like a long time ago, but also not that long.

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Michael Fulwiler [00:02:13]:

It does, yeah. Excited to catch up and hear about how your business is going and has changed in the last three years. We had Doctor Ayana Abrams on the show as well. So shout out to Doctor Ayana if you're listening. Really great to connect with both of you through that program.

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Dr. Jennifer Panning [00:02:29]:

Yeah, it was a great experience and yeah, it's been, a lot's happened and also just plugging along.

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Michael Fulwiler [00:02:37]:

Let's dive right in. So you started your private practice in 2004? Yes. Which means it's been 20 years. So congratulations on that milestone.

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Dr. Jennifer Panning [00:02:48]:

Thank you.

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Michael Fulwiler [00:02:48]:

Can you walk us through what that experience was like, in the beginning, what were the steps that you took to start your business?

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Dr. Jennifer Panning [00:02:58]:

You know, those were like the old days, right? I mean, we really didn't have, there's so much coaching and programs and support and all sorts of things now. So I feel like we kind of learn by, you know, picking the brain of somebody a couple years ahead of me. And it was all very much the wild west. I mean, we were doing paper forms to submit to, insurance paper. So, I mean, it was completely different than it is now. I did my postdoctoral fellowship at Northwestern University in Evanston, and they do short term work. And so I knew going out to the community and establishing my private practice in Evanston to continue working with the college students made a lot of sense, and so I decided to do that. I really didn't know what I was doing.

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Dr. Jennifer Panning [00:03:44]:

I mean, again, I had an accountant, I had some therapist friends that I could chat with, consultation group, but I really lacked a lot of confidence and just a lot of skills. So I learned as I went, and I learned by, you know, making mistakes and realizing things and learning from other people and all that good stuff. But I. It was completely different than I think now. There's just like, here's the template. Here are the 20 items checklist to start your private practice. Here's all the things set up that you can take advantage of, and that's great for people now.

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Michael Fulwiler [00:04:19]:

So it sounds like you were able to connect with the university ecosystem. Did you have to go out and get an office? I assume. And this is the days before Zoom.

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Dr. Jennifer Panning [00:04:29]:

Yes. You know, that was one of my big worries, was feeling isolated. So the first two years of my practice, I established it in kind of a center that there were therapists and acupuncturists and some other healthcare providers. So I felt like that was a nice balance because I had some gluteal contact, because I like having that in my life. And I just knew that me and an office, other clients would not be my ideal situation. So I think that was a perfect setting. And then two years later, they moved locations that weren't, wasn't a location I wanted to be in. And I moved my location closer to the campus.

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Dr. Jennifer Panning [00:05:07]:

So I had a two office suite at that point and just a colleague sharing and myself sharing an office for.

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Michael Fulwiler [00:05:13]:

People who may not be aware. Can you explain the relationship between your private practice, especially in the beginning and then the university counseling center, you mentioned that the university was doing more short term work. Were they referring students to you or students seeking you out? How did that work?

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Dr. Jennifer Panning [00:05:29]:

Yeah, definitely. They have a referral list and I think it's, you know, become a lot more automated and online and whatnot at this point in time. But back then it was like they would meet with a student and I think it was a twelve session model that they did. So, you know, if a student was, had some more serious needs or more wanted some longer term therapy relationship that they would refer out directly to myself. And so it was a great way to continue working with the students. But being in that outpatient setting.

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Michael Fulwiler [00:05:59]:

Yeah, it's like a built in referral network, sounds like.

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Dr. Jennifer Panning [00:06:02]:

Yeah, I mean, I felt very, you know, lucky and I did, I did marketing, I had a website, I did all the things. But I think having that referral relationship and still, you know, maintaining contact with them was a huge boon to starting my practice.

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Michael Fulwiler [00:06:17]:

Looking back where there mistakes that you made or things that you would have done differently, especially in the beginning.

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Dr. Jennifer Panning [00:06:25]:

Hmm. I mean, I've made lots of mistakes. Honestly, at this point, 20 years is like, it's so fuzzy in my mind because I started my practice in 2004 and then my son was born in late 2005. So I kind of went from having the practice to doing three days a week practice and being a mom and all that. And so, you know, I think the biggest thing was I did lack a lot of the skills, right. And there was a lot of generosity, I think, in the community of people that came before me and I tried to pay that back, pay it forward afterwards for people who are starting out as well, like, hey, take me out to lunch and, you know, pick my brain and that kind of thing. So I think that was helpful. But I really also didn't have a lot of confidence.

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Dr. Jennifer Panning [00:07:11]:

I mean, it was a bit like, okay, I'm just going to go out there and do this and trust it'll work out. But I didn't really have the foundation of skills or confidence going in.

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Michael Fulwiler [00:07:22]:

How did you think about the financial side of your business? How did you set your fees? Did you have a cancellation policy? You mentioned you hired an accountant. Were you doing bookkeeping?

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Dr. Jennifer Panning [00:07:35]:

Yeah, my ex husband was also self employed, so he helped me with some of the, setting up some of the financials, the same accountant and things like that. But I started my fee pretty low. It was $100 back in 2004. And that was suggested to me in terms of a brand new psychologist. I just gotten licensed and was just getting going and so, you know, eventually started raising that fee and insurance reimbursements changed as well. But, you know, the financial thing was pretty overwhelming. That's not how my brain works. It's still not how my brain works, unfortunately.

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Dr. Jennifer Panning [00:08:08]:

But I've just gotten more experience and learning more about how to do my financials. But my accountant now just does everything. She does the monthly bookkeeping and sends me quarterly reports and all that good stuff now that I can actually understand and read. But back then, it was like learning a foreign language.

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Michael Fulwiler [00:08:27]:

How are you taking payment in the beginning? Did you take insurance from the beginning?

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Dr. Jennifer Panning [00:08:32]:

Yes, I took. In our area, Bluecaster Shield is like the largest and best payer, and so I took them as well as at that point, Northwestern's student health policy was internal. They've now switched to Aetna. So we got them Aetna's panel as well. But we're still just blue cross for Shield and Aetna at this point.

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Michael Fulwiler [00:08:55]:

And at that point, you're mailing in insurance claims and just hoping that check.

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Dr. Jennifer Panning [00:09:01]:

Shows up, getting paid for eobs, getting paper checks, doing all that. Yeah, it was completely, I mean, I had a computer, you know, we think at that point I started having an EHR, but I started with, I think, like, Microsoft Word printout of a template for notes, and I would do handwritten notes. That's when I started.

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Michael Fulwiler [00:09:23]:

That's funny to think about now. Was there anything that surprised you that you weren't expecting when you started your own business?

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Dr. Jennifer Panning [00:09:33]:

You know, I think it's the seasonality, because working with college students, there is a seasonal component. Right? Like, summer is slower, August is, like, dead completely. Just, you know, not a lot of people around, social student population there, sometimes they go home or do internships or travel or whatnot. And, you know, for a while, I was so stressed about that. I was like, oh, my gosh, this is so terrible. What am I going to do? And then, like, clockwork, you know, fall would come and business would come back. And so I just at some point, learned how to let go of that stress and worry because it wasn't helping me. And it was also just more, you know, being able to figure out how to have some downtime, how to enjoy that, how to use that time for different things and not, you know, feel like I'm having to be on the mean.

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Dr. Jennifer Panning [00:10:26]:

You know, part of being self employed is like, you should be able to have some flexibility, right? That's the main benefit of having flexibility in your schedule, being able to take time off or figure out things that, you know, craft things the way that you want them. And so I kind of lost sight of that in the beginning. Until I was able to just kind of realize that and relax into it more.

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Michael Fulwiler [00:10:46]:

That's a. It's a great mindset shift. I've read about and seen therapists talking online about this idea of the summer slowdown or summer slump where, you know, clients are on vacation or the sun is out, so they're suddenly happy and not going to therapy. Imagine when you're working with college kids. It's like, to the extreme. So, yeah. Is that something that you would budget for as well, or, like, you would think about when you were doing your financial planning and business planning and all that?

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Dr. Jennifer Panning [00:11:20]:

Yes, I would try to overbook myself a bit during the school year, like, maybe take on, you know, two or three more clients during the school year to be able to have a little bit of a cushion going into the summer and also just recognizing, you know, there will be people around. There would still be clients, but especially in Chicago, like, people. It's like a circus right now outside. You know, people. It's like people are alive. They're coming out of their hibernation and, you know, just living life. And we are seeing more cancellations and more people that, you know, are. They have things to do, and they're living, you know, doing good things for their mental health, which don't always involve therapy.

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Dr. Jennifer Panning [00:11:58]:

During the summer.

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Michael Fulwiler [00:11:58]:

At what point did you expand your practice from just you to other therapists?

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Dr. Jennifer Panning [00:12:06]:

Yeah, that was 2014. I hired my first associate. It was. So I look back in my life and, you know, some people are the question, right? Where do you see yourself five years from now or ten years from now? I mean, I just. I don't like that question. It makes sense to me, but I don't always. Sometimes you just have opportunities and you go with them, and that is kind of how my life path has been, a little bit more of taking advantage of certain things and having a sense, like, I'll try this and see how it goes. So it just was happenstance.

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Dr. Jennifer Panning [00:12:38]:

I was getting a lot of referrals and turning them away to friends and also just had an office space. My colleague moved out to the west suburbs and realized her commute was just horrible, so she left her suite, and so I took over the whole suite and just had that office space, and I was like, well, I think I'll hire somebody and see how that goes. So it just started with one person, had no idea what I was doing. Learned a lot of lessons, but it worked, right? I mean, having one, it wasn't employee, contractor at that point. Having one person was not hard, and I had enough referrals coming in that he just took the overflow and it worked out well and then gradually started expanding more. And so then all of a sudden it's this big thing. And, I mean, I just, if you would have asked me 20 years ago if I would have been in this point in 2024, I wouldn't have said that. I'm just like, oh, I'll probably be doing private practice and whatnot.

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Dr. Jennifer Panning [00:13:39]:

It just, I didn't have the confidence. I lacked the confidence, and I didn't know if I really wanted to do some of the management and some of the other types of things that are difficult and challenging, you know, and I think some being what makes us good therapists, having empathy, being understanding, being flexible is not often makes us great business people. Right. Because we're too nice. Like, I'm too nice. I mean, I am much more trying to be understanding and take care of my employees and do right by them, which is, I think, what I want to do in the world and fits my values, but it's not the best for a business model, definitely.

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Michael Fulwiler [00:14:23]:

You mentioned that there were some lessons learned when you started to expand. What were some of those? When you look back on it?

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Dr. Jennifer Panning [00:14:31]:

Yeah, I mean, I started with 1099 contractors because that's kind of what everyone was doing at that point in time, and then realized that was not the business model I wanted to be in for a lot of reasons. One was, it was, I mean, Ir's is really looks, you know, is not favorably. It's not a good thing to have with Ir's right now in terms of therapists, because there's very specific delineation between a contractor and an employee. So I realized that that was leaving myself and my practice vulnerable. I also realized that I wanted to form more of a community and have a little bit more control over my therapist. That sounds a little bit strange, but just having a little bit more sense of this is how we do things. A little bit more of the policies and procedures and operations piece of. I think it was 2019 that I switched everybody to w two, and a good number of people left at that point because they didn't want that business model for themselves, which was my business coach is like, this will probably happen.

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Dr. Jennifer Panning [00:15:39]:

And lo and behold, it did. So I think one of the biggest lessons I've learned is it's humbling. Even having my group practice for ten years now, I'm still learning more, and laws are changing, and there's so many things, best practices, all sorts of things that are constantly shifting. And you have to have some compassion knowing, like, okay, I did the best I could with what I knew at that point, because I think the thing with therapists, if we have a group practice, generally speaking, we are managing the business and also still seeing our own clients. So there's a lot that we're taking on, and there's also a lot of output of energy and of caretaking and giving a lot to both our staff and the business and our therapy clients.

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Michael Fulwiler [00:16:29]:

That's a great point that people may not think about. I think this idea of expanding your solo practice to a group practice sounds great because you can make more money and just grow your business, but as soon as you hire someone else, it's no longer just you. Right. And now you're responsible for an employee. How do you think about your role now as an owner as well as a therapist? And how do you balance the two?

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Dr. Jennifer Panning [00:16:58]:

Yeah, I mean, I've had some tough, very tough lessons the past year. During COVID we expanded. Everybody was expanding. Everybody was starting a private practice. There's so much demand for services, and it was great. I mean, it was really something else. Whereas most small businesses and other industries were struggling to stay afloat, we enjoyed this boom. And what we saw in Chicago, at least mid 2023, was things just hit a wall.

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Dr. Jennifer Panning [00:17:29]:

Referrals slowed way down. People were requesting fewer sessions. Things just started to get very funky, and it was really hard. And I had, you know, had hired somebody, had hired an employee full time. And also we have now a training program, so we're training psychologists. And so I had all these people starting, and it was so hard to get them clients. Whereas before, it's like, people like, oh, my gosh, you have an opening. I will take it.

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Dr. Jennifer Panning [00:18:00]:

I don't care what time it is. Like, just, you know, that's awesome. And now things are very different. And it felt like it happened very suddenly, and it was surprising. And I still think, you know, like a lot of things, there's not, like, one answer to a complicated problem. There's multiple things that happen. And I still think, you know, there's the financial part. There's, I think therapy burnout.

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Dr. Jennifer Panning [00:18:22]:

I think burnout, burnout in terms of people just being tired and, you know, maybe needing therapy but not feeling motivated to take that undertaking on. And also, I just think, you know, that some of the pandemic anxiety and stress, I mean, Covid still around, but not be acute. Like, you know, we're all at home. We're, you know, doing kind of in that the first whatever it was couple of years. And so I think people's, you know, distress level has, has gone down a bit with that. And, you know, it was hard. I mean, the employee that I hired left, and I didn't blame her because she wasn't, you know, getting enough referrals to pay your bills. And I was, I felt terrible, right? I was like, my gosh, I had worked so hard to try to drum up business and do some marketing things and all sorts of things.

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Dr. Jennifer Panning [00:19:11]:

I felt like I was, and I felt the pressure because I don't like letting people down. Right. If it's your private practice, you're maybe letting yourself down or your family, but when you have employees, you're responsible for other people's livelihoods, too. And that's a terrible feeling. So that was really tough. The rest of 2023 was just like, I felt like I was kind of like a little bit of my nose above water just trying to figure out what's happening and what can we do about it and will it get better? Because the fall actually also was a bit slower, too, so it didn't follow the cyclical pattern that we had before. And it was really frustrating and hard.

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Michael Fulwiler [00:19:56]:

Talking to other therapists. Is your sense that that's happening across the industry, or do you feel like that was unique to your practice?

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Dr. Jennifer Panning [00:20:07]:

No, I think definitely people are feeling it more. I do a lot of marketing on local therapists, Facebook groups, and somebody will say, I'm looking for a referral for a woman with depression and network, a blue cross for Shield PPO. And sometimes you will see that there will be 40 or more therapists are like, you know, throw my name into the, into the ring. So I think a lot of people, as I said before, started the private practice, opened a private practice during COVID And it was so easy. Like, oh, my gosh, I'm filling, you know, two months. Like, this is really not hard. And then now I think people are, you know, there's this contraction and I think more of a back to pre Covid years of having more difficulty. And also, I think some of the larger, just some of the larger players of the venture capitalist companies are taking over some of the search engine optimization.

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Dr. Jennifer Panning [00:21:10]:

And there's a lot of, I think, unfortunately, in the public, not a lot of knowledge about why somebody should work with one of those larger corporations and therapists versus a small local therapist. So there's some of that, I think that's coming in as well. And I also think, you know, some of it is back to pre Covid levels and people, you know, there are group practices in Chicago. Like, I could, you know, at least five that I can think of that closed down. You know, they just folded and they didn't want to do it anymore. It became too hard. And I think, you know, with group practices especially, there's a myth that, like, you know, the group practice owner is, like, going home and rolling around like Scrooge McDuck in my cash piles, you know, and I laugh at that. And, you know, it's just ironic because the profit margins are even slimmer now because, you know, insurance reimbursement is staying fairly flat, and our expenses have skyrocketed with many other things.

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Dr. Jennifer Panning [00:22:13]:

And employees want. Want more. They want more money, they want more benefits. And so keeping up with all that is really hard. And honestly, I could be making more money in private practice. So, you know, it's tough. I'm hanging in there. I love, you know, the employees that I have right now.

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Dr. Jennifer Panning [00:22:31]:

I'm feeling very fulfilled. I love having the training program. We're doing some really cool things that I could do just on my own. But in terms of just the financial piece, it's been. It's been tricky because we, I think 90% of our clients are insurance based. So even though, you know, Evanston is a rather affluent area, people are paying so much for their insurance premiums that they want to use their, you know, blue cross reshield plan. And I don't blame them. I think, you know, that's a lot of money that they're spending on insurance, and they just want to be able to find somebody in network, which we're happy to do, but we're not getting, you know, that same kind of raises that we should be seeing at this point.

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Michael Fulwiler [00:23:10]:

I imagine working with college students primarily, there's also quite a bit of turnover. Is that an accurate assumption? You don't have clients that you've been working with long term for 810, twelve years because students are in Evanston, they're northwestern, they graduate, they move. Is that the case, or do you have longer term clients?

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Dr. Jennifer Panning [00:23:33]:

Yeah, it varies. I've had parents that contact us the summer before their child starts freshman year. They're like, all right, you know, my kids got a history of depression. I went to get their treatment team established before they start college. And so we'll see them, you know, for the four years that they're at Northwestern. And I have two people in my case. So now that I've been seeing since they're 18 and now they're in their mid twenties, so, you know, they just. They stick around.

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Dr. Jennifer Panning [00:23:58]:

And we do see, when we see age ten and above, I would say our majority of our clients are between 18 and 30, but some of the young adults and older adults in the community, you know, we certainly see for longer term. But you're right. Like, some, you know, because some college students are like, I feel anxious, I'm stressed. I want to resolve that and then just do my thing. And, you know, I think that makes a lot of sense.

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Michael Fulwiler [00:24:21]:

When things do slow down like they did last year, do you do more marketing? Do you try to cut costs? Do you just try to write it out? Like, how do you. Yeah. Like, how do you respond as a business owner?

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Dr. Jennifer Panning [00:24:41]:

Yeah. So during COVID you know, summers of 2020, 2021, and 22, we were gangbusters, busy. And that was unusual, right? Because pre Covid, we had that summer slump. So last year, I was like, well, maybe it's going back to, you know, pre Covid, and we're just seeing that summer slowdown. And that slowdown continued into the fall as well. And it just was, like, shocking. And so, yeah, definitely did some more marketing, revamped my website, did more blog posts, did some videos, hit the pavement, talking to other therapists, meeting with treatment centers, psychiatrists, dietitians, some of our referral partners. And also I have this wonderful consultation group of other women, group practice owners, which has been, like, helped my personal and professional sanity in so many ways.

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Dr. Jennifer Panning [00:25:38]:

We've been meeting since 2017, and so picking their brains and really trying to figure out, like, hey, what are you guys seeing? What are these trends about? What do you think's happening? And, yeah, looking at expenses, looking at how to, you know, at that point, it was a little bit of, as the months, you know, went on, I started feeling a bit like, oh, my God, what the hell is happening? And, you know, what do I need to do to take care of it? So it was very stressful. I ended up going on a long weekend in October by myself to northern Michigan because I was just like, I was done. I was like, I was just stressed. I can't think I'm not being a great parent. It was. I just had the sense of, like, if I don't do something to, like, really rest and restore myself, I'm going to be not in a good place. So I was able to do that. We have a clinical director who is wonderful and kind of my right hand person, really, and a great support.

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Dr. Jennifer Panning [00:26:39]:

So we were doing a lot of things about, you know, how do we. How do we do different marketing what do we need to do to get out there? Because the irony, right, was as of May of 2023, we had a waiting list. And so I was like, you know, it doesn't really make a lot of sense to do marketing when you have a waiting list. So you have people, you know, contact is like, oh, well, you can be put in our two month waiting list. So I got a little complacent or just thinking like, well, I'm not going to be doing some big marketing when we don't have the staff availability to see clients. So that was the thing, you know, and I think maybe just a humbling lesson to be able to do more consistent marketing year round. I'm looking at some other, you know, ways to bring in some more passive income, trying to do more speaking and workshops, and I would like to do some courses and things like that. But a lot of that takes time and energy and focus that, you know, just up until recently, I didn't have the bandwidth to do.

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Michael Fulwiler [00:27:45]:

I want to talk about other streams of income, consulting courses. Before we get into that, you mentioned that you have a business coach. I'd love to learn more about that. How long have you been working with the business coach? How did you find that person and what are some of the things that you guys work on together?

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Dr. Jennifer Panning [00:28:05]:

I have been meeting with Stacy for many years now. I mean, she does personal and business coaching, and she's not a, like, financial review, financial reports kind of coach. She's more of helping me with, with confidence, with putting myself out there with, you know, how to help me sort of just be okay with being vulnerable and failing. Right. Because that's, that's part of success. You're going to have to fail a lot. You're going to have to make mistakes. You're going to have to put yourself out there and think like, oh, this is a great thing, great idea.

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Dr. Jennifer Panning [00:28:45]:

You might get feedback. It's a great idea. And it might just fall completely flat. Right. So, and that takes a lot of, takes a lot out of you. So, you know, having her support of coming up with some ideas around also employees, like, I had to really have some difficult conversations and let somebody go and really look at where is my energy going? Because you really have to, as a business owner, you have to be able to work on the business and not work in it. I found myself just getting just inundated with the small minutiae that really was not where my zone of genius is from. Getting Hendrik's book, you know, working with her has really helped my focus and help my attention and remind me that that's where it needs to be.

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Dr. Jennifer Panning [00:29:37]:

I'm not good with details. I have ADHD. I've had it for many years. I have a lot of support. I've learned a ton about, like, what I need to do to shore up my weaknesses, and I've gotten to a good place with that. And my strength is the vision and being able to keep, you know, that really, really clear and moving forward. So that's a lot of what she helps me with.

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Michael Fulwiler [00:30:00]:

I love that there's a lot of negative connotation around coaching in the therapy world, and I think a business coach can be invaluable, especially if you don't have an MBA or didn't go to business school like most therapists.

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Dr. Jennifer Panning [00:30:20]:

Right, right. I mean, you know, I do. I don't do it on my own. Right. I have my admin team who does all the intakes and billing and all that. I have a business coach. I have a therapist. I have a consultation group.

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Dr. Jennifer Panning [00:30:36]:

I have, you know, a housekeeper. I have other things in place because I've learned throughout the years that I have to watch my energy, and I have a really good overworking. I'm really good at, like, just nose to the grindstone, overwork, get it done, and then I burn myself out, and that doesn't help anybody. So over the years, I've really had to learn, like, what kind of support they need and how to ask for help, how to delegate, how to kind of empower my staff a little bit more and set more firm limits. And that's something I'm still working on.

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Michael Fulwiler [00:31:12]:

Even just on the financial side of the business. I'd heard we talk about building a money team. So you have a bookkeeper, someone who's doing your books for you every month, a CPA. They're the ones that are actually doing your taxes for you. You have a CFP, often a financial planner, someone who's helping you with forward looking. So really building that team of support. I love what you said about being able to focus on your zone of genius, because, like, that's what you're really good at, and everything else is really a distraction, and it takes your energy and focus away from what you want to be working on.

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Dr. Jennifer Panning [00:31:54]:

Yes, absolutely. And I think we see people who are doing well, and we don't always see the behind the scenes of what that takes and what it takes to make that all work. Even so, like, you know, I sometimes am dealing with a clinical situation after hours that just needs my input and also, like, when I go on vacation, I put, you know, I take my email off of my phone. I put my away message that I'm out and that I will not be available until I come back. And, you know, the follow ups for people to connect with if they need help, and I expect my staff to do that, too. So that's part of, I think, the benefit. Right. Of having a group practice is you have coverage, you have colleagues, you have consultation, support, but also you have just sort of some of those things covered so you can go away and really vacate.

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Dr. Jennifer Panning [00:32:47]:

Because I think a lot of small business owners don't or can't.

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Michael Fulwiler [00:32:51]:

Yeah, I think that's a great, that's a great point. How do you, like, think about building that into your schedule? Is it, you know, once a year, twice a year? Because I know, like, taking time off can be really challenging, especially if you're new to private practice. Because I know I had to learn when I started my own business. Like, if you take two weeks off and you're self employed, you don't get PTO.

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Dr. Jennifer Panning [00:33:15]:

That's true.

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Michael Fulwiler [00:33:17]:

You're not making money for two weeks.

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Dr. Jennifer Panning [00:33:18]:

So. Yeah.

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Michael Fulwiler [00:33:19]:

Like, how do you think about that and planning for that?

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Dr. Jennifer Panning [00:33:21]:

Yeah, well, I always say I try to take vacation time with normal downtime in the schedule. Like between Christmas and New Year's often is a very slow time. So I usually go down to Florida for a week. I have family lives down there and for like, a family trip. And then I live in a very snowy, wintery climate. So I like to take more time off during the winter to be able to go and get some sun and vitamin D and recharge myself. But, like, this fall, I'm going to Greece. I'll be gone for two weeks.

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Dr. Jennifer Panning [00:33:56]:

I'm turning 50 next month, and this is my birthday gift to myself. And it's a dream trip. And I'm also like, okay, I'm taking on some more clients this summer. You know, I'm bulking up a little bit so I can have a bit of a cushion, so I can really go away fully. So, you know, somehow it does work out. And I think also that's another thing that when you think about the whole financials of a practice, like, we do work with intensity, we do work with trauma. We do have that personal and professional impact of just giving a lot. And also, if you're a parent or taking care of an elderly parent or whatever it might be, I have other responsibilities to somebody else in a caretaking role.

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Dr. Jennifer Panning [00:34:41]:

You have to be very careful about restoring, and it's almost a requirement that you take time off and you really take that seriously as part of being able just to keep being the best therapist and business owner as you can.

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Michael Fulwiler [00:34:54]:

You mentioned you're turning 50 next month, which is a big milestone. You also just had a kid graduate from high school.

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Dr. Jennifer Panning [00:35:02]:

I did.

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Michael Fulwiler [00:35:02]:

Which is exciting. How are you thinking about kind of this next chapter of your life and of your business?

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Dr. Jennifer Panning [00:35:11]:

Yeah, I mean, that's a great question, and I just feel like I've been having a lot of existential thoughts and questions around what's next. Right. So I'll have half of an empty nest in the fall. My daughter is still in high school, but in two years she'll be launched. Right. So that just opens a lot more doors and freedom for me. As I mentioned, I'm not a winter fan, so I've thought, like, well, could I relocate part of the year or do something where I can? I mean, telehealth has opened up a lot of possibilities, but also the reality is, I think the average lifespan of a group practice owner is eight to ten years. And I'm already at ten years.

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Dr. Jennifer Panning [00:35:52]:

And, you know, I don't know. I don't know what's next for it. You know, as I said, I love the staff and, you know, having the psychologist trainees, like, that's been really rewarding because just having that, like, new energy and freshness and being able to give back to the next generation, all that's been very rewarding. I don't know if I'll be, you know, ten years from now, still owning my group practice or if I'll somehow, you know, transition into something else. I mean, honestly, I've had that conversation and those thoughts a lot more with some of the rackiness I've had in the past year of, like, how do I do I want to keep doing this? And this is stress level, right, that I'm experiencing right now and going through and trying to sort of get back on a better course. Is that worth. Is it worth it? I actually just hired. So I have a practice management team I've worked with for five years.

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Dr. Jennifer Panning [00:36:45]:

They're out of state. They're great. I have nothing, like, great things to say about them. But I have missed having somebody local. Like, just the little things, right? Like, do I want to be swapping out the water bottle to the water cooler all the time? Somehow that comes back to me, you know, just having somebody to manage the office and be local. And so I hired an office full time office manager. She'll be starting in a few weeks, I think. I hope that will also help to turn things around a bit in terms of having, you know, one person handle all the things and having some support added to my plate and to some of our leadership teams as well.

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Dr. Jennifer Panning [00:37:24]:

So, yeah, it's going to be interesting. I'm open to possibilities. You know, as I said, I just think a lot of my career path has been being open to possibilities, taking risks, looking at opportunities, taking them when they, when they come, and also not being, like, really wed to a plan I did. I'm now trained in accelerated resolution therapy, which is a similar TMDR. I brought a trainer in for my staff last year to train in that. And so that's been a great addition. And I think that's also been great for burnout because it's just a very different model of how to work with a client. It's very different from traditional talk therapy.

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Dr. Jennifer Panning [00:38:06]:

So I'd like to keep doing. I'd like to become a trainer and doing art and still bringing that back to the community. And so, you know, I like to dabble in things. I like to do new things. I think that helps with burnout and that helps with creativity. And I don't know. I don't know what's next. I mean, you know, I think.

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Dr. Jennifer Panning [00:38:28]:

I think for me, what I look at is like, I have two more years to, you know, before my daughter is launched and before I need to, or I can think a little bit more broadly about even locations and things like that. But I'm enjoying it for now. And right now, the staff we have is terrific. They're just hard workers and good clinicians and grateful and really aligned with our mission and our values. And so I'm happy. And I think if things I don't think will continue to grow hugely, there's like, the 50 therapist group practices or whatnot. I like having a smaller group. I just feel like it's easier to manage.

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Dr. Jennifer Panning [00:39:13]:

I like having a little bit of my own, you know, fingers and things as well, even with, you know, having ten employees, just having a little bit more of the personal touch is how I like to do things. So I don't know. I mean, I'm also very curious about how our industry will be in the next five years, you know, with some of the venture capitalist companies, like, and even some of the other ones that are providing services to therapists like Alma and headway. You know, I'm very skeptical about some of the sort of the long term goals with some of those companies. And how that could impact the solo or small group practice owners. So I feel like there's a lot of interesting, you know, things happening and we'll play out and see how that all that goes. But I hope to be able to figure out a way to stay, to stay relevant and to stay around for a couple of years. But, you know, I think the one good thing about being a therapist, too, is like, we can pivot and that's exciting, right? I could go back to solo practice and that would be fine.

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Dr. Jennifer Panning [00:40:20]:

Or, you know, in retirement, people, a lot of therapists work, you know, c two or five or whatever clients a week because they can do that during, you know, their seventies, as long as they're cognitively sharp. So I think that's exciting.

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Michael Fulwiler [00:40:34]:

Has selling practice ever been an option or something that you've thought about eventually down the road?

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Dr. Jennifer Panning [00:40:42]:

I have thought about that. It's an option. You know, I feel like, again, I don't like to be close minded to possibilities, and if it was the right situation, I think I feel a bit protective, like, it's my baby, right? It's my, you know, for 20 years, I've built this business, and I, selling it to, like, a large corporation doesn't feel right. Also, you know, financially, who knows, right? I mean, I have one kid in college, you know, coming up and another one in a couple of years. So it's like I need to look out for myself, too. So I don't know. That's a good question. I'm still, I mean, I, what I'm focusing on writing down at least, is getting some operations tightened and some of the staff change with the office manager who came from actually a practice, who the practice owner sold after, you know, a number of years of being in Chicago.

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Dr. Jennifer Panning [00:41:44]:

So this person managed the practice for five years and now was out of the job. I wasn't looking, I didn't do a job ad or anything, but she kind of came up as somebody who was available, and I was like, hmm. So that's probably a good example of a lot of how my career has happened. It's like I see something and I'm like, huh, that is interesting. Let me think more about that. That could make sense. I think that could be a good thing. So it's more of a, I don't know, intuitive sense or sense of not always having the detailed plan of all the things that I want to do, but going with things that intuitively make sense.

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Dr. Jennifer Panning [00:42:24]:

And I've had a pretty good track record with that.

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Michael Fulwiler [00:42:27]:

It's clear to me from conversations on this show that there's not one path to success for therapists in private practice. I've talked to therapists who only ever aspire to have a private practice. They don't want to deal with being a group practice owner. I've talked to therapists who are at that level of, they have 50 therapists or they have ten locations, and they're expanding and growing, and that is very exciting for them. I've talked to therapists who they do want to sell their practice someday. Some don't. So I think a takeaway for me from this conversation is really to follow your own path and don't feel like you have to look like your business has to look like someone else's, or you have to sell your business to be a successful therapist.

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Dr. Jennifer Panning [00:43:17]:

I think that's a great point. And it's also what it brings up for me is there is a tendency to want to compare, like, oh, this practice is doing this, or this practice owner is doing this thing, and why am I not doing that? Or should I be doing that? It's hard because I wonder. I'm like, well, what? I want to grow and expand to whatever 30 or 50 therapists, and I check into myself, I'm like, no, I don't think I do. Could I if I wanted to, probably, right? But you're right. I think having, like, honoring our own paths and the reasons why we have them and, you know, like, I have, my mother is aging and has some dementia. Like, I have to think more about some of my personal life and how my personal life collides with my professional life as well. I mean, my kids, you know, for me, like, I know some practice owners who have young kids, and I'm like, God bless you, because that is intense, right? Just having that, like, hands on of the little kids and so much expenditure of that energy, plus the practice. So, you know, my teenagers are like, I'm lucky if they, like, ate dinner with me.

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Dr. Jennifer Panning [00:44:25]:

You know, they just don't. They're doing their own thing, which is great and exactly what they should be doing. But it has freed up more of my time and energy and sleep to be able to have more to pour into my business. But I think the personal component and the relationships, I mean, I think something I've had to learn along the way is just the importance of if I have a romantic partner, that that person has to be in a support role, and we're not easy to be in relationships with, right. Because we, I think, need a lot and we give a lot. But I also think, you know, there's a lot of, a lot of people can't handle or would want to be in a relationship and partnership with a therapist because sometimes we give in at the office and we come home, we don't have a lot to give. So, you know, I'm divorced. I went through a breakup several years ago with somebody who's just not a good fit and with somebody now who's, like an awesome partner.

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Dr. Jennifer Panning [00:45:26]:

And I realize now how much that changes. That's a game changer for, obviously, my personal life and me, but also my practice. So I think that's a, that was a huge lesson. I didn't really, I don't know, I didn't really think about that as much as what an impact that would have.

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Michael Fulwiler [00:45:44]:

That's a great point. How do you think about work life balance? Is it building your business around your life? Is it your life around your business? How do you conceptualize that?

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Dr. Jennifer Panning [00:45:54]:

No, I think it's always a work in progress. You mentioned my son graduated from high school, went on a trip to Mexico. I mean, my kids just like a graduation gift for him and just, you know, time to spend together before he leaves in a couple months and then came back and, you know, did the graduation party and just am getting back into summer and work mode. So, I mean, when I look back in this past year, I think, I mean, I take, you know, at least three or four weeks off a year, and that is really nice. And that, that works well for me. As I mentioned before, you know, that fall weekend away where I just was like, I was just done with things and a really bad burnout place. And so my goal is to not have that happen and, you know, to be able to take time off and enjoy things and not get to that place. And summer is a time for doing, you know, in Chicago, the weather is great.

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Dr. Jennifer Panning [00:46:53]:

You know, there's so many events and concerts and fun things. So I think there is more of a, you know, in the winter, we hibernate and we stay inside and we, you know, to work more because there's not much going on. It's more quiet and things like that. But for me, work life balance is about flexibility. Like, if I take on a new client, a therapy client, I tell them, like, hey, you know, I own the business. If you're, you know, if you see me for therapy, you have to be okay that there might be some weeks wherever I have a meeting or I have a networking thing or I have something else going on and I try to be as consistent as I can with my clients, but they know the deal, and I enjoy being able to still do things like networking and getting out and consulting with old colleagues, because at this point, there are years and years they've been in the business, and it's nice to have those connections and those relationships. The work life balance to me is about flexibility. It's about being able to do the things that I want to do.

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Dr. Jennifer Panning [00:47:59]:

You know, my son is going away to college in August, and I've already, you know, figuring out, like, obviously I want to be there and do the whole dropping them off at college and what that will entail and things like that. So I do make it work for myself, and sometimes that means squeezing, you know, my clients into a couple of days to be able to take a, the rest of the week off to do something. So I think I've learned the hard way of the importance of doing that.

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Michael Fulwiler [00:48:27]:

Well, I wanted to ask you about the Goldman Sachs 10,000 small business program that you did. Could you talk about that experience and share any takeaways that have been helpful for you?

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Dr. Jennifer Panning [00:48:40]:

Yeah, I mean, that was an awesome experience. I recommend it to anyone. Anybody I know. They have requirements for entry. I think there's a certain revenue requirement, and then there's also, you have to have at least one employee. So I applied right before COVID and did an interview and was accepted into the Chicago program. And then Covid happened. And, you know, I think we were supposed to start in February or something, and they're like, we need to, you know, pause, but we'll be in touch.

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Dr. Jennifer Panning [00:49:09]:

So then they contacted me for the fall 2020 cohort, and I was like, listen, I don't have the bandwidth to do it right now. So I ended up doing the next cohort, which was started January 2021, and I think it was about 30 small business owners from all sorts of different industries. And my cohort was awesome because we were 75% women business owners, which was just phenomenal in many ways. And so basically, it's a kind of a very small, condensed mini MBA coursework. I mean, it's from Babson College. It is curriculum. There's modules. Like, every week you just go through all the different aspects of running a business.

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Dr. Jennifer Panning [00:49:53]:

HR, leadership, marketing, financial forecasting, how to secure financing, to expand all sorts of things. So you go through the coursework, you have homework. You also have a small group that you met with. We met with once a week. I think it was, I mean, at least 20 hours a week of work. And it was so intense by the end of the 16 week program, you have completed all this, but also have done a five year business plan, including a financial forecasting. And so it was intense. And like some of those financial forecasting modules, this isn't how my brain works.

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Dr. Jennifer Panning [00:50:35]:

I'm pulling out my hair. I actually ended up, my dad's an entrepreneur and trained in engineering. I ended up going out of Florida. I was like, can we work on this together? Because I need your help, because I'm really not understanding all these over. So he was great help with that. But it was a great experience. I mean, I recommend it to anybody. It was just the confidence in terms of some of the things I'm like, oh, yes, I'm doing that quite well.

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Dr. Jennifer Panning [00:50:59]:

But I also learned a ton about operations, about also where my weaknesses were and things, areas that I wanted to keep not just improving, but also shore up some resources around. And then, you know, you, after you're done with the program, you have an alumni network in Chicago, and then you have access to this national alumni network, which is over at this point, well over 10,000 small businesses. And in 2022, every alumni of the program was invited to this conference convention in DC, which was awesome because it was put on by Goldman Sachs. I've never experienced anything like that. I've not worked in corporate America. So just the whole, like, schmoozing and the bands and the like, really awesome. I mean, George W. Bush was a speaker, and Gwyneth Paltrow and Chris Paul and so many, like, it was awesome.

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Dr. Jennifer Panning [00:51:53]:

And so being able to benefit from that way and just also have some fun. But I think what it did really was help my confidence and really understand, you know, the big thing that they said was like, you have to carve out time to work on your business and not work in your business. Like, that's the number one pitfall that we see with small business owners. So that was very, very helpful.

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Michael Fulwiler [00:52:18]:

That sounds like a great opportunity. I want to chat really quickly just about other income streams in your business. You've mentioned training, we've talked about consulting, speaking. How are you thinking about integrating other streams of income into your business, especially as you move forward?

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Dr. Jennifer Panning [00:52:38]:

Yeah, no, that is the million dollar question. Right. What I'm hoping to do, we have, as I mentioned, we have two side b, and so they're student clinicians. We are offering very, very low fee, you know, so we're giving back to community in that way, too. But some of them are also seeing regular blue cross with shield clients, which we can bill under their supervisor. So that's a bit of a passive income stream. What I would like to do, I'd like to do some courses, I've done some webinars and in person workshops. I just did one recently, my kids high school.

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Dr. Jennifer Panning [00:53:15]:

For parents of high schoolers to help their students transition to college and what to be aware of and look out for in terms of mental health concerns. Right. Because, you know, I, going through it this year was so overwhelming and so much work and just completely, completely different than when I went, you know, went through the college process. My parents were like, oh, where do you want to go? Oh, okay, sounds good. So now it's completely. Parents are so hands on. But one thing that they don't consider, and students really don't either is just the mental health impact. So we see that on the other side where students sometimes are not doing well, they're in crisis, they're kind of collapsing, that kind of thing.

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Dr. Jennifer Panning [00:54:00]:

So I would like to focus on is how do we help those students and getting them to a better place so they're nothing in crisis when they come to college. It's difficult though, because unfortunately, humans are not always the best at prevention. We tend to, like, wait until something is broken to fix it. I do think there's a lot of parents that were very responsive and grateful for that kind of information. So I would like to continue doing some, putting together some coursework and webinars where we can market that at a lower price point and be able to get that out to a lot of people. I would like to be able to do some speaking. And another thing that we're wanting to do more of is with the accelerated resolution therapy. I did the advanced training earlier this spring, and I want to be offering intensives for that, which would be more of like a standalone.

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Dr. Jennifer Panning [00:54:57]:

Somebody comes for six to 8 hours and does a lot of processing and traumas, and that's an out of pocket service. I mean, that's what we're looking at too, is just how do we get more out of pocket customers, right? Because the insurance is just, it's set at a. There's a limit to that. And so that's part of what I'm looking at as well.

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Michael Fulwiler [00:55:20]:

I love this idea of helping high school students transition to college. It feels like such a need. So if you're listening or watching this on YouTube, you're affiliated with a high school or a group that works with students, definitely reach out to doctor Jennifer. I think that would be a really valuable workshop or talk that you'd be able to provide we're coming to the end of our conversation. Unfortunately, we wrap up the show with a segment that we call the footnote. So my final question for you is, what's one thing that you want therapists to take away from our conversation today?

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Dr. Jennifer Panning [00:55:59]:

I think honor your path and honor, like, really get to know who you are as not just a therapist but as a business owner with your strengths and weaknesses and figure out what supports you need to have. And do that right. Like make that happen for yourself because you will be so much happier. And that is an investment that's well worth it.

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Michael Fulwiler [00:56:22]:

Well said. Where can people find you online? Or where can they reach out to you?

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Dr. Jennifer Panning [00:56:28]:

I'm on LinkedIn. Jennifer Contorino Panning my professional website is evanstonpsychologists.com. My practice is mindful psychology associates in Evanston. We are on Instagram, Facebook, I no longer tweet or whatever. X, you know, not much, but I am on formerly known as Twitter panning. But I'm much more active on LinkedIn and through my website. So yeah, I'm easy to find.

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Michael Fulwiler [00:56:58]:

Great. We'll encourage people to reach out and connect with you. We'll drop those links in the show notes as well. Doctor Jennifer, thank you again so much for coming on the show.

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Dr. Jennifer Panning [00:57:06]:

Yes, thank you for having me.

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Michael Fulwiler [00:57:09]:

Thanks for listening to this episode of Heard Business School brought to you by Heard, the financial back office. For therapists, visit the Heard resource hub at joinheard.com to support you in your journey as a private practice owner. And don't forget to subscribe on YouTube, Apple, Spotify or wherever you get your podcasts. We'll see you in the next class.