speech pathologists and marketing | Speechies in Business

Over the break, while couch-potato gazing at the cricket, I gave some thought to long-term, sustainable business models for private speech pathology practices. Specifically, mine!

When you start out, almost anything you read about launching a small business will at some point hit you with a frightening stat or two, e.g., that 80% of small businesses fail in the first 5 years. I’m not aware of any specific stats on speech pathology practices, but I’d expect that figure to be about right.

Why?

Lots of us start out in private practice because we want the flexibility and independence of running our own show. We are confident (or confident enough!) in our technical skills as speech pathologists and think we can do things better that where we were before to help clients with their communication or swallowing needs.

But knowing how to be a great speech pathologist is not the same thing as knowing how to run a business. To run a business, you need business knowledge and systems.

Business infancy

When I started my private practice, I was pretty much my clinic, and my clinic was me. My wife and I did all the work ourselves. But as we got busier, and our case load grew in volume and complexity, the work became harder to handle. At one stage, we were working seven days a week – often 12 hours a day – to ensure we kept our therapy service quality high. But, even working 60 hours a week to ensure our clients got the best possible service, “non-client” things started to slide. We just didn’t have the time or energy to attend to all the back office stuff.

Business adolescence

Eventually, we got some help. Initially, with some of the back office tasks we despised (e.g. book-keeping), and then by hiring high-quality staff to help deliver our services. The danger with this “teenager” stage of business is ensuring your quality remains high even though you are not delivering every assessment and therapy session yourself. This was (and remains) hard for a control freak like me! But I knew that my practice would fail in the long run if I couldn’t grow it to a stage beyond my ability to do and control everything myself.

Sometimes during this phase, I felt like retreating back to the comforts of the one-person practice. But then I remembered how awful it felt to be overloaded with work, turning clients in need away as my waiting list ballooned.

Planting seeds for growth at the outset

Successful businesses think about the future. Ideally – in the long run – you want your practice to work even when you’re not there. To achieve this, you need to think like a business-person and plan how your business will develop as it grows. So I looked in the mirror and asked myself:

What do you care about the most?
Why is your practice an opportunity worth pursuing? Is it aligned with what you care about the most?
How do you want to live?
How much money do you want (or need)?
How much freedom from working at the coalface do you want?
What sets your business apart?
How will you get clients?
What type of clients will you help?
How will you deliver your services?

(If interested, you can read more about our start-up philosophy here.)

I then developed a one-page business plan with my purpose front and centre, and my break-even point highlighted in pink.

Even though I didn’t want to, I needed to think like an “entrepreneur”. Now, I know that word has some colourful connotations, and not everyone in private practice is comfortable thinking of their practice as a business. But, as I’ve said before, I think it’s perfectly possible to be both ethical and profitable. In my previous career as a finance lawyer, I observed that it was often the well-meaning, but unprofitable and ill-managed, businesses that were vulnerable to major systems failures and pressures to cut corners at the expense of their clients.

Get out of your own way!

Here’s a quote I love from Michael Gerber:

“The problem isn’t your business; it never has been. The problem is you!”

That was so true with us! We needed to realise that many of our early struggles were caused by the confusion and tension of trying to wear multiple hats at the same time. Every day, in the clinic, I was part:

(mostly) speech pathologist, focusing on improving my technical skills to help clients with the latest, evidence-based therapies;
manager, focusing on boring (but essential) business and compliance systems, organisation strategies, and finding ways of doing things more efficiently; and
entrepreneur, creating new services and products, dreaming up new ways of doing things, looking for opportunities to grow and to connect with others.

The (ongoing) problem is figuring out how much energy to devote to each role at any given time.

How to build a business that lasts

Another top tip I learned from Michael Gerber:

“Pretend that the business you own…is the prototype, or will be the prototype, for 5,000 just more like it!”

Now, as an, ahem, former McDonald’s crew member, I’m not a huge fan of the franchise model for allied health. But I loved the idea of designing my clinic to be systems-dependent rather than owner-dependent. Documenting your key systems:

forces you to write down the (sometimes conflicting) contents of your head. I discovered scores of duplicated efforts, wastage and service gaps in my systems just by writing them down;
allows others to understand and work to your standards without being micromanaged;
ensures people are accountable for their outcomes; and
increases the predictability of your service quality.

When we started our clinic, we set up systems that we hoped would grow with the business – even if they seemed ridiculously over-engineered for the client flow at first. I even signed my own Code of Conduct.

Why we had an organisation chart for two people

Even when we were (literally) a Mum-and-Dad business, we wrote down all the roles in our practice (e.g. clinical, operations, marketing, Human Resources, accounting, finance, etc.), and then assigned them – initially all to ourselves, but, as the business grew, to our staff and partners. This helped us stay clear on who was accountable for what and when, even (especially) when we were doing everything.

Human Resources: hire people who are smarter than you

When we hire someone to help us, as an employee, contractor or service provider, we test candidates against the standards we’ve set for ourselves in the position. We look to hire people who are at least as good (preferably better) than us at doing the job. We also try to make sure staff and partners understand the meaning of the work they’re doing and how it fits into our purpose and plan.

Marketing: it’s all about the clients

Our marketing plan is simple: doing our job as well as we can. We don’t rely on advertising. We focus all our efforts on solving real-life problems for people who need speech pathology. That’s why we publish free blogs, books and resources, and address frequently asked questions. That’s why we do community and school talks. We try, consistently, to help people who need speech pathology services find the answers they need.

Don’t lose sight of why your business exists

The business development process – the design of business models and systems – never ends, especially in a time of great change for speech pathologists. When we look at our medium-to-long term business goals, we see a complex, but easy-to-run, set of systems and processes that all work together to support our primary aim: helping adults and children to speak for themselves.

Principal source: Michael E. Gerber, The E-Myth Revisited: Why most small businesses don’t work and what to to about it. Kindle edition via here.

Image: https://tinyurl.com/h2tx26v

“I need a blood test”*

Lots of people have never met a speech pathologist. Some have a rough idea of what we do, often along the lines of: “Oh, you work with kids with speech impediments, right?”

Others have absolutely no idea. And fair enough. There are loads of professions I know little or nothing about.

One of our key professional duties is to advocate for people with communication and swallowing needs. But it’s hard to advocate for some groups of clients if the public don’t know what we do or why we’re qualified to speak on issues as varied as adolescent literacy, Parkinson’s Disease, dementia care, youth justice, stroke rehabilitation, accent modification and professional communication.

Our peak bodies – like SPA and ASHA – do their best to spread the word through terrific projects like Speech Pathology Week, the 900 swallows initiative or the SPA Book of the Year Awards. But every speech pathologist has a role to play in educating the public about what we do: one of the main reasons I post so often to my clinic website.

Despite our collective efforts, I’d hazard a guess that few members of the general public understand our full scope of practice, or the many different ways we help people in different places. Shockingly, I didn’t know the full scope our practice until the second semester of my degree!

Getting the word out, ethically

One of the main themes that crops up whenever I speak to groups of speech pathologists or speech pathology students about private practice is a deep sense of ambivalence about self-promotion. And for good reason. We work with people with health needs who are vulnerable to misleading and deceptive advertising. It’s one of the main reasons the profession in Australia has such a robust Code of Ethics – Advertising policy.

But I think we can do more to explain what we do to others without trying to “sell” ourselves. And it’s a fairly simple idea, borrowed from Michael Port’s research on networking and marketing strategies for professionals:

How to explain what do you do for a living in 5 steps

The next time someone asks you what you do – at a barbeque, a kid’s birthday, a networking event, cousin’s wedding, etc. – don’t say “speech pathologist” and leave it at that. Instead, use Port’s simple 5-part formula, which I have adapted for speech pathologists as follows:

Summarise your key client groups: Who do you help most often: Infants? Toddlers? Preschoolers? School-age children? Teenagers? Young offenders? Young and middle aged adults? Older folk?
Identify two or three of the most critical problems that your clients face: In what areas of practice do you help clients? Language? Literacy? Speech? Voice? Fluency/stuttering? Feeding? Swallowing? Life-long disability/Multi-modal/AAC? Accents/intelligibility?
List some of the main ways you help people: One-to-one or group therapy? Telehealth? Parent training? Client coaching? Advocacy/education/lobbying?
Explain the number one result you want your clients to achieve.
Talk about the deeper benefits your client’s experience.

One of the great things I find when introducing myself this way is the genuine interest many people have in what I do. Rather than just a customary exchange of titles before moving onto the next topic (usually property prices in Sydney), it starts a conversation.

Examples

This is how I apply the formula to explain what I do:

I help children and adults…
who have difficulties with their speech, language, literacy, stuttering, voice, and/or accent…
with evidence-based, tailored therapy in my clinic, via Skype, or through online courses,
to pursue their goals and to make the most of their abilities and potential,
to get the most out of life.

Here’s an example for a paediatric speech pathologist focusing on traditional speech and language services:

I help infants, toddlers, preschoolers and children;
who have difficulties with their speech, language (including social use of language), and/or literacy;
to improve their language, intelligibility and literacy through home, (pre)school and clinic visits, parent training, and home programs;
to communicate with confidence, be understood and to participate more fully at home, in extra-curricula activities and at (pre)school.

Here’s another example for a speech pathologist working in a rehabilitation setting:

I help young adults and adults;
who have had a traumatic brain injury or stroke causing language, speech and/or swallowing difficulties;
with evidence-based treatments and carer training based on principles of motor learning and neuroplasticity in a multidisciplinary rehabilitation setting;
to recover maximum communication skills and to learn compensatory strategies for areas of on-going difficulty;
to regain independence and to go back to work.

Not just for introductions

The great thing about doing this simple exercise is the clarity it brings to what we do. I use my 5-part introduction not only to explain what I do to non-speech pathologists, but as a key part of my “mission statement”, business plan, strategy and even branding for my clinic. Once a year (or so!) I reapply the formula, taking into account new target clients, training and new competencies, and proposed service delivery changes for the coming year.

Bottom line

To advocate for, and to market, speech pathology services, we need professional credibility. For credibility, we need the public and potential clients to recognise our expertise, experience and authority across our scope of practice. Explaining who we help, how we help, and the outcomes we deliver for clients is critical for both public advocacy and private practice success. Port’s 5-part formula is a simple way to articulate what we do for a living to people outside the profession.

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