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[00:00:00] James Marland (2): Hello and welcome to the Scaling Therapist Podcast. This is the podcast for therapists who want to escape the trap of being fully booked and develop income streams. I'm your host, James Marland, and today we're starting a brand new series, the Three Pillars of an Income Flow System. Today we're gonna talk about the current system and why it might not be designed for your success.
[00:00:44] This, this series is all about creating income flow without burnout. And it's for the therapist who's already helping people, but they're wondering, can I keep doing this forever? You know, is, can I keep the, keep up this pace forever? I'm [00:01:00] going closer and closer to burnout. How do I escape this trap? I wanna start with a story from my uh, day hospital case manager days. Back then I did the intakes and I met with the clients and, and got their, filled out the paperwork and got their story about why they were there.
[00:01:20] And some of them had, like, you know, with day hospital level of care, the services were pretty intense. And I would hear these stories and then I would go back and I handled the insurance reviews for the clients coming in for treatment. So it was the pre-certification. So parents would walk, would walk in and you know, they were desperate.
[00:01:41] They were desperate for help. Their, their kids were in trouble. They were failing school, failing in life. Uh, having some sort of emotional distress. And I would hear these stories of struggles and then I would go back, get on the phone while the client was still in the building, and talk to the insurance [00:02:00] company and explain the needs and explain the story.
[00:02:03] And I would try to get authorization for care and. More times than I'd like to admit, especially in the beginning when I had this job. I'd hear this phrase that seemed really cold to me. Well, they don't qualify. They, you know, they, they're not approved for this level of care for service, and I felt whether they, they wanted to or not, I just felt like the system was designed to say no.
[00:02:29] The system. You thought insurance was there to help you, but underlying there was like this, this, these rules that if you didn't follow them, getting help was very, very difficult. And so I felt like the, the system was just designed to say no, and it made it difficult for the people who really needed help.
[00:02:51] And when you're doing pre-certification for people, you don't just do it once. You do it every, whatever the, the rules of the [00:03:00] insurance company are, every three to four days, you do pre-certification again to see if they get another day or another day or just one more day. And each time we wanted to help the clients, we wanted to serve them, we wanted to restore them to health.
[00:03:15] And each time we felt like we had to jump through hoops, just more and more hoops and even hoops that we didn't even know existed. I sometimes I felt like we were playing different sports. Like I was playing basketball and they were playing soccer and every time I tried to use my hands I would get a foul.
[00:03:35] I remember one time there, there was a family that they desperately needed help and I, and I was excited 'cause I knew we could help them. And I went back and explained it to the insurance company and they rejected him. And it was like, how, how can this keep happening? How can we. When, you know, how can we support the family if we don't even know the rules?[00:04:00]
[00:04:00] So I started collecting the rules. You know, I started, uh, every time I talked to insurance company, I would say, send me, you know, send me the link or send me the, the, the handout where I can understand what are your criteria. Some of them didn't want to give me the criteria, but I collected as many as I can and it became the.
[00:04:20] The, the guidebook, the guideline, the rule book that I shared with all the other, um, people who did insurance. And it was my playbook. It was my playbook on getting the services needed and understanding the rules so that I was playing the same game they were. And suddenly, you know, I was getting more and more approval according to your own criteria.
[00:04:45] They just started, um, you know, I got. Much better at getting those approvals once I understood the rules. So once I understood the system, I could work within it instead of being denied and [00:05:00] crushed by it. And I think therapists today are operating in a similar position. They're in a system that they don't quite understand the rules because they're.
[00:05:14] The system right now is telling therapists fill your schedule, book up every moment that you can to to see clients to make that money. So, and then you are successful if you are fully booked, if you have a fully booked schedule that is success. And the system tells people that to head towards that goal and.
[00:05:39] The, the subtle, the subtle lie, I guess I'm gonna call it a lie, is a full calendar equals success. But success how that, that system that you're working under is actually this, uh, what, what some people call success. A full, a full calendar fully booked out. [00:06:00] To me, that's also the road to burnout. That's the road to exhaustion.
[00:06:06] That's the road to feeling unfulfilled in your work. That's also the road to compassion fatigue. This system, the fully booked system, I don't think it's built for your success. It's built for you to, to eventually burn out.
[00:06:31] Going, going back to the, the day hospital days, um, we had seasons where we were sprinting the, the, the list for people who, who needed services, especially for child and adolescent, from the schools and the networks and the, even the insurance companies. Our waiting list at times would explode. There'd be like 30 people on the list and we could only get.
[00:06:56] Admit five to eight people a week. [00:07:00] So we would have weeks long waiting list and everybody maxed out. The clinicians maxed out the intake workers, the doctor, the support staff, the direct care staff, the teachers, everybody was working as long as possible. We'd, you know, skip lunches to do appointments, work late, do extra paperwork, coffee and caffeine, and hospital coffee's not that good.
[00:07:26] Um, just to share a little point there, but we'd drink it. Um, we were running on ca, caffeine and compassion, you know, and, uh, then. Then there's months later where everything slowed down. There were cancellations, empty schedules, and now the anxiety flipped. And now the anxiety is can we, can we make payroll?
[00:07:52] Will we have enough clients? Should we start taking forced vacation and work three or four days instead of five days? And we lived [00:08:00] like, it was like. An accordion, I guess, you know, the, it goes shrinks and contracts, shrinks and contracts, but the system didn't shrink or contract, like the staff didn't, you know, it was very difficult to have the staff, the right staffing levels when everything was changing so often.
[00:08:19] There, there was no, there was no flexibility, there was no rhythm. There was, uh, there was anxiety when, when we were full and anxiety when we weren't full. And I think that really models or, um, Aden, that that's a, that's very similar to the therapy model. You can't, if you chase full capacity. Then you're gonna have the anxiety of having 20 to 30 to 35 clients a week.
[00:08:53] You know you're gonna have that anxiety and that energy drain, or you're gonna be on the other side where, oh, I don't, you know, [00:09:00] I got 10 clients and that's not enough and I need to hustle to get those clients. And they may or may not come. Like you're just living on one side of anxiety. And on either side there's Ebola burnout.
[00:09:12] And, um, on the side where you're, you're, you're maxing yourself out. You're, you're, you're, you're, you think you're chasing success, but you're really chasing a system that's designed to burn you out.
[00:09:32] We're told, you know, you can be successful if you just work harder. If you just set up some boundaries, if you, if you just see this many clients, you're gonna be a success. But I, I think that work harder, chase, a full calendar is just a broken system, and I think we need a new way of thinking about income flow that doesn't [00:10:00] throw away the therapy model, like the, the one-on-one bread and butter therapy model is.
[00:10:05] It works for a reason, but I don't think we need to have a, a system where you, you put all your energies in that system because the ultimate end of that is, is burnout. So we need a way to multiply our energy instead of draining it. And that's where the idea of creating a system comes in. Uh, I call it buckets to aqueducts it.
[00:10:29] It's, uh, something that is meaningful to me. It goes from carrying every session yourself to an income flow type of system. I love systems, I love efficiency. I think about it all the time. One of the, one of the ways this shows up is when people, I, I help people move and I've moved maybe 10 or 15 times in my life and, uh, unloading the truck.
[00:10:57] I believe there's a right way [00:11:00] to unload the truck. The, the traditional way of unloading a a moving truck is everybody, uh, walks up the ramp, grabs a box in the truck, they walk down the ramp, they, they take the box inside, maybe up a flight of stairs. They drop it where they think it goes or where there's space, and then they walk all the way back, walk up the ramp, grab another box, and they do that over and over again.
[00:11:26] And it's not just one person doing that, it's multiple people doing that, that activity. And what happens is there are choke points, whether it's at the ramp, whether it's going inside, there's people waiting around. There's people not sure they don't know what to do. There's all this waste. It's exhausting.
[00:11:47] It's slow, it's chaotic. I get really frustrated by these inefficient systems. My favorite way of unloading a truck, a moving truck, or anything really where you have a lot [00:12:00] of things is you have one or two people inside the truck delivering the boxes. To the front of the truck or the, the back of the truck where people pick it up and then they walk it inside.
[00:12:12] And the owner or the the person, there's somebody inside who tells you where that box goes. Maybe the owner wrote where that bo, you know, living room, uh, kitchen, bedroom. And they put it on there and then it's delivered exactly to the right room. And then you go back out. Adding one more system to that. My favorite system though, is if you have enough people to, to do, uh, like the bucket brigade where you take the boxes off to the back of the truck, the, the, the box gets handed down and in a chain, and then it's set inside and then.
[00:12:52] Then there's somebody inside the house who runs it to the right room, and you just do that. Now, that's often difficult to do, [00:13:00] but it's, it's a system and it saves time. It's more efficient, there's less, um, waiting around, less confusion, and it just goes much quicker when you have a system that's designed for efficiency.
[00:13:18] It, it's just, it's a simple system that turns your effort into sweet flow. And that's, you know, maybe this is a flawed example, but that's, that's the difference between buckets and aqueduct in the bucket system. It's one-to-one, one person, one trip, one box at a time. And, uh, it's slow and inefficient. And the, the aqueduct is a system.
[00:13:42] You build the system once you keep. The, the water flowing, you keep the boxes flowing, you keep the clients moving and things can happen even while you are at rest. Instead of doing session after session week after week until the end of [00:14:00] time and instead of believing, that's the only way you create the system.
[00:14:04] That creates the freedom that designs a flow that works while you. While you, even when you are not specifically design in the process, now, you can keep walking the ramp alone. There's nothing, there's nothing wrong with that. In fact, it's very successful for many people. But I'm going to try to encourage you to design a system that keeps working and keeps moving even while you rest.
[00:14:38] And that's what. Architects do. Architects don't lift every box. They design the system that moves them. So I want to talk to you about just, just presenting the idea about becoming the architect of your own work. I think the architect mindset is you, you're built for more. [00:15:00] Um, you might not believe it right now.
[00:15:02] You might think, you know, this is the only thing I can do. It's very scary to do something new, but.
[00:15:11] If you're listening to this show and you've been practicing for a little while and you've had some success, I think there is more ways to help people than just the one-on-one model and a system that will help create some income flow and make you excited for the work you're doing rather than burn you out.
[00:15:33] You've probably, you, if you've been following me for a little bit and you've read some of my stuff, you might have heard this story before, but it, it really fits like after losing, um, my leadership position for the virtual assistant company. I started, I panicked a little bit and I was like, well, I need a job, you know, I gotta get a job.
[00:15:55] And, and I just started applying for anything at a hospital system or anything that was [00:16:00] stable and one job looked promising. It was hospital work again, but it was, it wasn't necessarily leadership, it was actually just moving hospital equipment from room to room and then cleaning it and it, it, it was safe.
[00:16:17] It was predictable and I was way overqualified. And I, I breezed through the interviews until the second interview came up and the manager glanced at my resume and he saw that I had two master's degrees and I was A-C-O-O-O and I was leadership potential or at leadership positions, a history of building teams, running programs, um, just, you know, making contracts.
[00:16:44] And he looked up at me and he said. Something like, James, why do you want this position? And I, I gave an answer that I thought was good, but, you know, we locked eyes. And I could tell, I could tell he didn't, he didn't [00:17:00] really believe it. And he, he was like, he saw something, he saw something that I had missed.
[00:17:10] He saw my potential. He saw the potential that I'd stopped seeing in myself. And he did not give me the job. Uh, and I went back to the car and it hurt a little bit, but as I, as I was sitting in the car, as I was driving home, I realized he saw something in me that rejection, um, meant he saw something greater in me.
[00:17:36] And it, it really woke me up because this person who didn't really know me, believed I was, I was better than. What I was give, giving myself up for, I realized, and he realized before I did that I was settling. Not because I lacked skill, but I just wanted to something stable. I wanted something comfortable.
[00:17:59] I wanted to stay in my [00:18:00] comfort zone. I was willing to trade up all my future goals and all my future, uh, uh, income and all the things I could build. I was willing to trade all that up for some, some, to build somebody else's kingdom for, for stability. I was ready to trade my paycheck. I was ready to trade in my future for a stable paycheck.
[00:18:25] And that's when I started to understand the, the architect mindset. Architects don't just work harder. They design structures that last. They build systems that serve people even when they're not in the room. And it took this, this rejection, it took somebody else to, to see my potential before I did.
[00:18:49] Somebody else saw my potential before I did. And when I look out into the sea of therapists and I go to conferences and I hear about what people [00:19:00] are doing and who they. Who they are helping. I see your potential. I see that you could go beyond fully booked to designing a system that helps people and takes care of you, gives you impact, income, and the independence that you, the system promises you, but you don't get.
[00:19:23] You are designed for more than maxing out and burning out. You're designed for more than survival. You're designed, you have the skills and the experience to design something that can create the incoming impact that you truly want. So here's what the, this the system, this kickoff episode comes down to.
[00:19:51] The system isn't broken, it's just not built to do what you think it's supposed to do. It's not [00:20:00] necessarily built for your success. It's built to keep you as close to burnout as possible for as long as possible without burning you out. And I want to give you a little bit of hope that you can move from, you can begin to transition from the bucket system, the one-on-one system, to building some sort of architect system, some aqueduct system that creates income flow for you, not fatigue.
[00:20:29] You are the architect. Your your, your role is not just the bucket carrier. Your role is design. Design, the system that creates lasting impact. So let me ask you, what is your current system costing you? Does it cost you your time? Does it cost you your health? Are you missing out on family? Maybe there you're missing out on the piece that you [00:21:00] used to have.
[00:21:01] This January, I'm gonna launch the Beyond Fully Book cohort. Together. We're gonna build your first aqueduct. We're gonna build your system step by step. You're gonna clarify your people, your product, your and your pricing. You're gonna connect it all through systems that flow so your income flow isn't chained to your calendar.
[00:21:48] Now you don't have to wait till January. I have a couple workshops coming [email protected] slash beyond fully booked. It's beyond fully booked [00:22:00] to learn more and to join us. I want you to remember that you were never meant to carry all these buckets alone forever. It's time to start thinking about building a system or an aqueduct that lets your income flow.
[00:22:30] [00:23:00] [00:24:00] [00:25:00] I.
