Ever felt caught in the middle when it comes to practice finances? A practice manager wrote in, sharing their frustration with an owner who regularly draws large amounts of money from the business—leaving the practice struggling to cover bills and payroll. In this episode of the Uncharted Veterinary Podcast, Practice Management Super Nerd, Stephanie Goss and guest Dr. Sue Sayles dive into the tricky dynamics of managing practice finances when the owner’s withdrawals disrupt cash flow and this practice manager's morale.
With 23 years of practice ownership under her belt, Dr. Sue has seen it all. She started out as a mixed-animal practitioner, then built a thriving small animal practice, growing it from $300k in revenue to over $2 million. She knows firsthand the challenges of balancing financial needs with business growth, and today she’s passionate about helping other practice owners and managers navigate these waters.
Stephanie and Sue share actionable insights on how to structure tough financial conversations, establish trust, and support the owner’s goals while keeping the practice afloat. They discuss ways to approach sensitive topics, build financial systems that work for both parties, and ultimately foster a practice environment that supports everyone’s success—even when priorities don’t always align. If you’re looking to navigate the rough seas of practice finances and improve team morale, this episode is for you. Let’s get into this episode!
You can also listen to the episode on Apple Podcasts, Spotify, Google Podcasts, Amazon Music or wherever you get your podcasts.
Do you have something that you would love Andy and Stephanie to roleplay on the podcast – a situation where you would love some examples of what someone else would say and how they would say it? If so, send us a message through the mailbag! We want to hear your challenges and would love to feature your scenario on the podcast.
Submit your questions here: unchartedvet.com/mailbag
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Episode Transcript
Stephanie Goss: And we are back. It's me, Stephanie Goss, and I am joined today by my dear friend from Uncharted, Dr. Sue Sales. Sue is a practicing veterinarian and a practice owner. I got a question in the mailbag that just felt like it was right up her alley because she has gone from buying in as a young practitioner, not that long out of vet school to a one and a half doctor practice, , to being a large multi doctor, team of 25 kind of practice that went through building a brand new building.
And we got a letter from a practice manager who's in need of some help having some really hard conversations with their practice owner about the amount of money that is being spent in and out of the practice. And I knew that I would want to talk this one through with Sue. We had a great time. I hope that this helps. I hope you enjoy the episode and let's get into it.
And we are back. It's me, Stephanie Goss, and this week I am not joined by my partner in crime, Dr. Andy Wark, but instead I am joined by one of the smiliest, friendliest, kindest faces that I have had the opportunity to meet through Uncharted. I am joined by my friend, Dr. Sue Sales. Sue is a practicing veterinarian.
She is in Michigan and she is a practice owner and she has had a practice owner journey that has kind of taken her all over veterinary medicine. And we had a mailbag question come in that matched right up with something that I feel like as a private practice owner Sue has gone through iterations of this of her own.
And so I said, Hey, let's do a podcast. And also it just so happens that she is going to be leading a session at our practice owners summit, which is happening in December. And so even perfect, more perfect timing to be able to talk about that and all that we've got coming that Sue is participating in from Uncharted. So welcome to the podcast my friend.
Dr. Sue Sayles: Hey, Stephanie, I'm super excited to be here. You guys are awesome. Uncharted is awesome. I drank the Kool-aid.
Stephanie Goss: You, you may have, and also you are not one of ours that have an anchor tattoo yet that I know of.
Dr. Sue Sayles: No, I have no ink and not because I'm anti ink. I just haven't found anything that I want permanently.
Stephanie Goss: Yeah, I, I can, I can respect that. You do, however you do lead the charge every time uh, we're together in Greenville for Uncharted Karaoke, which I can appreciate and admire. And that's one of the many things that you do outside of work. So I don't screw up your bio, like I know you have, now you're seeing small animal patients and you've grown your hospital tremendously from where you started, but tell us a little bit about your, your background and kind of how you got to where you are in your practice owner journey.
Dr. Sue Sayles: Sure. So, like many people, my first job was not the job that I wanted it to be. Didn't know how to interview and didn't know, ended up there for just three months.
Stephanie Goss: Oh
Dr. Sue Sayles: yeah, yeah, real short time, not even the whole year. I, I, I told them that I wanted to do surgery and they said, yes, you can do surgery. You can do all the surgery. Little did I know that I would be in back doing all the surgery while they took all the credit and no one even knew that I worked there. And yeah, it was just, was not the right fit for me.
Stephanie Goss: Fair. Okay.
Dr. Sue Sayles: There was no mentorship. There were a lot of things that I was like, yeah, these are the things I don't want to do. So I found another practice that was also closer to home, which made it nice as well, and small animal exclusive that first practice was mixed. I actually wanted to go into mixed animal medicine and didn't get again the mentorship that I was looking for to do that. So I found a small animal practice. The doctor who was there was only there half a day every day of the week and I was there all day And after a couple years of doing that I said, “hey i'm doing really a lot of the Day to day management stuff here.” Even though it wasn't financial management, it certainly was culture and it was medical management.
And I said, I want to have a little stake in this. Would you partner with me? And he said how about you just buy me out? And I said, 'cause I have student loans. I was only three years out of school. And I don't have any money. And he financed for me to buy the practice and we reversed roles and he became my employee.
So that was kind of a different perspective for me, but he was there to mentor me through ownership with whatever I needed. And then when things were ready to end he left and we were on good terms and it was a really great transition for me. I always thought that that was something I'd never heard of and it was pretty unique.
Stephanie Goss: That's awesome.
Dr. Sue Sayles: That was a great experience. And the year that I bought the practice I also got pregnant and hired two more doctors. So we started growing right away. As soon as there was ability for me to make financial decisions and to do things there was a need. And so we took off from originally about five employees to where we're at now.
Eight years ago, we built a brand new building. And now we have 25 employees and four doctors and went through the ups and downs of the economy over the years, but I've, I've been in practice 27 years and owned practice now for 23 and love practicing, love mentoring, love culture in the practice and developing us into a family where we have core values together and, and we're happy.
My fourth doctor, just as a kind of fun And in this economy and the way things are, I didn't even advertise. She reached out locally and said, I'm leaving my practice and yours is a practice that I would really be interested in working in. Are you looking for a doctor? So I didn't even have to advertise.
So that made me feel like we were doing something right.
Stephanie Goss: Yeah, heck yeah, you are. That's awesome. That's
Dr. Sue Sayles: and we've been able to stay fully staffed and we're doing well. And now I'm at the point where I'm practicing part time as that doctor came on, I was able to give myself time to do some of these management things that I'd always wanted to do and starting to talk about leadership and management.
Stephanie Goss: Yeah. Which is so great. And so you are going to be leading a workshop at the Practice Owners Summit coming up here. Not too long after we air this episode we'll be in Atlanta, Georgia in December the 5th through the 7th. And so if you are a practice owner listening to this, or you are someone who is in the process of purchasing your clinic.
And you're like, I have no idea what I'm getting myself into. No matter where you are in your practice zone or journey we've got a bunch of different activities and conversations and workshops and things planned for diving into how do we make our practices work for us instead of feeling like we are busting our butts working for the practice, which is how a lot of us I know for me, I felt like I was chasing my tail as a, and I was only a partial owner in practice.
And it was just overwhelming to feel like every waking moment was spent on working on the practice and or thinking about the practice or stressing, stressing about something at the practice. And so, I am excited to have you add your voice and perspective and and I thought of you when we had this mailbag come in because you've grown from that space of having a state really like a single one and a half doctor practice and growing.
The roles and making that shift from the team of 5 to 25, you've gone through the different iterations of maybe now we have you know, someone who's unofficially a lead and then eventually you get to the point where not only do you have official leads, but you have a practice manager and maybe even an office manager.
And when you start to get over that, you know, 25 to 30 team members, it looks radically different than it does when you're a small single or, you know, one and a half doctor practice. And we got a mailbag from what I assume is a practice manager who was asking some questions about how to confront their owner who is a practicing veterinarian in the practice regarding the amount of money that they are taking out of the practice in addition to their salary. And the reason that I assume that it's a practice manager is because in order to know that, I would assume that they would have to have access to the financials. And they said, you know, I've tried to talk to this person. I've tried to present the numbers and the data to them.
I've tried opening up the conversation in a, in a very clear cut perspective in terms of the impact that it has to the practice financially with the amount of money. And from the perspective of this is your business, don't you want this to be successful? And they said things eventually Go right back to the way that they are and they are struggling to keep up in their role.
It sounds like financially with making ends meet and paying all of the bills and they said that, you know, I've, I've tried to have the conversation multiple times and I guess I'm at a point where I feel like I need an outside opinion or perspective on how I structure the conversation, but also how I help them plan for something that's going to stick in the long run because they said, you know, the truth is, I'm in a position where I feel like I'm getting more burnt out and discouraged and it's really unmotivating to be in this environment where I feel like I'm working for a practice owner who is actively working against us financially with what they're doing on the back end of the practice. And so when I read this, I immediately got super fired up as the practice manager who has worked for the single practice owner and who has also had experience working with a practice owner who Sounds very similar in terms of financial and intermingling and finances and all of that kind of stuff in the practice.
And so knowing that you had gone from that perspective of very small and when you are small, and we'll talk about this when we get into it, but when you are small, there often is a commingling of finances to a place where when you have a team of 25, 35, you It's much more structured and things on the back end look radically different and yet there's all of this gray area in between.
And so I thought, Hey, let's have a conversation.
Dr. Sue Sayles: Yeah, absolutely. I mean, the growing pains are real when you go from a small to a larger practice. Especially going from two doctors to three becomes huge because when there's just two, it's like, if I didn't do it, I know the other doctor handled it. And when you go to three, all of a sudden there's that, that concept of communication becomes so critical within the office and being able to, to know, Where things are at, but finances become huge. The bigger you get to, it's a, it's a real challenge.
Stephanie Goss: The bills get bigger, the payroll gets bigger, the responsibility on your back as a practice owner gets bigger, like the, there's definitely a significant difference in that smaller practice compared to what it looks like structurally, usually when you're bigger.
So let's come at this. I think when we were talking about it, you have the unique perspective of being in the obviously the practice owner's shoes. And while I have been in that in that position as well, I think what stuck out to me when I read this was, Ooh, I've some opinions and thoughts as a practice manager on how to approach this and also some of them learning from some of the mistakes that I've made in my, my journey and how not to maybe do it and you, you know, coming from the practice owner perspective.
And so let's start with, let's start with headspace when we think about this because there were some very strong words used in the email and so for me when I, when I started with headspace, there was immediately a few things that came to mind that this conversation has potential and conversations and changes have the potential to go well.
And I also in reading this thought this has the potentials to go off the rails in a very bad way very quickly.
Dr. Sue Sayles: Oh, yes.
Stephanie Goss: How do you feel about that? Agreed?
Dr. Sue Sayles: Absolutely. Yeah. And this is part of my journey as an owner as well. I am not the same owner I was, you know, when I took over. And in the beginning I probably would have been a lot more defensive about someone approaching me about my decisions because I didn't, I didn't have as much comfort in them or as much knowledge and experience in them.
And so your immediate response is to become defensive and this is the way I'm going to do it. And you can't tell me how to do it. So the safety ness of the conversation is huge here. You do not want to come at it from a perspective where you're going to be blaming or, or using words that make the practice owner feel judged. That was the kiss of death.
Stephanie Goss: yes. I think I agree 100%. So language is really, really important. We talk a lot on the podcast about getting SAFE and this is absolutely one of those conversations where you cannot come at it if you are triggered. You need to be able to sit next to them. You need to be, you really need to be able to assume good intent.
And from the tone of this email, I think this is a manager who is probably struggling for personal bias or personal judgment perspectives. And I say that with all the love and no judgment because I've been in that shoes, in their shoes, where you're looking at decisions that someone else is making, and you're looking at the impact that it's having and it's hard not to judge that behavior because of the impacts that it's having.
And so I say that with no judgment, but it, it, they are definitely fired up. And so from a headspace perspective, immediately leaning into making it a SAFE conversation and being able to work all the way through S to E. And can you smile at them?
Can you assume good intent? Really also looking at the F I think is really important here. And you and I were talking a little bit about this beforehand, but how have you been, how has this person been set up to fail? I think the F the, probably the work here for this manager on the F is what is it? What is their fault?
But in a different context here, I would say, what do you actually have control over? Because you may feel like you want to have control over more than you actually have control over. And I think working through that F. piece from that perspective is really important. And then ultimately, like, what is the end result?
What are you trying to do here? And I think they're coming from a place of good intention in that it was very clear in their email, they want the practice to be successful. They want this owner to be successful. They want it to be a thriving business. All of those things are coming from a place of good intention.
And it still has the capacity to come across as very judgmental and negative if we don't consider the language that we're going to use as part of the headspace.
Dr. Sue Sayles: Yeah, absolutely the F part is really important here. I think what kind of systems do they have in place for accountability? Is this part of the job description of this practice owner that she needs to be handling this or is it not and there, there can be boundaries here that are not well described in a lot of practices between owners and managers of who takes on what, and unless you have those conversations and lay it out this is fair game. This is not fair game. That can really get ugly fast.
Stephanie Goss: Yes. I'm so glad that you said that because I think the second big piece of headspace for me was understanding where the boundaries are, and I think that's important part of headspace because I think it is really important to know what is your actual role as the practice manager spoken and unspoken, and I think that's really important because that's going to help define the boundary lines.
It may be that in the practice owner's head, and I would love to hear your perspective on this, that they're like, I hired you to just write the checks and put it all in QuickBooks because I don't know how to do that. I don't, I'm not hiring you to tell me how to spend money for my own business.
And that could be a spoken idea. It also could be an unspoken idea because I have been the manager who has worked with those owners who have had those things in their head. And the only way that I learned that was speaking up and asking questions or trying to have conversations with them. And then it became like you described in the beginning, that defensive, it's my business.
This is not what I'm paying you to do. Just do your job conversations in it. That's where it can go badly really quickly. And so I think part of the headspace process is doing that investigative thought work on what do you actually know? What is your actual role here? And then part of the action steps probably is starting from a, from that place of what do you know is your actual role?
And then instead of maybe approaching it in the way you think you might want to approach this conversation, I, when we get to action steps, I've got an idea in terms of how you might approach it from a different perspective. different perspective, depending on what you get when you do that brain work.
But from a practice owner's perspective, what is your thought there?
Dr. Sue Sayles: You want to find common ground. You want to lay out where that common ground is between the two of you before you start this conversation. And if that's core values and you have your core values, that's awesome. That really helps. It gives you a foundation to talk about from those perspectives.
If it isn't, then some other common ground, you both want the practice to be successful. You both want the practice to have such and such amount of profitability. You both want patients to be well cared for. Whatever that perspective is, if you can start with that common ground and then approach the problem from how it's, affecting those core issues, those core values then that makes it a lot less angry of a discussion, a lot less defensive of a position for the practice owner.
You know, if my, if my manager came up to me and said, I have some concerns, I feel like the finances of the practice aren't what they could be, and I'd like to see you be more successful. Can we talk about it? That's a lot different than, I see a lot of money coming out of this practice, and you're, I don't know what you're doing with it, but it belongs in the practice.
Stephanie Goss: Yeah, absolutely. Absolutely. And the thing is, is that when you, I'm going to be really candid here and say I have been in this manager's shoes and I worked for a practice when I was very young. It was actually my first full fledged practice manager on my own job. I went from an assistant manager to a practice manager.
And it was a solo, it was the same, very similar to your, your practice. It was a doctor and a half. The practice owner was younger practice owner you know, had not been in practice very long, but we were in a very affluent area. There was a lot of, money that went into the move to the location that we were in to support the affluent client base and that the things that they were asking for and I approached it because I wanted to do a really good job.
I was approaching it from a place of good intention. I wanted to see the business be successful. I wanted to see money reinvested back into the practice and be able to support the, we were making technological investments, we were making equipment investments and at the end of the day, like I was. Also struggling with the fact that I'm looking at the checking account and there's not enough money in there to pay the ultrasound bill for the 60,000 ultrasound machine we bought.
And so I was really struggling because I was like, look I want us to be successful and I know you're doing the right thing for the right reasons. And I also made the mistake of coming at it from the perspective of like, hey, I need to pay this ultrasound bill, and there's no money because you wrote yourself a 10,000 check this month.
What, how am I supposed to do my job? I was, I had the best of intentions in trying to have that conversation, and it doesn't change the fact that the way that it was received, the way that I was perceived, did not go off, did not come well. It did not sit well with the owner, because to your point, the defense, the walls immediately went up, and they were on the defensive because they felt judged.
And so their human response, as I think some of us can understand, was to attack you and be like, to have that attitude of “listen, I'm not paying you to judge me about my own practice. It's my business. I'm going to make the decisions I want to make. And who are you to judge me?”
And so it set us off on the wrong foot in a lot of ways at the beginning. And I learned a lot of really hard lessons in communication Uh, that practice and ultimately it was the best, worst years of my life in terms of practice in that I learned a lot of very painful lessons.
I wouldn't undo it because I learned so much and I grew so much. And I think this is a potential learning opportunity for this manager. And because it's, you know, they're, they're feeling really sad. They're feeling burnt out. They're feeling discouraged. And I know what that feels like. And there is some silver lining here and I think a lot of it is in how you approach this and it could go very well or it could go very badly.
Dr. Sue Sayles: And things have changed over the years since I started practicing too. We recognize, or at least a lot more people recognize, that our owners, we deserve a return on investment. This is part of what should be happening. We're not practicing purely for the joy of practicing. Although we love practicing, most of the owners, that's why they become an owner.
Cause they really have joy in it. They deserve that return on investment. But again, if you don't have that structure set up of how that's going to work and have conversations you can put your practice, at a real disadvantage by taking funds that really should be earmarked for something else and you know, who is in charge of that who's watching that and are you working together as a team?
One of the things that I would say as far as the relationship goes. I think that's the biggest hurt right here is not that the doctor is taking the money, but that the practice manager feels unlistened to because they've tried to approach it several different ways and now the relationship has been damaged.
And so we've got to figure out how to get that trust back in the relationship and see how that can be reflected in how the funds are taken out or if the funds are taken out. And it could be, and this is something that I think a lot of, of managers may or may not think about or understand.
The two things that I always think of are, is it an ability problem or is it a motivation problem? Is it an ability problem for this doctor in that they need the money? They have a tuition bill for their kid or they have this or that. They need to come up with it and this is where it's going to Or is it a motivation problem where they really just like to spend extra money and don't have the motivation to save or, or don't understand what they're doing and how it's harmful. And so how you approach those two things are a little bit different from each other.
Stephanie Goss: Yeah. And I think, I think from a headspace perspective this is very much I think action steps wise going to end in it where it does a lot of the time for Andy and I, which is like, you got to pick your poison, but here, I think it is really important to remember as a practice manager at the end of the day it's not your practice.
And so you may see the writing on the wall. You may see mistakes that are valid mistakes being made, mismanagement of money. Like you may see all of that. And at the end of the day, one of the big pieces of headspace is what is actually in your control because you can only control so much.
Now this manager is approaching it from a great perspective in terms of education. And the other headspace thing that I think that is important is just like you mentioned, the relationship and making sure that you're approaching it from the relationship centered perspective to have really good results.
I think the other piece that's really important is recognizing the communication styles, because this manager mentioned that they went to the with data and the black and white and the facts. There are absolutely practice owners that is going to resonate with. And there are also practice owners, I think to this, to my own experience, if I had gone to that person with, the facts and figures, which would make the most sense for me because I was learning about business.
I was learning about finances. I was learning how to put everything into a fancy spreadsheet and make it make sense. If I went to that person, they would have looked at me in the face and been like, I don't give a crap. Because that's not their communication style. They were a very high D on the disc scale.
So a very dominant personality. It was cut it short. Get to the point. Move along. That was their communication style. And anytime we try to have a conversation where I tried to come at it from, the data and the importance behind the business side of it, their eyes would glaze over and they would immediately tune me out and they were hearing nothing.
And so I think the communication styles piece of it is really important here and how you action step this because it's going to help really make or break the experience here.
Dr. Sue Sayles: Yes, it is. I, we talked a little bit about is it in your job description? First and what is in your job description? And if it's not in your job description, that doesn't mean that you can't reach out and have some conversation about it, express concern those type of things. But it comes to that pick your poison. If it is not in your job description, you may not be able to have a lot of influence over this. Um, and you may have to decide if that's something you can live with or something you just can't. That's not your personality and your style and you need to have more control.
Stephanie Goss: Yes. I think the last thing from a headspace perspective for me is I think it's really important to remember as a manager and this is a learning curve for managers and owners because it is applicable on both sides. The setup and structure purely from a business perspective financially and tax wise for one doctor solo practitioner is radically different than the setup when you have a bigger company, more staff.
Now they can be the same. They can still be the same, but generally the bigger the practice goes, the more the structure behind the scenes changes. And so one of the mistakes that I see a lot of new young managers make is that they the mistake is not in finding community because they're finding community, whether it's uncharted or a Facebook group or a local practice managers group, they're finding peers and they're saying, Hey, I have this problem.
I need help. And they're asking for help. And the downside to that is that it's really easy to compare the answer someone else gives you and look at it as comparing apples to apples when really you're comparing apples to oranges.
And so I think it's really important from a headspace perspective to understand that financially there is generally, and this is a generalization, but it applies across a large percentage of practices, generally there is a radically different structure to a business when you are smaller than when you are larger. And so I think it's really important to remember that you may not be comparing apples to apples when you're asking for advice from other people.
And it's really important to educate yourself and know do you know what the. structure is of your company? Are you are you an LLC? And if you are an LLC, what type of setup do you have? Are you an S corp or not? And, or are you just a, are you just a sole owner, single liability company and all of the money technically is the owners in, and in terms of how it flows through for their taxes.
And so win or lose, it's their money at the end of the day. And that, that is very different structurally. And so I think a lot of, I had to learn this lesson as a young manager. And like I said, I do not judge this letter because I had the same bias and judgment as myself as a young practice manager in understanding how my owners got taxed and that really that it was their money and so it didn't matter whether they waited until the end of the year to take a profit distribution or they use the money to write a giant check to their kids school in a month when we had big bills to pay at the end of the day, it didn't matter because it was all coming out of wash and understanding that structure and the business implications behind it was really, really important.
And so from a headspace perspective, last thing before we take a break, because I want to dive into action steps with you. Sue is, if you don't have the knowledge and you don't have the business acumen, this is a place where you have the potential to do some learning on your own before you maybe approach the conversation with your owner.
Because I think you're going to have more significant impact, if you have the ability to understand their structure and come at it from a place of asking questions to support them in getting the greatest return on investment from the practice. Then if you come at it from a place of, like I had to, the place of, Hey, I need to pay this bill.
The vendors are calling for their money because we're past due and there's no money in the checking account. Because I saw that you just wrote yourself a 10,000 check, right? The conversation still has to be had, but let me tell you, no matter how you approach it, that conversation is going to be a hard conversation and it's probably not going to end well because there is going to be that, that judgment factor.
And so educating yourself on what is the company set up, understanding what the tax structure is. And to your point earlier, Sue, none of that may be in your job description. And so if it's not, if you don't have access to that, if you don't have access to the CPA, if you don't have access to all of that information, you're going to have a significantly harder time having this conversation.
And you are going to have to frame it like you said, Sue, from that place of, hey, I want to help support you. And I want this business to be the best that it can. And I want you to get the best return on investment. I don't know about X, Y, or Z, and I would love to help support you because I'm seeing these things that make me concerned that there may be some impact on this side or that side or whatever.
So I think recognizing that this is an opportunity for you to learn and not get bogged down in trying to compare people's answers that you may get if you're asking for help, because it is important to recognize that this is like the dental conversation in your practice. When a client goes and gets a dental estimate, we always tell them we need to make sure we're comparing apples to apples and not apples to oranges. This is that kind of scenario for you as practice manager.
Dr. Sue Sayles: Yeah, it is. And, and the sad thing the sad truth is, there are owners who don't understand the implications as, as one, when I started out, you know, and I, I'm better than I was, but still, you know, you, you separate yourself from that, my accountant is for certain things and I don't need to know those things.
I need to know the medicine. It really makes a difference in the conversation. If we're on the same playing field, as far as knowledge and helping each other understand things versus judging. It really comes back to that judging.
Stephanie Goss: Yeah, totally. Let's take a quick break here and then let's come back and talk about action steps because we've talked a lot. There's a lot of potential pitfalls. I think in this scenario, we've leaned a lot into that. And also, I do think that it is possible to have the conversation and be able to be able to potentially have it go as well as it could be. And so I want to talk through some of the action steps. So let's take a quick break and then we'll come back and talk through all of that.
Dr. Sue Sayles: Amazing.
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Stephanie Goss: Okay, so let's talk about the action steps here because we've talked a lot about ways that this could potentially go, but let's narrow this down and say, okay, you're this practice manager, you have concerns about the finances over the practice.
We talked about the headspace, the things we need to think through, what is in your job description, what is not, what is in your control, what is not all of that kind of stuff. So assuming you're in a good, safe headspace and you're ready to approach the conversation with your practice owner, how do we approach this?
What do you think from the owner's perspective? If you think back to the young practice owner, Sue, who bought a practice, was learning it as you went, let's say you had a practice manager, an office manager that you inherited with the buy-in of your practice. What would you want the approach to have been at that point in your career?
Dr. Sue Sayles: I think with a lot of conversations, but especially with this type of conversation where you're having a discussion with a superior, it's always nice to ask for permission.
Stephanie Goss: I love that.
Dr. Sue Sayles: I'd like to talk about where we are with some of our finances so that I can understand and do the best job for you.
Is that something we can do and ask for permission? That makes a huge difference. If someone asked me for permission about something versus coming in and starting throwing facts at me and telling me what's going on.
Stephanie Goss: Because you don't feel bulldozed, right? Like you feel like you have the opportunity to say no.
Dr. Sue Sayles: Yeah, maybe now isn't the right time. Maybe I do want to have this conversation, but I'm not in the head space right now to have that. I'm upset about a client or a patient or something else that's going on in my life. And yes, let's get that. Let's set time aside and let's do that. So I think asking for permission is a great first step as far as the conversation goes.
Stephanie Goss: I love that. Okay, so I, we're going to ask, we're going to ask permission and let's just assume that the practice owner says, yeah, let's like I'm ready to have the conversation. I might not have all the answers, but let's talk about it.
Dr. Sue Sayles: Sure. So I think starting with some facts is good. Making sure that it is factual. It is not your impression of the facts. So this is what's happening with the checkbook. The last several months. When it comes time for me to pay out our payables, I've been struggling and I didn't know if you knew that. So I wanted to share that with you.
Stephanie Goss: Yes. I love that.
Dr. Sue Sayles: if, if they know it and say, yeah, what's the problem? Again, that's, that shifts your conversation and where it goes from there versus, Oh my gosh, I didn't even know that. I'm so sorry. I didn't want to put you in that situation. So talking about the facts, making sure you're on the same table with the facts and understanding facts.
And then again, figuring out if this is an ability issue or a motivation issue for this owner, if it's an ability issue and they need this money, then we need to look at what are the alternatives for the practice. Do we try to generate more income for the practice? Do we try to cut expenses somewhere?
What, how can we come together on this if we can't take the barrier of I'm going to have to make this draw happen. What else can we do for the practice?
Stephanie Goss: Yes. And I think that's really important for several, several reasons. And I love that that was step number two. So we've taught, we talk a lot in some of the work that we do with the uncharted community about the idea of when we give feedback to someone and I love that you're setting this up very similar to a feedback conversation too.
So we're going to ask them permission to have, is this the right time? Are you in the headspace? Can we sit down and talk about this? And then using the SBI approach, which is the situation, the behavior and the impact is you and you laid it out in an example. You've asked me to pay the bills and the last two months, three months being as specific as you can about the situation.
Over the last three months when I have gone to pay. Whether it's one in particular or all of them or whatever, as much descriptive info as you can put in there. That's the situation. I'm describing the situation. I have struggled because we might have been overdrawn or it would take us down to a very small amount in the checking account.
So that's the situation. The behavior is I have struggled with making the decision over what to do, because I don't know where the comfort threshold sits for you. Are you okay with us getting down to 5 in the checking account? Do we need 10,000 in the checking account? We've never had this conversation.
And again, you're, you're keeping it positive and upbeat. It's not judgmental. It's just, we've not talked about this. And so I want to help you. What is the impact, right? I want to help you run the most successful business we can together. And in order to do that, I need there to, in order to run a successful business, I feel like we need to have a certain amount of money in the bank account because I want to be able to write the checks and not have to worry myself and also not have to worry for you that we're under your.
So, then for me, SBI, I always add an N, which is next where are we going next? Can we sit down and talk about what that comfort level is for you in terms of money in the bank? Can we sit down and talk about how you would like me to handle it when I notice that the checking account is dropping below a certain level, or I noticed that I'm gonna, if I pay this bill, it means we're going to be overdrawn.
Can we also include in that conversation some background information for me so that I understand what the needs you have are from the business, right? When we use the SBI approach, we're setting ourselves up automatically to use I statements and language that is less likely to be accusatory for them and more likely to help keep them on neutral territory instead of having them immediately get defensive and feel like this person is judging me because it is all about how you want to help them and it removes that, that judgment and blame because you're still asking for permission.
Can we have that conversation? Can we? Can we do this? Can we do that? You're asking for them to partner with you, to move things forward, and so that takes a lot of that immediate defensive attack feelings off of the table for people, because it is about the situation and the behavior. It is not about their intent.
You're not questioning the fact that they needed to take 10,000 out or that they paid their personal credit card with the business account. You are asking for help in understanding what their needs are and how you can help them run a business better.
Dr. Sue Sayles: Yeah, you want to look at and have conversations about what the natural consequences of this behavior are over time, if we continue to do this, I'm worried that we're going to. Bounce a big check or we're not going to make payroll or X, Y, Z, whatever, whatever your, your biggest concerns are and show them those consequences because sometimes they get caught up in what's going on in their life and aren't seeing the consequences for the whole practice. That's why we pay you to manage stuff. You know, we don't, we don't want to, we don't want to have to have all of that, have all of that amount of detail.
Stephanie Goss: It’s true and I think being able to come from that place of “Hey, I think part of why you hired me to help take some of that load off you. I’d like to be able to do that for you.” I think the other piece that I would add to what you just said about that is normalizing for them that this is.
This is a stage I, for, I try and normalize for my practice owner friends who are solo practitioners or one to two doctor practices, even the bigger practices, everybody goes through ups and downs financially and the structure of the practice changes over time. And so for me, how I got some.
traction and level ground was to come to the conversation with my practice owner and be able to say “Hey, I was talking to other practice managers and asking for help and in understanding how other businesses are structured and the way that they have things set up. And what I learned is this is really common. It's really common when you're first starting out to be learning as you go, I'm learning as I go. And what I realized now is that you're probably learning as you go too, and also when you're small, it makes sense in a lot of ways for the lines to be blurred between your personal finances and the business finances.
And I'm not judging you, I just want to help you run the best business possible and be able to support obviously our team and yourself because you should get a reward as being a practice owner. Like there should be something in it for you at the end of the day. And a lot of people recognize that those returns may not come right in the beginning.
And there are people out there who will expect those returns to come right away. And when they don't, that can be hard and separating. That making that line less blurred is a really hard thing to do, but I think coming at it from that place of I'm, I want to help you and this is normal and helping them normalize.
Cause to your point, Sue, even now, every time I talk with practice owners from Uncharted, I, I forget. And then I relearn how much we don't know that we don't know. And I have to put myself right back in those shoes of, Oh, yeah, when I was first starting out, I didn't have a freaking clue about it
Dr. Sue Sayles: Right?
Stephanie Goss: any of this, it was totally normal to run, personal expenses through the business account and vice versa.
And you know, I think putting ourselves back in those early day shoes and recognizing that. Hey, this is normal. Does it mean that it should be happen all the time? Does it mean it should happen forever? No. Should it be sustainable? Yes. The business is not going to thrive if it's not, if they're not sustainable practices that are not happening, but we have to be careful.
Dr. Sue Sayles: I mean, those consequences are not only for the business but there, there are consequences for the practice manager. I can't do my job well, if I don't understand what is happening. And I'm worried that you will lose faith in me that you will think that I am mismanaging things and so I need to have a little more structure here so that I know what I can and can't do or what things you want me to handle and watch over Is there a threshold where when we hit a certain dollar amount you have to talk with me or is there a, when you're going to make a withdrawal, you give me a heads up so I can say, hey, we're in good place. What is that structure or that system? And lay out a system so that you can both be comfortable with it.
Stephanie Goss: Yeah. And I think, I think to your point, when you lay out your plan or your system or offer it, remember, it's not your practice. And so at the end of the day the best chance you have at getting traction is to have them come to the table with ideas. And if you tell them, I would like to approach it this way.
That's fine, but you're not inviting it to be a work together moment. If you're like, this is how I think you should fix it. If you come to the conversation and you say, I would like us to talk about this and brainstorm together, some solutions that would work for you and have your needs be met. And that also would help support me in making sure the needs of the practice and the team are met as well, right?
Because that feels radically different than you're inviting them to the table and to the conversation. And I think that's really, really important because at the end of the day, you can have a perfect system in your brain. If they are not a part of the conversation, if they feel like you're as, especially as a new owner who's figuring things out if you feel, and this is just human nature, that somebody else is trying to tell you what to do, we don't like to be told what to do. We're practice owners because we didn't want to have a boss, most of us.
Dr. Sue Sayles: Yeah, that was what prompted all of right?
Stephanie Goss: So, if we feel like someone is telling us how to live our lives, the initial caveman brain human response is to be like F off, cause that's, I'm not paying you to tell me how to run my life. And so it is really important to come to the table with that that ability to have them be a part of the solution and engage them in that, in that conversation,
Dr. Sue Sayles: I want you to be successful and to live the practice owner life that you want. While I take care of the practice for you. And is there a way we can find a solution that fits both of those?
Stephanie Goss: Yeah. I love that. And I think you're the ending place for us. I think is where you already hit before, which is at the end of the day, you probably there. There's two ways that this conversation goes really goes well. And you start to have more conversations because this is not a one and done conversation.
This is the opening the door to a series of conversations and growth over time, or it goes sideways, or it's no go, right? And they just shut it down and they will not engage in the conversation with you. At the end of the day, you are going to, as a manager, if you recognize that is not your practice and you are not in full control, at the end of the day, you're going to have to pick your poison at some point.
And so the question for you is are you moving in a direction that you feel like you can live with in your position or not? And it may be that this is not the right fitting relationship for you. It may be that you want to be more in control. It may be that you want to have responsibilities that you don't have.
There's a lot of maybes here and we could spend three more hours diving into, you know, hypothetical scenarios here. But the reality is there is a possibility that you come out of this and the answer is I can't control this situation and it, I don't like feeling like this and they're not willing to change their behavior.
And so I may need to go find another position. I mean, to go, go somewhere, somewhere else. And so remembering like, what do you actually control? What is important to you? And recognizing that you may not be able to change them. And for me, As long as I felt like I did my best to communicate the risks, communicate my concerns about the risks, I could sleep just fine at night and be willing to walk away, which ultimately was, was the decision I made because it wasn't the right fitting relationship for me but it took me a long time to get there because I wanted to try and I wanted to work it out.
And so we had the conversations and ultimately it came to a place where it was like, okay, this is not the right fit. But whatever you do, I think coming at it from that place of recognizing the end of the day, it may not be, it may not, it may be your circus, but it may not be your monkey. And you may not be able to do anything about it.
Dr. Sue Sayles: Yeah, you know, look at, at your core values and are they truly matching and fitting and, you know, looking at the language in the letter of being burned out, frustrated, discouraged, unmotivated, sharing that as part of your conversation that this is, this practice is really important to me and this is how I'm feeling because I don't have any input.
And again, Then be willing to listen to what that response is and, and make your decision, pick your poison.
Stephanie Goss: And not take it personally that the answer may be no, because at the end of the day, it's there. They bought it. It's their practice. And there's a financial investment there. And so they have every right to have the perception that there's going to be a return on investment for them. And so I think that's the hard part.
It's the hard lesson, at least for me learning as a practice manager, was that I can't always control things. And from the practice owner perspective, recognizing that I have to communicate what I want because I can't employ people to help me run a practice if they don't know what I want.
Dr. Sue Sayles: Yeah. You have to have those conversations and sometimes you don't know which conversations to have. It's a growing and learning experience. And so by asking for permission and reaching out to say, Hey, I really want to have this conversation. You may be enlightening them about something they hadn't even considered.
Stephanie Goss: I love it. Thank you so much Sue for being on today and having the conversation with me. And we've got the info on the Practice Owner Summit in the show notes. So if you haven't signed up, if you're a practice owner and you want to come and dive into conversations with owners like Sue come join us in Atlanta.
There's still time. And if you are in the process of buying a practice, come join us because there's no better time to make a community of people who know what you're about to go through because they've been in your shoes then our practice owners group. Take care, everybody. Thanks for listening.
And we'll see you again next time.
Dr. Sue Sayles: Bye.
Stephanie Goss: And that's a wrap on another episode of the Uncharted Podcast. Thanks for joining us and spending your week with us. If you enjoyed this week's episode, head over to wherever you get your podcasts and leave us a review. It's the best way to let us know that you love listening. We'll see you next time.