Cheri Timko of Synergy Coaching: 5 Things You Need To Know To Create a Highly Successful Private Practice
An Interview With Luke Kervin
Ask for help when you need it. Many colleagues are willing to answer questions or point you in the right direction. Our whole profession suffers when a competitor provides incompetent or unethical services, so most colleagues have a vested interest in helping. You will still need to do the research and set the standards for your business, but having a handful of trusted colleagues can make streamline the process of knowing where to look for useful information.
As a part of our interview series with prominent medical professionals called “5 Things You Need To Know To Create a Highly Successful Private Practice” I had the pleasure of interviewing Cheri Timko.
Cheri Timko has specialized in couples counseling at her private psychotherapy practice for almost twenty years. She recently started a coaching business to provide support and education to couples who want to have an extraordinary relationship. She has been happily married for over twenty years and is a homeschooling mother to three daughters.
Thank you so much for joining us in this interview series! Before we dive in, our readers would love to “get to know you” a bit better. Can you tell us a bit about your ‘backstory’ and how you ended up where you are?
I am the oldest of four kids. My parents had a pretty happy marriage. They taught us the value of hard work, persistence, and frugality. I was heavily involved in church and Girl Scouts.
When I was 19 years old, I started volunteering at a shelter for homeless and runaway teenagers. I loved working with the teens, but it was challenging because I was only a little older than the residents. I moved up the ranks until I worked there full-time after college. Although I could empower the teens to advocate for themselves and know what they needed, I was often frustrated that they had so little ability to change their lives.
When I switched to working with families, I was better able to help the teens improve their lives because the parents were also involved in the process. I quickly realized that family counseling improved the lives of all of the kids in each family. Later, when I started doing couples therapy, I realized that I could have the biggest impact. If I can help a couple to function well, it usually improves life for everyone in the family. I don’t even need the kids in the room to make their lives better. So, I guess I work with couples so I can help the kids.
I’m a huge fan of mentorship throughout one’s career. None of us are able to achieve success without some help along the way. Who has been your biggest mentor? What was the most valuable lesson you learned from them?
I have been fortunate to have people who helped me at each stage of my career. One of the counselors at the shelter for teens, Kim McDonald Stribling, saw potential in me. She made the work look fun and valuable so I stuck with it even when it was hard. She made me believe that I could make a difference in kids’ lives.
I started working in private practice because one of my college professors, Mark Fisher, invited me to join his private psychotherapy practice. I had not even considered switching from agency work to private practice, and without that encouragement, I don’t know if I ever would have. His other associate, Tracy Carter, held my hand through the process of getting started and when I dealt with a tough case. She taught me the value of having trusted colleagues to get support from.
I also consider the coach who help stream line my practice as a mentor. I joined Laura Long’s Your Badass Therapy Practice in October 2019. She taught me to put systems in place that helped me save valuable time and energy. During this time, I realized that I was an entrepreneur and fully embraced that identity. I also made an important mindset shift to better value my own investment and the personal sacrifice necessary to provide support to others.
What made you want to start your own practice? Can you tell us the story of how you started it?
I didn’t have a well-defined path for my career. When I was in college, I believed I would get a Ph.D. That didn’t work out, so I found a job. Each step I took was to find a better situation than the one I previously was in.
I started a private practice by accident. While in my master’s classes, a college professor offered me a position in his private practice as a psych associate. I didn’t even know what that was. That opportunity turned into opening my own business. A door opened and I walked through it before I really thought about what I was doing. If I had known that starting my own business had a lot of risk to it, I might have done something else. If I had listened to other people’s fears, I never would have started a business. As it turns out, starting a psychotherapy private practice can be done with very little risk because, compared with other businesses, it can be done with very little capital.
Can you share the most interesting story that happened to you since you began your career?
Perhaps a better question is what’s the most interesting story from this week. Every single day I have an interesting story. Every person I meet has a unique and important story to tell, so my work is always interesting. I get an inside view of so many situations, lifestyles, places, and jobs that I couldn’t have experienced if I lived 20 lifetimes. For example, I would not have pursued a job in a coal mine. However, I have worked with many coal miners. I learned about the dangers they face every single day and their difficult working conditions. Likewise, I have worked with several EMTs who described the routine harrowing situations they deal with on a daily basis.
Because it is a “helping profession”, some healthcare providers struggle with the idea of “monetization.” How do you address the business aspect of running a medical practice? Can you share a story or example?
I have struggled with the balance between helping others and running a business. Helping clients improve their mental health is a mission I live out every day. I believe that I can change the world by helping as many couples have a great relationship as possible. Working in this mission while also running a business that is designed to support my family, often presents contradictions that I have to work through.
The mission inspires me to help as many people as possible, which means wrestling with situations when clients have limited resources. Weekly, I get calls from individuals who would benefit from therapy but don’t have the funds or insurance to cover services. I could easily fill most of my waking hours with therapy session because there is a great need for help. I have to limit the number of hours that I work and the number of services that I give away at a reduced rate.
As a business, I have to make decisions that allow the business to run for many years and that support the financial and health of the employees. The business has to generate income to cover operating expenses. Therapy requires the psychotherapist to give of their own personal resources of energy and stability to help others gain that. The business won’t survive long enough to help anyone if it doesn’t run well.
When I started in the field, I leaned on the side of service and mission. As a mental health provider, I was trained with the belief that we go into the field to provide services to others who are less fortunate. For me, this fit with the mission and service values that I was raised with. It was difficult for me to see that I also needed to be able to financially support myself. It felt selfish to make my own needs a priority.
It took fifteen years of working to realize that attending to the business side of the business was necessary for me to achieve the mission. I could easily see that mental health providers do a lot of good for society. Our work demands that we get a lot of education before we can begin to work and that we continue to be educated every year so we can provide a high quality of services. I had to adjust my mindset so that I could see myself as helper AND an entrepreneur. I do not expect to get rich off of clients but I need to be fairly compensated for work that is highly demanding and causes a lot of burnout.
Managing being a provider and a business owner is a constant balancing act. How do you manage both roles?
I’ve always felt that I had to wear two hats. As a therapist, my actions are tied to my professional ethics and laws. I need to make decisions based on the best interest of the client. As a business owner, my objective is to maximize profits and ensure the long-term survival of the business for the benefit of the employees. These two are frequently at odds.
For example, I would answer the question of when to end treatment for an individual client differently depending on which role I am in. The best decision for the business is to work with clients for a longer period of time but it is better for the client if we base discharge on progress towards treatment goals. I always make those decisions based on treatment goals, but I am acutely aware that it costs the business’ bottom line.
Another example is how the business and the work compete for my time. I simultaneously need to run the business and work in the business. As much as possible, I try to identify the tasks that only I can do versus those that can be completed by another person. If I can afford to outsource a task, I need to do that for the sake of the business and so I don’t get burnt out. For the business tasks that I need to complete, I have to schedule them on my calendar to ensure that I get them done.
When I am in the therapy room, I am completely focused on the client’s needs. Outside the therapy room, I make business decisions that will sustain the business for the future.
From completing your degree to opening a practice and becoming a business owner, your path was most likely challenging. Can you share a story about one of your greatest struggles? Can you share what you did to overcome it?
For me, being an ethical mental health provider has always been of the highest importance. Every few months I run into an ethical dilemma to wrestle with. Some examples are:
- How to advertise in an online market without violating the ethical requirements that restrict getting reviews from previous clients
- How closely related can clients be.
- How to balance the competing goals of insurance panels and ethical standards.
- How to price services.
Each dilemma really challenges me to examine why it is a problem and how to effectively solve it for everyone’s best interest. Although each is different, the process of resolving them is similar. I usually do research into the issue, talk with colleagues who may have previously resolved the issue, and create a policy for moving forward. It has taken several years to develop a good process, but this one seems to cover most situations.
Ok, thank you. Here is the main question of our interview. What are the 5 things you need to know to create a thriving practice, and why? (Please share a story or example for each.)
- You will always be wearing multiple hats. Do not ignore any of your roles, even if you feel ill-prepared to perform them. Many providers in private practice started their practice with the mindset and training of a health provider. There is usually an important part of the business that they have little or no training to complete. The temptation is to put off those tasks until they have freetime to deal with them. That is a recipe for disaster. Several options to deal with this is to 1) schedule a regular time to deal with the unpleasant tasks, 2) get the training you are lacking to make these tasks easier, or 3) hire someone competent to handle the tasks. Even if you hire someone, it is wise to be able to recognize if they are handling those tasks in a way that fits your business values.
- Ask for help when you need it. Many colleagues are willing to answer questions or point you in the right direction. Our whole profession suffers when a competitor provides incompetent or unethical services, so most colleagues have a vested interest in helping. You will still need to do the research and set the standards for your business, but having a handful of trusted colleagues can make streamline the process of knowing where to look for useful information.
- You will wait too long to hire help. You will think that things are going well enough without help or that you just can’t afford to hire someone. The sooner you have support, the sooner you can scale up to increase your income. I have avoided hiring someone out of a combination of fear of hiring the wrong person and not having time to dedicate towards hiring someone. Every time I hired someone, my own work improved and my ability to serve more people expanded.
- Specialize in an area that you love. Otherwise, you will burn out too easily. For a long time, I reasoned that I would miss out on potential clients if I specialized. What really happens, is you become really good at the work you do, so more people have good things to say about you, so more people want to work with you. But you have to choose something that you love. It’s ok to change later, or get broader, but you need to get really good at something first.
- Treat self-care like a necessity that must happen in order for you to perform your job. Being a business owner and a provider is like having two overlapping jobs. Many new entrepreneurs work far too many hours trying to save the money it would cost to hire staff. When we don’t get enough sleep, eat healthy meals, and take breaks, we are less likely to make good decisions that will move the business forward. It is not selfish to take a day off or to get a full night of sleep.
As a business owner you spend most of your time working IN your practice, seeing patients. When and how do you shift to working ON your practice? (Marketing, upgrading systems, growing your practice, etc.) How much time do you spend on the business elements?
I love the work that I do with my clients. It is challenging in a way that energizes me. The business side is harder because it is necessary, but less enjoyable. I have put as many systems as possible in place so the work of running the business is streamlined. I also have a bookkeeper who takes care of some of the backend work. I have to allocate several hours each week to staying on top of the work. I have found marketing strategies that are enjoyable to me. In order to get it all done, I use a detailed list of things to do and schedule everything on my calendar. I spend about 1/3 as much time running the business as I do working in the business. It is a careful balance, but both parts need enough time and energy.
I understand that the healthcare industry has unique stresses and hazards that other industries don’t have. What specific practices would you recommend to other healthcare leaders to improve their physical or mental wellness? Can you share a story or example?
- Each year improve your business skills. Take a class, read a book, or work with a professional in an area where you are weak. This way, you will become more competent and feel more confident even as the marketplace is quickly changing.
- Know what helps you decompress. You are juggling many priorities. The list of things to get done is never ending. So, develop a list of ways to decompress even when you have a lot going on. Although the specifics are going to be different for each person, they should help you grow stronger, more confident, and better as a person. If your ways of decompressing are hurting yourself or others, then you need to explore options so we can manage better over time.
- Develop habits and routines that support your wellbeing. Have meals at regular times, schedule exercise, use a start and stop time to your work day. These will help you accomplish everything but also have time to enjoy life.
Can you please give us your favorite “Life Lesson Quote”? Can you share a story about how that was relevant in your own life?
A favorite quote of mine is “If you do what you have always done, you get what you have always gotten.” It helps me stay focused on identifying the areas that are not functioning well and encourages me to try new things. I am not committed to a new way of accomplishing a goal until I see that it works better than the old way, but it gets me to think outside the box and try new things when I otherwise would stay committed to ineffective tools and processes.
How can our readers further follow your work online?
Thank you for these great insights! We wish you continued success and good health!