How Your Bootstrapping Mindset Is Keeping You Small

Resources mentioned in this episode:

• Daring Dozen Mastermind (coming soon)
• Future-Proofing Health Professionals Facebook group
• The Entrepreneurial Clinician book

If you know you need more support, please visit my website at https://jomuirhead.com

TRANSCRIPT:

And welcome back to another episode of the Entrepreneurial Clinician Podcast. I am your host, Jo Muirhead, and you have me all to yourself.

Today I am doing another individual session on a mindset topic. Hmm. You excited, yet? I am. I am gonna share with you how our bootstrapping mindset is actually getting in the way of genuine growth.

So what do I mean by bootstrapping? Well, bootstrapping is a term that has been applied to people who basically start their businesses from their garage or the boot of their car. We’ve heard all of these stories. It’s probably one of our origin stories as well where we just picked out a date that we were gonna start our own private practice. We got a phone, we got a laptop, we worked out how people were gonna pay for our services and we just started from there.

That was certainly my origin story. I had completely run out of money and needed to pay for food for my son and I, and I went, what on earth am I going to do to be able to put food on the table for us? And I went to my market that I knew and said, let me help you with your most difficult client. And all of a sudden I had more work than I knew what to do with, from a phone, from a laptop, and in my case the car because I was very community based. And I started making money and that felt great, but it was very, very much a bootstrapping mentality. Like there were no bells and whistles. I didn’t have a VA, a PA, an EA. I didn’t have any administrative support. I probably had a bank account because I was smart enough to know I needed one of those. My mum was trying to help me with all of my bookkeeping. I don’t even think I had office space in my home setup. I think I was still doing it from our kitchen table. I wasn’t sure about how it was gonna work or whether it was gonna last. I certainly didn’t have a plan for growth and development. It really was about I needed to put food on the table. What can I do to help do that make and make that happen?

So a lot of us bootstrap the beginning of our private practice journey. Okay? Most of us don’t get into a private practice in the beginning to say, I’m gonna build a big multidisciplinary team. It’s something that kind of emerges. Most of the people I speak to kind of go, well, I woke up one day, knew I wanted to be in private practice, but I didn’t realise it was gonna be this big. Or I didn’t realise how much leadership was involved, or I didn’t realise that it was gonna change the way I thought about my work. So bootstrapping is this term that’s applied to, you know, just cutting back all the bells and whistles, all the frills, all the nice to haves, and what is it that you need to do to sell your time to sell your expertise and an exchange for that sale. You are receiving income.

And because so many of us start this way, we get busy and then we hire because there’s need. So we are like, oh, I better bring on an associate, or I’d better bring on an employee, or I’d better bring on a contractor. And then all of a sudden we’ve got this small team emerging, but we’re still doing 90% of the clinical work and we’re kind of just giving these other people maybe our leftovers or maybe the work we don’t wanna do or maybe the work that they generate themselves. And we start to see this leveraged piece of the world turn up for us. But we still haven’t changed our mindset away from this bootstrapping idea. We’re kind of just making sure that our associates have the tools and equipment that they need to be able to do the work, get paid, but it’s now starting to become a bit of an inconvenience.

But we don’t have the time or the energy or we don’t have the perspective or the people in our world to help us start to notice when the bootstrapping mentality is no longer serving us because we’re carrying this clinical load. But now we’re managing people. But what our staff or our team, or our associates or our contractors really need is leadership. And we are not in a leadership frame of mind right now.

But before I get onto that, let’s unpack this a little bit more. So, back in the day, you could start your private practice and you can still start your private practice without a website. I’ve got clients who are doing exceptionally well without a website; long waiting lists, always full. And they don’t have a website. It is possible, it’s probably not something I recommend, but it is possible. There are still free tools that you can use LinkedIn being one of them. But I digress.

So if you have started your business from the back of your car or from your laptop or from your lounge room,you’ve got expenses like a phone, you know you’ve got expenses like a laptop and subscriptions, and you’re probably a bit resentful about all the subscriptions that you kind of have to pay for. You’ve got your licence, you’ve got your credentials. Maybe you have to pay for a room and, and you get a little bit nervous or a little bit angsty when somebody puts a price up by $5. You go and hire a room and then you find yourself in a Facebook group group going, can anybody help me find a cheaper room? Or does anybody know of a better phone plan? Or is anybody using a cheaper EHR if you’ve moved to an EHR, some of us are still, you know, out there. I know you, you’re out there doing all of your client notes and everything on spreadsheets. I hear you, I see you. I started the same way, but you stop. You think about everything as an expense, not as everything as a way of helping this business to grow and flourish. 

Now, I am not here to tell you to go spend money unwisely. What I am trying to do is show you some of the thinking that’s going to need to change if you want to experience genuine growth. Because what these overheads start to show us is that as we grow, our overheads will increase. Now I know you’re sitting there going duh Jo, but really when you are the person pushing the ‘pay now’ button and you are watching the amount in your account decrease, you get nervous about that. I get nervous about that. I don’t get as nervous as I used to about that now because I know and I trust my numbers in my business that it’s all gonna come back. I know the flow of cash.

So bootstrapping actually creates a false economy. We are so used to overheads being so low that we don’t understand that as we bring on a person or an admin assistant or as we start paying for another piece of software or as we start upgrading our customer and client experience, that those are genuine expenses in our business to help us grow. But we get concerned because everything’s starting to get more expensive. And for some reason we knew that we would have to pay for more things. We just don’t like to see it when it comes out of our bank account.

So meanwhile here you are in your bootstrapping mindset, carrying your clinical load. You’re now doing a whole heap of admin. You are managing all the compliance, you’re doing all the marketing, you’re doing accounts payable and receivable, and you’re chasing debt and you’re wondering why you’re not getting paid. You are operationally managing your business. You are managing your team. You’re still not leading them, but you are managing your team members. You’re concerned about your CPD and your CEUs and making sure that that’s happening. And gosh, can somebody find me some free ones please? Your clients need you. Your staff need you, your team need you. Everybody needs you. Yet you are still worried about your bootstraps.

Now here’s the kicker. We actually don’t feel like we’re contributing to the business if we’re not actually out there making money. This is the core of this bootstrapping mindset. We grew up in our businesses knowing that if I see a client, there is an exchange of value. And that value for me is income. I get money. I see a client, there’s $150 in my account, I see another client, there’s $150 in my account. It is a transaction. It’s a very simplified transaction and it’s easy for us to see. And we’ve created this business doing it this way. So it’s known, it’s safe, it’s what we know, it’s what we can control. I see a client, I get paid money, therefore I am valuable and I’m adding value to this business. This keeps us stuck. Incredibly stuck. All the stuck. Because you’re not leading anyone or anything anywhere. You are not scaling and it’s actually starting to diminish your capacity to care. It’s an incredibly vicious cycle of boom bust. And pretty much you’re busting all over the place. I know this story. I am preaching to a lot of you. I hear it. But please let me go on and explain.

So recently in my Daring Dozen Mastermind, we had somebody on the hot seat and she brought up this exact issue happening in her business. Now, this woman is incredible. She has created a seven figure revenue business. She’s done it. That’s many of us are sitting out there going, woo, I wanna be able to do this. She’s there. She’s already done it. But when we got through to what was really going on for her and why she was struggling to execute some new service delivery that she’s been wanting to grow, what we identified is that if she is not seeing clients at $150 a session, she perceives she’s a burden on her business. This person is leading a team of 20 people. She has created employment for 20 people who then see thousands of clients every year. She’s project managing multiple locations while she’s learning how to be a CEO. However, she is stuck in her bootstrapping mindset of ‘I am a burden to this business’. I do not deserve to be paid if I am not seeing a client and getting my $150 into the business.

Now you hear me say that and you probably hear the tone in my voice and you go, Jo, that’s crazy. How many of you are actually listening going ‘but she’s created this business but she gets to serve so many people. But she’s obviously doing something really well and really great and you wanna encourage her and support her’. How many of you actually went to that place? Because I certainly did. I was a bit shocked. We wanna actually go in and start telling her, you are worth more than that. Look at what you’ve created, look at what you’ve done. But then I also wonder how many of you listening are going, oh my god, that’s me. Because I know it was a big reflection for a lot of people in my mastermind community who went, ooh, you are not the only one who thinks like this. Which is why I thought this was an incredibly important episode for me to bring to your attention.

So where we got to with this conversation is if you’ve created the business, if you’ve employed the staff and kept them employed and kept them safe, you pay their wages and their benefits, then you, my friend, have made that $1 million or $7 million or $15 million revenue possible. Without you, that would not have occurred. Doesn’t this now make your $150 an hour transaction with a client seem a tad unhelpful? Can you see how keeping yourself in that transaction mindset is stopping you from having the growth, the influence, the significance, creating the legacy that you wanna create? Because without you, those clients wouldn’t be seen. Without you, those clinicians would not be doing good work and work the way they wanna be doing it. Please do not cheapen the sense of who you are and your contribution to $150 per session.

Now I am not having a go. There is nothing wrong with anybody selling their services for $150. I am speaking to those of you today in leadership who need to step up and understand why your business isn’t growing, why your bootstrapping mentality is keeping you stuck. And I’m gonna give you some clues right now and how you can actually move beyond this. Because if we can create healthy private practices full of healthy clinicians doing good work, we will actually transform our communities. We cannot rely on government institutions, we cannot rely on corporations. We cannot rely on community services to do this. We know that. It’s our responsibility and our legacy. How cool is that?

So there are some of us who are going, I don’t want the responsibility. That’s cool. Great, go find an organisation that fits really well for you. But for those of us who know that we can lead, once we learn how, that we can help our teams grow and develop so that they can serve the community in ways that the community are not being served, then this is the message for you. Hold on. Because I’m gonna share with you one question that is going to transform how you start thinking about this.

So how did I move beyond this, right? How did I move beyond feeling like I need to see all the clients and make all the money because somehow that proves to everybody that I’m working as hard as they are, that I’m just as valuable as they are and I’m not any better than them. Yeah. Well, the question I now ask myself, and it’s usually an end of day reflective practice, is what did I make possible for my team today? What did I make possible for my team today?

Now the team for me is not just my clinical team, it’s also my support team. It’s also my designer, my accountant, my practice manager. All of these people become a part of my team. My coach, my mentor, she’s a really big part of my team. So some of the things that I impart, some of the things that I get to do, that I can help my team with on a daily basis are things like helping establish improvements to workflow, making sure that I am financially responsible for this business. So everybody gets paid. I don’t worry about that anymore, but I know that it’s a really big worry for most people until you get used to knowing how the cash flows in your business. And I’ll do another podcast episode about that as well. So I may have not even spoken to a person in my business delivering services over a day, but I’ve worked with a support team member to come up with an improvement to a workflow that cuts time, improves efficiency and stops frustration. That is how I’ve contributed to my team today. And in doing that, I’ve just opened up space in my team of both emotional space, but also time capacity for my team members, my clinical team members to maybe serve a few extra clients each a month, which then impacts my revenue positively. Yay. I may have created a debt consolidation strategy because I know how to use debt wisely in my business. I may have started a new marketing campaign. I may have gone and done a quality assurance interview with one of our key customers, making sure that we’re still meeting their needs and doing it in a way that is responsible to them. I may not have seen a client for two or three days in my business, yet I know that my contribution is making sure that my team has good work to do, good ways to do their work, and that they’re resourced appropriately. And this fosters an incredible culture in my business where everybody knows that they’re gonna be looked after, that no question is a stupid question, and that everybody gets to co-create with me the business the way we wanna run it. It is very, very cool.

Now it took me a long time to shift to this focus and now I love it because what I was able to recognise was that when I was overcommitted with clinical clients, plus trying to manage and lead a team while trying to build a business, I started resenting the very things that I said I stood for. So being over-committed either got me resentful of all the clients who needed my help, or I became resentful about my team members who needed my help. And then I got resentful because everybody needed my help and I didn’t have a moment in the day to think about anything. And I just better go have coffee and go to bed. <Laugh> This is when our businesses start to decline cause everything rises and falls on your leadership. John Maxwell talks about that a lot. He’s a great leadership thinker and talker. He does talk a lot. Because when my attitude turns up when I’m too tired, if one more person asks me to do one more thing, I’m going to explode. It’s too hard. There’s too much to do. Then my business shrinks. And it’s not shrinking because I’m not marketing. I could be doing all the marketing and chances are I am doing all the marketing. It’s shrinking because I am putting energy out that says I’m too tired, I can’t take on anymore.

And I see this happen time and time again with the clients that come to me for coaching and mentoring. So the first thing we need to do is get you back into a healthy, safe way of working where you are not exhausted every night.

So it’s time for us clinicians, leaders, business owners, to up level our bootstrapping mindset. Maybe you need to go and buy yourself a new pair of boots, some fancy boots. Yes. I just gave you permission to go shoe shopping. Because if we continue to maintain this startup mentality as a clinician, it’s gonna keep you stuck and you’re just gonna stay in this rat race cycle that you tell me that you wanna get out of. You’re gonna be boom busting all over the place and we’ll probably lose you from the profession because you’re burnt out and exhausted. You actually deserve more than that. And we really need to keep you healthy, safe, and vital because our communities need you to lead the way for change.

Go forth, be your awesome self, and I look forward to coming back to you in our next episode.