Tiffany(00:00):
What does it mean to be a Christian, to be a black woman, to be a Christian and a black woman who grew up with messages around wealth and service? The the idea that if you pursue money or wealth or financial security, ease, if you actually desire ease in your day-to-day life, that you are not in integrity with your Christian values. Or the belief that people of color, black people in in particular, they don't have the means to pay for therapy or they simply wouldn't choose to pay for therapy. These messages that barrage us from the wider society media culture, what does it mean to then say, I wanna charge premium fees as a black woman, as a Christian, I wanna leave insurance panels. I wanna charge 200, $350 per session. What tensions arise? What conflicts come up? This is exactly what we're talking about in today's episode of the Money Sessions.
Tiffany(01:02):
I'm your host, Tiffany McClain, licensed marriage and family therapist. I'm also the creator of the Lean In Make Bank Academy, where we help therapists have nuanced, thoughtful conversations around how are upbringing, how are unconscious beliefs, how are the beliefs we've internalized from a wider society impact the fees we're charging? How we approach money in our private therapy practices? And not only do we have nuanced and thoughtful conversations, we help therapists make this change. We hope therapists go from being paneled with insurance or charging, you know, $50 per session, being overworked, seeing 40 clients a week, and stressed out to actually having a premium fee, cash pay practice that is in integrity with who you are and how you wanna show up, both as a professional, as a clinician, but also as a human in the rest of your life. So in this conversation today, we are talking with Dr.
Tiffany(01:58):
Marcuetta Sims. She is a lean and make bank graduate, a therapist who went from being on insurance panels to charging premium fees, opening and closing her group practice. And now thinking about the next phase of her professional life after becoming a mother for the first time. This conversation is thoughtful, rich, nuanced. We really get into the details of how her thinking was shaped by her Christian upbringing and her current Christian faith being a black woman, how she actually doing the work in Lim allowed her to get in touch with some of the internalized biases that she had adopted from the messages she heard growing up. We're also going to hear about what it was like for her to leave insurance panels. What even allowed her to have the thought that a premium fee cash pay practice was possible for her? What it meant to actually have an insurance panel force her to terminate with a client.
Tiffany(02:54):
We think about insurance panels as being accessible, actually allowing us to continue to do ethical work. And if we get off insurance panels, we're out of integrity. But this, in this episode, Marquita actually talks about a situation in which an insurance panel suddenly cut off a client's access to virtual care, which meant Marquita could no longer serve this person. And the way that actually forced her to confront what it meant to have a practice that was dictated by a third party. We're just going to get into all of it today. We're really gonna spend a, a time at the end talking about also what it was like to get into group practice. The downsides of group practice and how it really shifted her thinking about what it takes to be a provider. Be in practice. If you are somebody who is on insurance panels or charging low fees, you're just burnt out.
Tiffany(03:44):
You're just overwhelmed in your practice and you feel like I'm just working so hard and I'm not making, I'm just not making enough. I'm not present with my, my kids. At the end of the day, I'm not present with myself. I don't have time for my professional development. I'm just going through the motions and kind of living in the gray zone. I encourage you to go check out our fund with fee calculator. Go to lean in, make bank.com/free. You can download our free fund with fee calculator and we'll walk you through what it would take for you, how much you would need to charge to actually have a practice that works for you. That's lean in Make bank.com/free. Download that calculator. I'll also send you a little tutorial video and we'll start getting you back on track. My love, we'll start getting you back on track. In the meantime, enjoy this episode with Marcuetta. I know you're going to have mind blowing moments. I certainly did. Let's dive in.
Intro (04:40):
I think there's a difference between saying what your fee is and like fully committing to it. I believe in this like law of attraction, but you also have to take action. I don't think I do enough to help other people despite being, despite being a therapist, I was worried that I'd end up only serving wealthy people.
You know, I was being so delusional about my actual cost, but I wasn't actually paying myself a real salary. Now that I am charging more, I'm not lying to myself.
This is ridiculous. Completely broke, man. If people knew who they were, I do what she's doing, like she's doing this.
Tiffany(05:22):
Okay, here we go folks. Marcuetta and I were just talking catching up on live. So now both of us are like, okay, we gotta get in podcast mode. So here we are getting into podcast mode. Marcuetta, we're here with Marcuetta Slims. Oh my God, look at folks. I'm already not even pronouncing. I don't even know what I'm talking about. You heard about all this in the intro. You heard us talk about Marcuetta in the intro, but Marcuetta start by telling folks in your own words a little bit of about you and your practice, what it looks like today.
Marcuetta(05:49):
Oh, that's a great question, Tiffany. So today my practice is a little bit of just focusing on speaking and consultation and training. 18 months ago, my life shifted for the best, in the best way when my daughter was born. And it really changed the way that I wanted to show up in my personal life and in my professional life. And so I kind of let go of my group practice, got my employees situated other places, and I'm just focusing on one to many work right now.
Tiffany(06:20):
I didn't, I don't think I knew that.
Marcuetta(06:22):
You knew that Tiffany ,
Tiffany(06:24):
You're not the only one not sleeping. I'm like, what? Okay, so we're gonna wind it way back. Let's go way back. So for folks, we're gonna catch folks up on some of the journey and then we were gonna catch me up clearly on some of the journey . Talk about even when you went into private practice, were you in a community mental health first? Were you into private practice straight out of your school? What was that early stages of the journey like for you?
Marcuetta(06:47):
So my early stages, I was primarily in college counseling spaces. So my postdoc within a private practice setting. And then once I got licensed, I transitioned into a university counseling setting and I was there all the way up until I started my practice.
Tiffany(07:00):
Okay. So I also didn't tell folks three other things we're gonna really be focusing in on today are getting off insurance panels, raising your fees, and also eventually setting a schedule that worked better for you. So take us back to the early days when you went into your private practice. How did you even decide, I'm gonna, I'm gonna get on insurance panels?
Marcuetta(07:18):
So it felt like that was just a thing that I was supposed to do. It, it was a no brainer that if I was starting a practice, the only way that I was gonna be able to have a practice and people were gonna be able to afford it and pay for it was to be on insurance. And so that was actually one of the first things that I did when I started my practice was apply for an insurance panel. I knew though that I didn't want to accept every insurance. For some reason I had that level of discernment. And so I only applied for one, but the one that I applied for was the one that everybody in the state of Georgia took. So I was pretty full when it came to insurance, but it felt like that was the only way that I could make money at the time.
Tiffany(07:58):
Interesting. So everybody, like literally that was just what you did, that's what you heard of, that's what happened.
Marcuetta(08:02):
Yep. What
Tiffany(08:03):
Were some of the positive things, you know, I talk a lot about oh, insurance, but actually what were some of the things that in those early days worked for you about being on insurance?
Marcuetta(08:13):
Oh, well my caseload filled up quickly. I left my full-time job and of course, well, no, not of course, I started my practice at the top of the pandemic. So I resigned February of 2020. I stayed until May of 2020 just because the school system calendar. But by the time I left I was already at a full caseload with my practice and by July I was already making five figures. So insurance worked, right? Like it was, it's a constant flow of clients coming in. There wasn't a lot of marketing that needs to happen. It was pretty quote unquote easy. The timing of it probably had a lot to do with it as well, but I didn't have to, there was not a lack of clients coming in when I was on insurance.
Tiffany(08:59):
That part is good. Okay, so that part's good. Yeah. What were some signs, how many folks were you seeing come July when you're making five figures? How many people are on your caseload? Yeah,
Marcuetta(09:09):
That's the, that's the drawback to it, right? I was seeing about 26 clients a week in four days. So I was seeing clients Monday through Thursday, six to seven, sometimes eight clients a day, some days starting at eight and not ending until six. It was a full, it was a full day, a full week every single week to make that money.
Tiffany(09:31):
What were some signs? So you're doing it, everybody around you, around you is doing it. It's just the way people operate. What were some signs, three signs, let's say, that made you start thinking maybe this isn't working for me after all.
Marcuetta(09:45):
Yeah. First and foremost, I didn't have any time to myself. I didn't have any time to my life. Like I know that I was just saying that it was pretty easy. Clients were coming in and flowing and still I had a business to run. I still needed to make sure I had a website. I still need to make sure my notes were getting done because of course, with insurance specifically, it's like there's this anxiety around getting your notes done, making sure you're not getting audited, making sure there are no clawbacks. And so the time that I wasn't doing work, I was invested in business stuff, administrative stuff. So all of my free time was devoted back into the business. And even on the weekends, I worked on the weekends because I didn't have time when I was seeing clients to network and market and meet with people or do consultation.
Marcuetta(10:30):
And so that was the biggest sign for me was I literally had no time to myself or to do anything. The second sign for me was I actually had, I started my group practice October of that year. So within six months of me starting, I had hired my first employee. She was a fully licensed clinician. And of course, if you know about how group practice works, the owner of the practice gets a cut of their pay. So I got her in, got her on the insurance panel, super easy and quick, and I started seeing what she was getting reimbursed and I felt ashamed for her to be paying her a portion of what she was receiving. That's how little she was getting a fully licensed clinician making, I wanna say at the time it was like $50 a session that she was being reimbursed from insurance.
Marcuetta(11:20):
So that was painful for me. And then the third thing that happened, and this is a little ways down the line, but I had a client that I was seeing, she had come from the university with me, came into my private practice, we were using her insurance and insurance just stopped paying for her sessions. So I reached out to them and asked them why. And it was essentially because they were no longer covering telehealth. And we are talking like middle of pandemic still. They were no longer co covering telehealth. And so I had to cancel our sessions with her because she was not able to pay out of pocket. And for me, that's not social justice. That is not like, I don't, I didn't start my practice to have someone telling me what I can and cannot do with clients. And I just wasn't in the space at the time to be able to like navigate like, oh crap, what do I do? You're college student, do I see you for free? But I'm in private practice. And so being forced into terminating that relationship prematurely, that was something I said I will never do again.
Tiffany(12:19):
That's, I I mean I'm sure that happens a lot and for some reason that's never come up on the show, that's never come up when I'm talking to therapists. Usually it's a therapist worries that they raise their fee and their clients can't afford it. But the fact that insurance can just say, Hey, we're not paying for this person anymore for these reasons that we come up with based on our own whatever we're doing on the other side of things. And then you either have to terminate that client or maybe I can imagine a lot of therapists are like, okay, what can you pay? You know, 15 cents, I'll see you for 15 cents. So the fact that the system is forcing you to actually terminate early or take a massive pay cut on your behalf is something we haven't actually addressed before. That's very interesting.
Marcuetta(12:58):
Yeah, that was one of my big reasons.
Tiffany(13:01):
So you got on in July, you got on insurance panels, is that right? Of 2020?
Marcuetta(13:07):
Oh, I got on them at, it was like a month. I was on them last March. Yeah, I was, I started seeing clients on insurance in March of 2020.
Tiffany(13:16):
March of 2020. And then when did you decide I'm done. I'm literally getting off in panels. Do you remember what time period that was?
Marcuetta(13:22):
January of 2021. That's when I emailed you. It was like, Hey, so about limb , let's do this now. .
Tiffany(13:30):
That was pretty, that was pretty fast actually. So, so not even a full year of being on insurance panels before you realized. So it sounds like you're somebody who had kind of a slow burn, like the time you spending a lot of time, you didn't have a lot of time for yourself, but you tolerated it. Mm-Hmm . Then you saw in your, the person you hired, your team member, oh, you could see in them like, oh, these reimbursement rates are really low. You could see that for her, what you couldn't see for yourself, another little nail in the coffin. And then it sounds like once the, the insurance actually impacted your clinical work, like that's when I'm getting goosebumps, like for yourself. No, you'll keep pushing for your team member. It looks bad, but you'll keep pushing. But once it came to your client, that's when you said no.
Marcuetta(14:11):
Yeah, absolutely.
Tiffany(14:12):
That's interesting. What were some of the things that were scary about getting off insurance?
Marcuetta(14:19):
Oh, just the thought that everyone was gonna leave, that I would, I was still in the beginning phases of like understanding this private pay space and it's so interesting thinking back to that person, even what you were just detailing of how it took everybody else for it to impact me and me to make that decision. I'm such a on the other side of that today, so we'll talk more about that later. But I think it was so scary to imagine a world where I could have a full practice, a thriving practice and full for whatever that would mean without the the safety net if you will. Like insurance felt like a safety net that everybody uses insurance and nobody goes to therapy without using their insurance. I was going to therapy using my insurance. I in fact had never seen a therapist except for the lower sliding scale. I had never not used my insurance. So, and I didn't have insurance at that time. So the concept of doing this and building this practice without insurance just felt absolutely terrifying and impossible.
Tiffany(15:25):
I'm also struck again, what you just said is you were paneled with insurance so you could see clients who were using their insurance, but you yourself did not even have insurance. Is that what you just said
Marcuetta(15:37):
At that time? So in the past I had seen a therapist on a sliding scale because I didn't have insurance at that time. Did I not have insurance? I might not have had insurance at that time. There was a period when I first started my practice that I didn't have insurance and then I eventually got insurance again. But yeah, there was a time where I didn't have insurance.
Tiffany(15:58):
Yeah, interesting to think about. Even our clients, again, your clients are being taken care of when you're not even being taken care of yourself. Isn't that
Marcuetta(16:06):
Loud?
Tiffany(16:06):
Yeah, we do it all the time. Right? We do it all the time. Yeah. So when you were thinking about, okay, all my clients might leave it is, even though it's bad, even though insurance has a lot of downsides, at least, at least it's con in theory, consistent, maybe a clawback, maybe they're gonna terminate your clients without giving you any notice, but pretty consistent. How did you feel it let me, how do I ask this? You made the decision, I'm gonna get off panels, but then you actually had to do it, you actually had to go through that process actually. What's your, at the time when you were taking insurance and you don't need to name the company, of course. What, what around were you getting reimbursed per session?
Marcuetta(16:46):
I think I was getting reimbursed for a 45 minute session, about $75. Oh
Tiffany(16:52):
My gosh. So not even much more than the person, your team member. Yeah.
Marcuetta(16:55):
And I thought that was normal. When I talked to other group practice owners, they were like, yeah, this is the one that pays the highest this. I'm like, oh, this is what we're all making here, which is again, wild to think about now
Tiffany(17:08):
And the cost even maybe we'll get into the group practice stuff, maybe we won't, but the, the, but the idea of like, okay, maybe your clinician's getting reimbursed 75 maybe, but you still have to take a cut of that so they're gonna get even. So you're doing all that workup training a person, hiring a person, managing a person, HR for a person, employing a person for $25 an hour, you're getting not even an hour. That point, that person sees one client themselves, they get, you get 25 of that, but then how many hours it takes you to have to like run that whole business is just astronomical. So often group practice owners get a bad rap or I even talk about leaving groups, but not 'cause group practice owner is scamming the group practice owner is probably getting way paid way less for how they're working than even a therapist on insurance is getting paid. For folks who are just listening to the podcast, Marta is nodding all day long. Okay. So you got off insurance panels. What did you set your fee at after when you were leaving panels?
Marcuetta(18:00):
When I left panels, I first set my fee at $200 because my pri my out-of-pocket fee. And this is an interesting little tidbit. My out-of-pocket fee was $150 and the very first client that I got, and I think that this had planted the seed in my head, which is why this process moved along a little faster. My very first client, when they reached out, I asked a friend, I was like, oh my gosh, what if she asked for a sliding scale? And she was like, well, some money is better than no money. And so I was like, yeah, you're right. Somebody is better than . No, exactly. Somebody is better than no money. Went with that. I reached out to the client and she's like, no, I want to pay your full fee. I wanna pay you what you're charging out of pocket. And I was like, oh wow, that is so fascinating to see. So that was always my fee from the beginning. So when I raised it I was like, oh, one 50 to 200 is not a lot of money, so we'll go with 200.
Tiffany(18:55):
Okay. What did it feel like? Do you remember charging that fee for the first time or, or actually getting that fee?
Marcuetta(18:59):
I do and it was fine. Like, it was, it was nothing like in terms of me, my feelings were definitely like, who's gonna pay this? Is are they gonna pay, are they gonna balk at it? But once I had the conversation, I ran that card the first time, it was like, oh, people, people do this and it's okay and we're fine . It was just like a, the anxiety was there. I think the conversations were probably harder than the actual charging because they were clients that my first clients of paying 200 were clients that were, had already been working with me. They knew the services that they were getting. Some of them did come off of insurance and continue on. And so it felt like, okay, we have an established understanding and I think that most of those clients too were already paying the one 50. Hmm. So it wasn't, the shock value of the extra $50 wasn't so much. But when I first did it, it was definitely like, okay, we did this, we crossed that hurdle. Let's move on to the next thing. Yeah,
Tiffany(20:04):
It's really interesting. You didn't talk about this in your anxieties. You said, you know what if all my clients leave Mm-Hmm. . So that's, that means you have no caseload anymore. But just now you also talked the, you talked about the other side of that, which is maybe the clients you worked with, you have an established relationship, they've been using their insurance, they might have some feelings about you upleveling and earning more. How did you feel going into those conversations with existing clients who have been using insurance to tell 'em, you know, I'm not gonna be using insurance anymore. You're gonna, you're paying $20 now as a copay pretty soon. If you wanna keep seeing me, you have to pay one 50. What, gimme a little bit of that story how that was for you.
Marcuetta(20:40):
I do think that that was the most challenging part, especially for the clients that did speak to like the value of the work that we were doing and decided not to continue on because they weren't able to use their insurance and that. So if there was a piece of like validating that fear, right? That that is a, that is absolutely a reality of what could happen. And so in some ways it would tug and pull at my heartstrings of like, am I right making the right decision? Am I am I actually doing a disservice to these clients by leaving insurance panels? Am I not able to really serve the people that I wanna serve if I'm not accepting insurance? So I think that all of those questions were coming up related to leaving the insurance panels and raising my fee, right? So if I had kept my fee at one 50, there's a possibility that it would've just been like, okay, this has always been my fee, it's fine. But I think the leaving insurance panels and the increase also really tugged at me in a lot of ways. Particularly because I had to say goodbye to a lot of people that I did not want to stop working with.
Tiffany(21:52):
Hmm. We're I have a, I have many questions about that. Let's, well before we do go into the deep dive you are somebody who went from working in the college system, went straight onto insurance panels, knew what that was like, got off because you saw what the reality was and how it impacted you, your team member and then your clients. You were able to say, I can't do this anymore. Let's say there's someone listening right now and maybe they've been at on Insurance for a year, maybe they've been on using insurance for five years or 10 years and they're starting to have this first thought, oh, maybe this doesn't work. Or maybe this is not, maybe I don't have to tolerate this. But they're terrified. What are three pieces of one to three, either strategic advice you'd give them about the steps or even just a mindset shift that you had to go through that allowed you to make these changes?
Marcuetta(22:43):
I think the mind, one of the mindset shifts that I had to go through was, you won't know what the other side looks like until you actually do it. So the thing about fear is that it usually stifles us. It makes us stay right where we are. We're just, we're uncomfortable, but maybe not necessarily uncomfortable enough. That's kind of where I was in the beginning. Like, I'm uncomfortable with this schedule, but I'm not uncomfortable enough to make a change. And I could not see the other side of that until I was actually on the other side of it. And so that mindset shift of, oh, because this is scary, I must be doing the wrong thing, or I need to just stay where I am because it's scary if you shift that to, oh, this is scary, so I need to do the thing that I'm a, I'm afraid of.
Marcuetta(23:28):
You get to experience the other side of it and it helps to soothe some of those fears and anxieties. Not that you all ever have the fears and anxieties again, but you do it scared. You do it with the fears and anxiety as opposed to letting them stop and stifle you. Another kind of, I guess a strategy if you will, is go ahead and terminate the contract so that the next clients that you have, you can start talking about your fee. Because if you stay on insurance panels and you try to do this like slow get off of it transition, you end up stuck in this place of where clients will still be coming in with insurance. And as if you accept insurance in any way, you know that like you can't not accept clients who have insurance, you have to try to fill out a form or something.
Marcuetta(24:17):
Which I think we just kind of made up to make ourselves feel better about like accepting private pay and accepting insurance. 'cause I don't think that that's an actual thing, but go ahead and submit at least one contract to terminate so that you can start having those fee conversations and saying like, this is my fee. If you wanna work with me, this is how much you would have to pay. Because once you actually start having those conversations, again, doing the actual work really does make a difference in building your confidence about being able to do that. And then the last thing that I would say mindset work, just kind of, I think financial trauma work. Mm-Hmm. is understanding where our money stuff comes from. I think that was probably one of the most clarifying experiences for me. So not just the money stuff. And I know we're gonna talk a little bit about some of those beliefs, not just the money stuff. How does your family talk about rich people, finances, wealth? Like what does that look like? I don't wanna discredit the fact that as black people, we have been disenfranchised since we have been in the states. And so considering the ways that those,
Marcuetta(25:30):
Those external factors dictate and determine the ways that we show up in these spaces, I think it's really important to understand and get therapy around. Because without that understanding, you're gonna continue to essentially make blocks for yourself around why you're not raising your fee. That probably doesn't even have a lot to do with the actual fee.
Tiffany(25:55):
I love it. So there's, there's this thing around you mentioned a couple of things. You talked about the doing it scared. And I think when people hear about the things we talk about in limb, they they think about mindset work. Mindset work. Like get your mind right and then you take the action and we're like, no, you gotta get your mind right enough to take the action. 'cause You literally will learn the thing. The thing on the other side of that fee raise or that cancellation policy you're setting is you're gonna discover something about yourself. You're gonna come to know things you literally can't know on this side of the equation. So even it's, it is nice to earn more money, yay, that's all wonderful. But who you become and how you show up in the world shifts as a result of doing this scary thing.
Tiffany(26:40):
So let's talk about two aspects of your identity that you came to learn something new about by virtue of actually leaning in and doing this work. So one, you're a Christian and there are a lot of, there are a lot of certain aspects of Christianity or the way we have interpreted them or the way we put it on black people and women to interpret them has lots to say about what it means to be wealthy or pursue money or take care of yourself financially. Can you talk a little bit about what you believed beforehand about making money or actually striving to earn and take care of yourself financially?
Marcuetta(27:13):
Yeah. From that perspective, I think the biggest thing that, well, a few big things. One is that money is the root of all evil. people have misinterpreted and misquoted that scripture forever. It, I think one of the other ones is like, it's harder for a rich man to go. What? It is harder for a camel to go through the eye of a needle than a rich man to get into heaven, right? Yeah. So always different just idioms, if you will, about money, wealth and how it is so bad and so evil. And so I didn't even realize that I had inherited that thought process and that it shifted so much about my ability to seek and desire and want more money that I would feel shame and guilt about wanting more money. And that in the space of like the religious community, it was difficult for me to be able to say that I wanted money or to say that I had it or to even talk to certain people because it's almost as if like, if you're not struggling, then like are you really a Christian?
Marcuetta(28:21):
Like if you are not in the trenches, if you're not poor, you're not being martyred. In some ways there's, it's almost like there's a that's a gold medal or gold sticker that you get for like the struggle life as a Christian. And when people see a elevation or people I look at different pastors who have a lot of money or they appear to have a lot of money. Their churches appear to have a lot of money and the way that people like, comment and degrade them and talk negatively about them, it's just a very contentious place. And it felt very uncomfortable to be wanting to have more money and think about money in a different way. And then I think the other part of that is this service orientation, like being a Christian is all about being of service. But a lot of times when you hear being of service, it is associated with free. It is associated with not charging. It is associated with pro bono. And yes, there is some capacities where ser that is service, community service, but we are in a service field. Like in my profession, I am of service, but I cannot like disconnecting this idea that I, I want to make money and be of service. It just got to be very complicated,
Tiffany(29:41):
Very complicated. Especially about what you're talking about is we have literally chosen to go into a profession where our way of making money is also of service. We're not making widgets. We're not on Wall Street where we're making money. We're literally serving people. So it does get complicated to think about, wait, I have to charge for this 'cause it's my job, but I'm not allowed to charge because I've misinterpreted some things that I read in the Bible. And my, my community is literally saying to me right now, were you in Lim? Were you in one of the groups, the Christian groups that formed Okay, talk. So I think this is where finding a new community comes in. So talk a little bit about the importance of finding like-minded folks, other Christians who also were wrestling with and trying to work through the things that you were working through.
Marcuetta(30:22):
Yeah, and I actually started it because of this struggle. I was like, now who else in this space can help me and re resonate with what I'm experiencing? Because I am really struggling with this. And a lot of us, and I love what you just said, like this community piece, I cannot emphasize enough how important that has been through this entire journey. And that specific community helped me so much because it really did, it helped to challenge those narratives, it helped to validate them that we've all experienced this. And it helped us to kind of explore and unpack and really dive into why are we doing this? We talked about other scriptures and messages and understandings of actually the ways that we are able to serve. The way that we are able to give back the ways that we are able to tithe and support our church community is by making more money because the money need, the church needs money to be able to function and it comes from tithers.
Marcuetta(31:26):
And so that group really helped me to situate myself and doing really good work, working as if you're working for the Lord, right? So bringing in some of those other concepts and still understanding that for me to be healthy, for me to do good work for me, not to be martyred. We, we have to make money. So the community helped me to like break down and break through those blocks and those mental barriers that I had created by having like-minded people who were doing the same work and people that I thought were good. Right? So this scripture of money is the root of all evil. Which again, that's not the scripture. is the love of money that is the root of all evil. Yes, correct. Exactly. They leave that key word out. It is the love of money that is the root of all evil. But being around all of these good people, these people who are doing important things, really highlighted to me that no, you can still have a good heart and have a, a focus on God in Christ and still make money and use your money in a way that supports the things that you value and you care most about.
Tiffany(32:39):
Including yourself. Including
Tiffany(32:42):
Yourself. Correct. Including yourself. It's really interesting to also talk about the difference of when you went into private practice and went on panels because that's just what you do. Like literally you had no other thought in your head to this transformation where you were in a community, you found, you invested in finding a community where people were actually saying, I wanna do things differently. I'm gonna do something outside of the norm. Who also like-minded and had similar values who you could actually trust and believe in and had similar, you had similar basis of foundation and faith. That was a huge part of what allowed you to continue forward and make these changes. A black woman. Number two, I had this too, I had this too when I went to practice the idea of like, black folks, either they're not gonna pay for therapy or even if they wanted to, they don't have the money to pay for therapy. Even as black women who are trying to make money having money, we still have those ideas in our head. So talk a little bit about that belief and how where that came from and kind of at what point you started to notice, wait a minute, with this belief
Marcuetta(33:39):
. Yeah. That, and that one is so wild to me to think back now at four years later that I actually held that belief because, so I'll tell it this way. One of the reasons that that started to get challenged for me is because I looked at the people in my close circle and all of the people in my close circle could afford to pay out of pocket for therapy. Like hands down, easy because we talk about money, like we have financial conversation, it's something that I understand about them. And so I started to really look at that belief like where did this come from? , like who said? But I think that it was, it was more so a a historical understanding of where we are situated or have been situated in society. When we look at the numbers and we look at the pay gap, the wage gap like that is still a very real thing.
Marcuetta(34:32):
And so it's almost this like emotional interpretation that I layered on top of the very real data and statistics and knowledge that I have, the historical generational trauma that we have experienced, the ways that black folks stereotypically historically do not trust the healthcare systems. Mm-Hmm. . So if we are going to consider ourselves to be in the healthcare field, just like what the perception of that is and are they going to pay for a service where they feel like they don't even trust the services that are being provided? And it is, it is often just felt like a narrative that has just been passed down and passed down through conversations, through people and honestly through some experiences. Like I also don't wanna discredit that some of those same people that I know could pay out of pocket for therapy are like, I'm not paying out of pocket for therapy.
Marcuetta(35:29):
I'm using my insurance. Right? So it's not even that these things are not necessarily true for some people, but there was this internal belief that like, oh, because I've heard that with one person, that must mean everybody. And I'll also go back to something that I said earlier. It was an internalized thing that I was doing too. So for me, I was not going to therapy without using my insurance. And it wasn't even until around the same time that I started li I started paying $200 a session for a therapist that I was like, oh, this is different. And it clarified for me my own reservations and hesitancy until I actually started doing it.
Tiffany(36:12):
Can you say something, this is so powerful. Everything you've said, I'm looking at the time and I'm like, I wish we could have another hour to dig into this. So I'm just gonna pick up the last piece. What shifted in you, if you can articulate it, when you got stopped paying for your own therapy with insurance or sliding scale and started paying 200 session, can you talk about the shift?
Marcuetta(36:35):
Yeah.
Marcuetta(36:38):
For me, I think it was one confirmation if you will, that it can be done because I, I was not if, if we think about the timeline of this, so that was January, 2021. I had started my practice in March of 2020. So this wasn't like I was making a ton of money. So that $10,000 month was like a one month kind of situation. I wasn't making a ton of money at this point. And so it wasn't like I just had money to throw out and burn on therapy. No, it was a sacrifice that I had to make, but because it was something that I had invested in, I made the sacrifice to do it. And that was the biggest shift for me is that someone who wants to pay for therapy and wants to have quality services, they are going to figure out a way to make it happen is not gonna be as convenient as pulling out your insurance card and letting us file a claim.
Marcuetta(37:30):
There may be a little bit more work on your other side. I also submitted out network claim benefits because I wanted to see what that experience was like too, but it really clarified for me that no people will do this and you can expect people to do this if they wanna work with you. So I think that was probably the biggest thing for me. And every week, every week $200 was getting charged onto my car and I was paying that money. And it also gave me this sense of, and I know you talk about this in the program it was not, it was no joke for me. Like this was a very serious investment that I was making. And so I showed up in a different way. I believe I invested more in the work that I was doing and I felt that in the therapy that we were having because I was not just like, oh, this is free or this is $25.
Marcuetta(38:26):
The amount of money that I was paying to invest in that made a big difference in the way that I'm getting my treatment too. And I also believe for being a provider in the opposite, on the other side of that, I care about how I show up more when someone is paying 200, $350 a session. And I'm not saying that people who accept insurance don't care as much. I'm not saying that they are not as good clinicians. I don't wanna make it sound like insurance makes a clinician. No. But what I will say is that being a person who charged $350 for a session, it changed the way that I showed up for those sessions. And I can't, I cannot imagine that anyone that is saying that, that doesn't change for them, that they are being honest because you have to show up different and you have the capacity to, because what I also believe is that if you're accepting insurance and you are seeing 10, 15, 20, 25 clients a week, 40, 40 clients a week to make ends meet, you do not have the space and capacity to show up for a client in the same way if you are not seeing that many clients.
Marcuetta(39:40):
And so I think it just shifts something for you.
Tiffany(39:44):
I have zero to add. That is our Instagram reel right there. It's the facts. It's true. It's true. Like anyone who says there's no difference when they were taking insurance and seeing 30 people a week versus when they're making 350 procession and seeing 10 people a week who says that doesn't make a difference in how they show up clinically personally in their work and in their lives. I don't, I can't, I just don't buy it. It's, it's false. That is a lie. That is a lie. Okay, I wanna take just a few minutes. You had an interesting journey. You started a group practice fast. Mm-Hmm, . Right now, are you seeing any patients
Marcuetta(40:20):
Not No, I'm not. I'm taking a sabbatical.
Tiffany(40:23):
Okay. Taking a sabbatical. Maybe a forever sabbatical, we don't know yet, but some changes have happened in your life. So you went into, started a group right away. I don't know if I told you no, but I would've told you no. I don't know if you asked me, but you, you did it before. You've enjoyed Lynn, you started bringing people on. Can you talk a little bit about for, for therapists who are not even full yet or maybe haven't done that and they're like, I'm gonna start, I wanna just start a group practice. What would you say to them in terms of ? She's rolling her eyes, folks. Talk a little bit about that journey. Yeah,
Marcuetta(40:58):
So man, I have so much to say we'll definitely have to do another I think so because I have so much to say about this. And I say this because I don't want to discourage anyone. If that is your dream, if that is your passion, do that. But I think that when people start private group practices, and I think this happened for me personally too, it's this sense of, oh, I'm full. I need to add on someone else to make more money to bring, generate more income, to see more clients. And that is not a good enough reason to start a group practice because there is a huge weight of responsibility. You actually don't make that much money in the beginning. You have to reach a certain number of clinicians before you actually start seeing the kind of money that you're looking for. And it takes a lot of time and a lot of effort to be able to build a successful group practice.
Marcuetta(41:51):
And I don't think that people go into it really understanding that. It's kind of like, I'll hire one person and they'll see some clients and I'll take a portion of that. It's really not that simple. And for your, your heart has to be in it, or at least this is what I learned. I felt like my heart needed to be in it in a different way in order for me to really be able to do it. And don't get me wrong, I had a great experience in my group practice. There was one point where I had hit, how much did I hit? Like I think I hit like a hundred thousand dollars in the first quarter of the year or something like that in the group practice. Like it was, listen, I'm not saying that it is not something you can do. I will say that I didn't see most of that $100,000, so I'm not driving a Tesla or anything out here because I was making all this money.
Marcuetta(42:40):
But, so I don't wanna make it sound like, oh, group practice is horrible, don't ever do it. And just make sure that you have the capacity to invest in it because it is not as glorious as, and this is from talking to lots of people who have group practices. It is not always as glorious as it looks or appears or seems. And on the other side of that, you have a lot of people who work in group practices and are disgruntled about the ways that group practices are run, particularly about the split, about the money that the group practice owner brings in. And that can also be very difficult and frustrating because a lot of people don't understand the backend work of group practice and they don't know what actually goes into keeping a business, a business with employees or contractors alive. And so they want so much more from the group practice owner.
Marcuetta(43:36):
And a lot of times the group practice owners are not able to provide that because it does not, it just doesn't make sense. So it can be a very beautiful and wonderful and amazing experience, but I think that having the right mindset going into it and knowing why, like people who have a passion for training, people who have a passion for supervising people, who have a passion for building up other clinicians and supporting them in getting where they wanna go, and people who have a really great skill at delegating Mm-hmm. And bringing on the people that you need to bring on to be able to support you. Those are the people that I think really thrive in group practice and can really kind of stay in it for the long game. But I definitely don't think it's something to go into lightly if anyone is choosing to do it.
Tiffany(44:27):
Definitely. I would love to have you come back and really we could deep dive into this conversation. There's so many aspects, the things I'm pulling out from both what you're saying, what you're validating that I've heard out. Also, I talk to a lot of group practice owners. I've certainly thought about like group practice looks so good sometimes on the outside. You gotta teach, you gotta work with clinicians. I would say you gotta know the numbers. You have got to really do the math before you go in. And most of the time the math is not gonna work out. If you're a one person trying to run a a group, the math is not gonna work out for maybe 10 or 15 or 20 years. And that's, if you're extremely data and numbers oriented, that's number one. I know a group of people right now who are in private have a group practice and it works really well because there are two different people.
Tiffany(45:11):
There's one who wants business and operations and thrives and loves it a CEO. And the other one loves to train work with clinicians. Clin like the being able to find a one therapist who's like really systemically oriented, operation oriented, number oriented and is really good at training and showing up and people that is unusual and maybe doesn't even exist in one person. So unless you are a unicorn, which you know, I don't actually know that this person exists or you're, like you said, able to say, I'm really gonna focus on training and hire someone and pay them a ton of money to run the operations. Or you are on the operations and pay someone a ton of money to run the training. You are working 80 or a hundred hour weeks not making any money for years. It, it is something where you have to be crystal clear about the numbers and I love that you learned it, although also I hear you saying there was no regrets because really like you who you are now after having done that, you no longer wonder. It's no longer a mystery. And you have learned tons about business leadership, clinical work, what it really takes to show up. You've learned a ton hard, a hard way, but that's the way to learn those lessons. You're not gonna forget. Nope.
Marcuetta(46:16):
,
Tiffany(46:17):
We're gonna wrap it up. My final question for you is you're taking a sabbatical, you're now doing speaking and engaging. You went on a retreat, I saw you on a retreat a couple weeks ago with some group, some folks from Lim. Talk a little bit about that decision to stop seeing clients and what led you to make it and also what life is like now and what you're kind of thinking about in this next phase.
Marcuetta(46:39):
Ooh, this is, this is a really good question because I don't, one of the things I do not think that I've talked about as much is the way that leaving graduating Lam being in LA changed me as a person outside of the fee increase. Like I know we talk a lot like it's lean in Make bank, right? It's all about leaning in, making more money. But the reality is by making those big moves, those big financial moves, doing the work that I needed to do, it changed how I showed up in the world and as a person. And so even me being able to get to a point where I said, you know what? I don't wanna do this group practice anymore. I don't think that I would've done that had I not gone through this process. I would've kept white knuckling it. I would've kept trying to figure it out.
Marcuetta(47:28):
I would've kept suffering slowly because I was doing that for other people. And one of the things that shifted so dynamically for me, well one, I gave birth to a child . And so that had a big part in what changed for me. I went on maternity leave, I stopped seeing clients then. I just have not gone back to it. But giving myself the permission to be able to desire something different was a massive shift for me. I have always been very business oriented, very goal oriented, very much so. I can do it. I am perfectionistic all of these different things. So the concept of not doing that in the same way anymore was unsettling for me at first, but I was able to remember that I could it because of the ways that I had done these really hard uncomfortable things and growing my business.
Marcuetta(48:28):
And it really did allow me the space to be able to do that. So the being on stage and speaking has always been something that I've desired for like all this time. And taking that leap of faith to just start doing that has just been a really phenomenal thing. It gives me the capacity to really still be able to invest in in su in clinicians and in supervision and in training. And it does not take away from my home life. It does not take away from my child, my husband. Like it still gives me the balance that I need in this season right now to continue to do the work that I wanna do, but not at a, at a sacrifice to myself and to the things that I wanna be able to do in life. And that feels good to me in this season.
Marcuetta(49:16):
And the funny thing is like, it has not changed my mindset. Like I am getting paid for these speaking engagements. I am absolutely like, no, I won't do that for five. I will not speak for six hours for $500. Like no. And so that has also just been really refreshing is to be able to say I've been pretty adamant this whole time about like my worth is not tied in my fee. Like charging a bigger fee does not make me worthy. My services are worth that though. Like the work that I do, how I show up and how I present in the things that I bring to a space is absolutely worth every dollar that I charge. And so being able to be settled in that and understanding that this is a long game. This is not something that happens overnight, that I can tolerate discomfort in different situations.
Marcuetta(50:09):
Like those are the things that really sustain me for right now. The retreat that we planned a couple of weeks ago, it's like I've never planned a retreat before, but I collaborated with someone who had a different strength and skillset than I did. And we put together this amazing retreat, which is another dream that she and I have both had and we were able to make that come to fruition because of the work that we've done, the season that we're in, and the the capacity to just show up and be exactly who we are and the spaces that we exist in and just do the thing. So
Tiffany(50:45):
This is wonderful. We're definitely gonna have you come back to both talk about group practice life leaving that it's a hard choice to make. And then also this next phase speaking running retreats, actually investing in learning about these other parts of yourself and your professional identity. We're gonna have you back, I know that there are folks who would love to work with you or watch you talk or come to your retreat to learn more about what you do. Where can folks find you? How can folks get in touch with you to learn more or work with you?
Marcuetta(51:13):
I would say just visit one of my two websites. So you can either go to dr marta sims.com or worth wisdom wellness.com and all of my contact information is on both of those. Do not message me on Instagram. I barely check my inbox. And so you would be Sally disappointed that I probably won't respond for a month or five.
Tiffany(51:33):
. I love that you don't check your Instagram. They is. And gentlemen, folks, do not contact Myta on Instagram 'cause you will not hear back. Marcuetta, thank you so much for coming and sharing your story. I'm excited to have you back. We're gonna have you back soon, I hope. And folks, if you've been inspired by what Marcuetta said by your journey. If you're somebody who's thinking about group practice, or maybe you're in group practice and feeling like, uhoh, maybe I shouldn't make this choice. I encourage you. I don't know if you do strategy sessions or consultations, but I encourage you to pay Marta for her experience, learn what that journey has been like. I guarantee you, she will have a thoughtful, kind, empathetic, and strategic plan and way of you help you think about the situation you're currently in. Marta, thank you.
Marcuetta(52:17):
You're welcome, Tiffany. Thank you, .
Outro (52:24):
All right. Whatever you're doing, I want you to pause. If you're driving, pull over. If you're chopping a carrot, put that knife away. If you're making sweet love to your woman, well, I mean, that's, that's, that's kind of flattering in a weird way. Huh. You can go, you can just go ahead and you can keep doing that. But for the rest of you, if you learn even just one thing of value today, please share this episode with even just one therapist who could benefit from the message. Here's how. If you're listening on iTunes, click on the episode and you'll see a small purple circle with three dots. Click on those dots and you're gonna see the option to share at the bottom of the list. Click that, and you can just go ahead and share it on Facebook, or you can even just text it to one therapist who you know needs to hear it. If you're listening on Stitcher, just tap the triangle icon on the upper right corner. It's next to the menu that displays your upcoming playlist. You'll see the option to share the episode you're currently listening to right on Facebook. Look, it's time to get the word out. We gotta spread the message. Thank you so much, and we'll join each other again soon.