67 | Bouncing Back when Life Issues Impact your Private Practice

Annie: Well, hey there, Leah.

Leah: Hey, Annie, good to see you again. How are you?

Annie: I'm how I always them just hitting the ground running at the start of the week. How about you?

Leah: The same here, just ready to tackle all the lists of things that need to happen and remembering that I'm only one person. I can only do so much. So I'm just gonna take it one step at a time over here.

Annie: Totally, I've been in a morass of dealing with insurance related stuff, which is why it was so great to have that deeper dive with Rebecca a few weeks ago, and just really think about it. Hopefully, we're going to be able to create some more space for those kinds of questions about the business side of things because the insurance stuff affects your money and we've got to figure it all out. That's why I'm also excited that our next deeper dive is coming up on April 27th and it's with Shondra Mattos, IBCLC. She's got a lot of great insights about business strategy and marketing and SEO and website design. We are putting together a great program, we are planning to apply for SERP for it. So that is coming up on April 27th at four o'clock Eastern, one o'clock Pacific, and you can register for that just by going to lactationbusinesscoaching.com and you will see a registration link on that page.

Leah: I'm really excited about that one as well. It's just like one of the many hats we wear as private practice owners. We have to keep our attention on all these different things so these deeper dives are so nice because they're like after I leave them, I'm like, okay, I wore that hat today. Now I have my list of things to do when I'm wearing that hat and then I'm like, okay, next hat marketing, okay, put that hat on, remind myself of all the things I need to focus on. It really does help me so much to just put on those hats. Sometimes we just shove them in the back of the closet and we're like, I can't wear that out right now. I love having these moments to refocus, learn new things, and add in new strategies, and systems that help us not make mistakes, all the things. So I'm excited about that, too. But today we're going to be talking about when life kind of knocks you down. You might have personal issues going on. You might have a pandemic. You might have things that are outside of our control. There's so many things that can impact our ability to run our business that might be outside of our control or events, health concerns, things that are really slowing us or making us have a full stop in our private practice. It's something we really need to consider because when you hit the ground running like we always do, we think, oh, everything is gonna be just like this forever. Annie and I have realized, I've had some huge life events that literally took me out of practice for a while. I've also had a bunch of small stuff just overwhelm or burnout, where I'm like, recognizing, oh my gosh, I need to figure this out. Have you experienced that, Annie, I know you have, but tell me how you feel about it. Those things that have happened, that have kind of pushed us back from running our businesses.

Annie: I mean that's been the story of my year so far this year and 2022 because I started the year by getting COVID like so many other people. That really knocked me out, not just the part where I was sick because I did get sick. I didn't have the COVID where it was like I tested positive, but I was fine. I was like no, I was sick in bed. Then I had some lingering fatigue and brain fog issues that have thankfully gone away. But I've also in addition to that, I've been dealing with some major tooth and gum work and had to have a procedure on my foot, which my doctors like don't walk on it for a month. It's just been a lot of interruptions and a lot of uncertainty. Then a lot of playing catch up around it and so when we were thinking about preparing for this episode, I was looking over the notes that you put together. I was like, how much of this stuff do I feel like I know is a good idea and how much of it have I actually done. Present Annie doesn't have a lot to thank past Annie for so far in the first couple months of 2022. I really was flying on like just it'll be fine and you know what? It's okay when it's not fine, but you do have to prepare for it.

Leah: Yeah, definitely. I mean, the major one that I learned the most from, we always learn from things that happen lives, my son, when he was 13 and a half, had a bike accident. He had a skull fracture and a brain bleed from it. It was a Saturday afternoon and had a full week of clients coming and then I was out for six weeks because he was in the hospital. Then he had to go through rehabilitation and oh my gosh, did that put a huge impact on my business. I was completely unprepared for that, had no, nothing, other than, like, thank God for the other lactation consultants in Houston, I was able to just refer everybody out. But I wasn't able to do that. I had to pass all that off to my admin at the time and other people to say, like, because I was in the PICU with my son. I couldn't be dealing with client issues or their referrals. I think the number one thing I learned from that is to have some kind of policy and procedure so if something tragic happens, one of my other LCs had a child that got really bad sick and was in the ICU, and it was similar, we had to just jump in and figure out okay, what's the plan? I think having some kind of awareness of like, what would you do. You hate to think those terrible things might happen in your life but what would you do, okay, this is going to be the process, and write it down somewhere. That way, you can say, hey, just look in this policy and procedures manual, it says what to do, like, go. Then you can step completely away because when it's your kid or your family member or somebody that you care about or yourself, you can't then be rescheduling clients or talking to them. It's like you need to be all in where you're needed. So I think that was something that I learned from that moment, is we were unprepared with some kind of process.

Annie: I think one of those policies that you can come up with, to your point earlier, Leah, about being so grateful for your community of local lactation consultants, is having that list of people to refer to when you need to. Sometimes you're going to be able to plan ahead and be like, okay, I'm having foot surgery, and so I'm gonna need to stay off, not work for a week, or whatever it is, or just be virtual. But there's other things like what happened with your son, where it's like, life changed instantly, and your family becomes your immediate priority. So being able to kind of pull the trigger on like, I have eight clients booked this week and I can't see any of them, being able to send off that message to be like, I've had a family emergency but please contact this person, or being able to pull them into your practice and just say, help. I can't even take these over, I can't even send these texts.

Leah: That's one of the many benefits of talking to the other LCs in your area, being familiar with them, and having each other's back, I think is so invaluable. Then don't forget, I know, a lot of LCs that have prior practices, we've heard them on deeper dives and stuff tell us like, hey, I'm the only person in my area, what would I do? Don't forget now, I mean, we have the blessing of there's hundreds and hundreds of LCs that provide virtual support. So don't forget to know about those LCs. You might be just making some notes and connections with lactation practices that have virtual options for across the world, they'll do virtual options. Those are great resources when you are in an area where maybe you're the only LC and just to know about them, like you think, oh, I'll never have to use that but like, just in case. Just know who they are, have a list, get their contact information, make that connection so you have that, but I also know that like m, who I don't even remember who it was, I think it was the person who helps us we plan our retirement and everything that's who it was, she was like, do you have disability insurance? I'm like, never crossed my mind. Have you looked into disability or FMLA insurance for your private practice?

Annie: I don't have FMLA insurance, but I have disability insurance. I have worker's compensation for myself so there is coverage. I have had disability insurance since even before I had a lactation private practice just like in my life. It was all the other jobs I've done.

Leah: I hadn't thought about it but of course now I'm like, oh yes, please do all that. I'm realizing like, oh my gosh, there are so many things that can take you out for sure. But in the times where you're like, have you had an instance where you did like oh my gosh, I gotta reschedule people like when you had COVID? What steps did you take? What was kind of like looking back on the process when it does happen when those things do happen?

Annie: There's like the moment of panic, where you're like, what am I going to do? I tend to just freeze when I'm panicked, or I'll freeze and then instantly be like, I just need to do something. So I'll do the first thing that comes into my mind, which is often an overreaction to the situation. So don't be like me.

Leah: We're learning from our mistakes.

Annie: I think just starting with I've had a family emergency, and I'm going to have to reschedule you. Then I would immediately reach out to one of the people I know who serves that area and be like, I have a family emergency and I need to transfer all my clients to somebody else. Can you help me? I think what's hard to imagine for me is the part where I wouldn't have to handle all of that. I have an admin who helps and now I have an independent contractor who's with me, and so I think they could step in. They could step in, but if it was just me, I don't know, you would have to be like, at somebody's bedside texting people, and the trick would be to just really make them go away. Do you know what I mean?

Leah: Yeah, I think that's where I think about my Spruce account, and how I have the auto phrases like to have stash down in those auto phrases like, I've had a family emergency, please contact these other lactation consultants, I will not be able to serve you at this time. I'm terribly sorry. I'll reach out when I'm available again. In that instance, with my son, it's just like your brain can't, I couldn't process anything. I could barely think straight. So if I was the one that had had to do that, I would need something predetermined language, predetermined people. I would not have even been able to think about who are the lactation consultants in Houston. I don't think my brain could have processed anything else. So just give the gift to yourself of just little things like that, like, what exactly am I going to say, if that were to happen. If something were to happen, and I was sick or family members sick, and I just like 100% cannot care for these people and they need to pass them off, what is going to be the first thing. It's going to be like, I just already have language, I can copy and paste. If you have somebody who is working with you, you could just hand it off. They already have the right language to use and you can say, okay, here, just take care of these people. But I also, like you said, our first thought is like, oh my gosh, might be I'm letting these people down. You might beat yourself up, like, I can't believe I'm having to do this to these poor people and they've been waiting for an appointment. Life happens, these things happen and we have to be very gentle with ourselves. I think sometimes what happens is maybe it's not a full stop, like these kinds of crazy things that we're talking about happening, like you needing a foot surgery or my son getting hurt. It could be something where you're burnt out or you're sick, or you're going to need to pull back. Maybe you have a child who is not deathly ill but has something going on for them that you need to pay more attention to, needs appointments, and things like that so you're going to need to pull back. I think that's where, I know Annie you're really good at this, is knowing, okay, what's the bare minimum amount of consults that I need to do at in a timeline to make sure I can sustain our life, pay my rent, and get food for my family. Knowing that I think really gives you some peace because you're like, okay, I don't have to push myself, once I hit my bare minimum, I'm going to refer out like. I'm not going to try to add an extra people or do any extra work. I can hold this boundary that I need to hold right now for myself, might be for you because you're feeling overwhelmed or it might be because somebody in your family or whoever needs you. Boundaries need to change. I think that's so valuable. I know you kind of process those numbers in your mind. I feel like I've heard you talk about that before.

Annie: Yeah, I think knowing the numbers is so important because when you're in private practice and you are a small business owner, you don't have sick days. You don't have personal days. You don't have vacation days. You don't have those kind of benefits unless you give them to yourself. So one approach would be to look at, here's what I need to maybe in a year and starting to divide, I want to make this much money. Okay, how much is that a month? How many consults in a month do I have to do to make that amount? Then you look and you say, okay, I want to give myself a week off in the winter holidays. I want to give myself a week off in the summertime. I want to make sure I've got these two weeks of sick days and personal days that I can just use and looking at how can you bank your consults? Like is it like, Okay, at this moment, I'm going to try to do more than feels comfortable that I like to do but I'm banking that against the day when I need to do less. It's really important to look at it that way. Another way to also look at things is to look in not in terms of how much money can I get in my bank account through doing consults, but thinking of it in terms of a business that has revenue that pays you a salary, and that can be an actual salary through payroll if you're an S-corp, which is what I am. What I do is that I get a monthly salary that is not based on how often I worked and to look at how you can structure your revenue streams to sustain your salary, so that you can keep getting paid even if you get sick. That was a very difficult shift for me to make I spent a long time looking at my business, more like an ATM than an actual business. I'm like, well, this is how much money came in so that means that's how much money I have. That means that you're going to be stuck in a real just paycheck to paycheck mindset. Listen, I have lived paycheck to paycheck, where I have overdrawn my bank account paying bills. That has happened to me in my life and I never want that to happen again. For me to look at that has been to focus on really recognizing that I'm trying to build a business that can take care of me not make money to pay my bills.

Leah: Yeah, I mean, I think that's such a good shift to have. Obviously, we can't be thinking about that too much in the middle of some crisis or event so having some awareness around those numbers and what is required, can give you peace of mind in the moment. You're already going to be stressed with something else some other life circumstance happening and we talk about like if past Annie can give future Annie this wonderful gift of like a tiny bit of peace of mind. I mean, I think that's where knowing about this financial aspects, knowing about the policy and procedures, if it's like a crisis situation, and then also maybe thinking through what are you able to delegate. It's not just clients that we have to think about, we manage a business. We have bookkeeping to think about, claims processing, invoicing clients, there's so many pieces to the back end of things that we might need to delegate if we're really having to pull back. We might need to think about what's the bare minimum I can do in this area of my business management that would keep us afloat while I'm dealing with this life crisis. You might just kind of think through that. You don't have to have, certainly it's always great to write things down in your policy and procedures book but I think it's very helpful to just kind of think through. I wish I could have gone back and give my gifts when my son had an accident, like, what was all that going to look like, and you hate to think about like I said, the worst things that could happen, but just kind of thinking through who would I delegate to? Who would I lean on? I think the other helpful thing is telling, if there's an event, having someone tell or you tell people that refer to you commonly, like, hey, I'm going to be out for a while so don't refer people to me, because then you're going to have less of those requests coming in, less pressure on you to figure out how to deal with those requests and making sure that they know, hey, this is going to be temporary, but I had a family emergency. I think that's really helpful too. I mean, that's kind of word of mouth happened in our town when my son was hurt and nobody then called me which was really nice. I think that was helpful and something to think about. But there's going to be a point where like, hey, you get through the crisis and like, okay, I'm ready to jump back in. I've gotten to the other side. I've gotten my life situated in a place where I'm ready to jump back in, what are some of the things that you did when you had issues like this where you've stepped back and jumped back, and what are some of the things that guided you or helped you?

Annie: I think going slowly and not overwhelm myself has been a big thing. So saying, okay, I'm going to rest my foot for a week but when I'm cleared to walk again, I'm not going to book myself five consults on my first day back. It's also okay for me to be like, book two consults home visits. I think that is the hardest thing because I think any unexpected break from work does give me income insecurity, just stress, and I'm like, okay, I'm ready to work and now I'm going to make up for lost time. You can't think that way because you'll make yourself worse.

Leah: And end up back where you started.

Annie: Exactly and really being this low measured approach does serve you best in the long run. You might think, like, I don't know if you think this way, but my brain wants to be like five consults equals this much money, but five consults under hurried, frantic, desperate conditions, where I'm driving myself to do them, means burnout, exhaustion, I'll just show up poorly. Those five might mean less down the road in the long run, whether it's me or because I'm getting bad reviews for being like, alright moving on. I'm a lactation factory over here. But saying like, okay, what would I do if I hadn't taken two weeks off? I would be seeing two home visits today and I would not be squeezing in a third because it will come. You need to take care of yourself. Hopefully, you've got that business that is taking care of you that you've put those things into place. You have an income cushion so the bills can get paid and you can dip into savings a little bit and look at repaying yourself over the long term, not in the immediate term.

Leah: Yeah, definitely. I know one thing that happened for me, I was out, I think a full six weeks, my brain was not anywhere near lactation. I was all in traumatic brain injury mode. I was learning everything I could trying to help my son, I pushed everything about a baby or breast out of my head for a solid six weeks, because I was all in his rehab and just working with him every day so that he could get better. So I also had to go slow getting back into the groove because I was totally out of the mindset. If I had to overwhelm myself with like, okay, I'm back, I'm gonna do as many visits as I could possibly do, I think, yeah, I would not have shown up as the best lactation consultant. I had to dip my toes back in the water and kind of get back in my groove, and going slowly was a gift to myself. It was hard, because I'm like, okay, I'm back, I got all these people that really want to see me but I was like, \no, I gotta take care of myself because, although my son was better, we still had a long road ahead of us. So it's like, if I go crazy and burn myself out ordo too much, it could all end up even worse and we'll be back in the same place. Then you got to let everybody know you're back too so making those connections back with your referral sources and other lactation consultants that you've been referring to, like, hey I'm back, I'm ready to do some visits. You might not do that right away, you might just slowly start letting those trickle in, as well as you kind of get back in gear and you're like, okay, I'm ready to take this back on. All those things you delegated, don't go too fast bringing them back into your life. Pick them up if you were able to delegate some things, pick them up as you can. I think that's really thoughtful too. I don't think I did that as well as I could have now looking back. you can always learn so much looking back. Any other lessons from your experiences where you've had these issues or life events that you think are like, okay, if I did it again, I would definitely do it like XYZ?

Annie: Yeah, I think that the being slower about and not working from a place of being frantic and trying to compensate for what has been lost by circumstance. But thinking about, okay, let me build this back. It doesn't have to be today. That definitely is something I can reflect on and say, basically because of COVID, it was COVID and planned time off at the holidays, but I didn't work for almost five weeks. I was too tired to do virtuals. I couldn't do home visits. At this point, by the time we're recording this which is at the end of March, I have made up for that. But I did it over the course of weeks, not immediately, and it's the kind of thing where when you're working with a family and they just had their tongue-tie release, and they want to know when is it going to be better? You're like, it just needs time. We do all the things too, of course, but there's that piece of it, where it's like, it will be different at some point and I can't tell you when that is. I know that you can't necessarily believe it but you see it over and over again that time really does help.

Leah: Yeah, I know, tinctures of time are like the hardest medicine to take. Except that this will be any better or different. I totally agree. I also had moments where I let the stress of like, oh my God is gonna ruin my business. Am I gonna be like, this is the end and I was willing to accept that obviously for my situation. I was like, okay, my son, if I lose my whole business, oh well. I'll figure something out. I hated that the stress of that would come into my head every once in a while when I had to turn somebody away. I'd be like, oh my God, what is the end? What if I'll never recover from this? I wish I could have been the little voice in my head to be like, you're going to be fine, your business is fine. You'll be able to build it back up, don't stress about this, don't give energy to this, give energy to what is in front of you and needs your attention right now. If I could go back to past Leah and whisper in her ear, let that go, that's not a thought we need to even chase down, everything's gonna be fine. Obviously, it is. It's like many, many years later, I think it's been eight years since that happened. Eight years later and look, hey, we're still growing strong, and everything's totally fine. Pass Leah at the moment was really wondering in moments so that would be my advice to you. If you're having something don't be afraid to take that time if you need it. If it's something mental health issues or overwhelm or burnout, it's so much more valuable to focus on what you need to be healthy and well or what your family might need to be healthy and well and in a good place. Then do your business, full throttle. So that's my reflection, lessons I've learned.

Annie: When something catastrophic happens in your life, your life isn't gonna be the same again, and you don't know where that journey is gonna take you. So anything you can do to stay in the moment, rest on what you have built up and the processes and procedures and policies and local network and support and all those things you've built around yourself. You could find your life completely changed and you're like, I now have a completely different life than I did six weeks ago. That life doesn't include being a lactation consultant and that's okay. If you're meant to have it come back, it's gonna come back. It might not be like, things being fine might not be like things get to be exactly how they were before this happened. It's going to be different. The things that you're feeling in this moment, you're not always going to be feeling them. You need to give yourself space and room to sit with them be present for this crisis that needs your attention. That's the best way you can take care of yourself.

Leah: Yes, so we are sending like so many hugs out to anybody out there that might be experiencing this right now because Annie and I both know how hard these times are when something has really shifted in your life and your business has to take a backseat. We hope that these tips and strategies and learning from all of our mistakes, which is Annie's and I's specialty. Don't do what we did. Here's what we learned. We're sharing that will help you kind of move through this and we send our love and hugs to you if you're going through a hard time right now. We know your business is going to be just fine or it's going to be just what it's supposed to be. Thank you so much, Annie, for chatting today about this. I think this is such a needed topic and conversation and I'm so happy that you were able to share your insights too.

Annie: Definitely. It was great talking to Leah.

Leah: All right, talk again soon. Bye.

Annie: Bye