EP 56 | Nurture Your Private Practice: Expand the Circle of Care (part 1)

Annie: Well, hey there, Leah.

Leah: Hey, Annie, how are you?

Annie: It has been so long since we recorded together. It's been the whole summer, we really took our promise to take a hiatus seriously.

Leah: Absolutely. I'm glad we did. It felt good to have some space and we got to come up with some great new ideas and really get creative. I'm super excited about this next season of our podcast.

Annie: Me too. We're kicking it off with nurture your private practice, expand the circle of care. So this hiatus that both of us took was really about nurturing our private practices in our business. I know both of us did do some fun stuff, including hanging out at your pool in Houston. That was the highlight of the summer for me and my family, we had such a fun time being together in person. It was amazing.

Leah: I know. That was so fun. It was just, after all that's gone on in the last year and a half, it was a dream come true that we were finally actually able to be in person together and our families together, which was even more fun. I'm so glad you guys made it down to Houston.

Annie: Me too. Originally we were like, oh yeah, we'll record a podcast while I'm there but we were like, actually, we're just gonna float in the pool and sit in the hot tub and not do any work and just hang out and that was great. It really was. So before we get into our topic for this episode, nurture your private practice, expand the circle of care, just wanting to let you know that registration is open for Clinical Complexities in Private Practice, which is 30 hours of clinical trainings, all focused on implementation for private practice. Leah is actually one of the speakers. She's doing these case studies of all of these things that she's seen in her private practice, where it's all the unicorns, it's all the stuff where they're like, it'll never be that, but for Leah, it is that and so she's got pictures and she's got stories. I'm super excited for that one. Leah and I are also going to be doing two deeper dives as part of this clinical track. Deeper dive into nurturing your business and deeper dive into clinical complexities in November and December. So anyone who registers for Clinical Complexities in Private Practice will get access to those deeper dives. Early bird pricing is currently available through the middle of November so you get a discount and you get to hang out with us. You get all these amazing clinical trainings and you can go to paperlesslactation.com/course to learn more about that. So let's dive into our episode today.

Leah: Yeah, I'm really excited about this topic because I think it is such an evolution of discovering this concept of nurturing your private practice and how that actually really serves your clients so well but it didn't start out like that. I think both of us didn't start out with a business mindset. I know I didn't. I was so excited about just the opportunity to help more families because I was so helped by somebody who knew a little bit more than me about lactation. I was just in the mindset purely of how can I help more families, that's all I care about. I just love lactation. I love the journey I had. I want to give back. I want to know everything I could possibly know about lactation so that I can help another family. Never on my mind was like, wow, I'm gonna be this amazing entrepreneur building this business. I just did not have a business mindset when I started out. So the way I came to it just wasn't from a business perspective at all, but boy has that developed over the years. How about for you, Annie? I think you and I had a very similar journey in that.

Annie: Very similar and I was like, you mean I can help people with their babies, just like my lactation consultant, Kathy Watson Jenna, helped me. Just kind of feeling that really deep desire to make a difference in the world and do something that helped other people and make money I was like, okay, I could get paid to do this. If I become an IBCLC I can charge money for this. That was kind of all I really thought about. I wasn't really thinking, it wasn't like I sat down and was like, okay, here's my 10-year plan, here's my 20-year plan, and here's my business plan. It begins with me becoming an IBCLC and it ends with total world domination. Yeah, that was not how this worked. It was more I could do that, I would love to do that and geeking out on all of the clinical stuff that I was learning in my training and just being so in love with all of the science and physiology and immunology.

Leah: It's interesting how I kind of stepped my toes into the pool of the business world. I'll tell you it's kind of a funny story. So at the time, my original business partner and I had studied for the exam together and we would meet at this coffee shop every week. We had a little schedule to study for our exam. So every single week, we were super dedicated, I mean, the stacks of notecards we created were astronomical, because we were every single week on the clock, we would each like, you have new note cards to drill the other person. Then we took the exam and we're like, what do we do now? We literally kind of were like, do you want to start a business or something? Literally, that was what are we gonna do now. We got to keep meeting because we were having so much fun meeting. We were like, okay, let's do that. It was so like we were starting a babysitting club or something like, yeah, let's do that. So we're like, okay, let's meet next week because we already finished the exam. So we're like, well, let's meet next week and we'll look at businessy stuff and I felt like I was 12 in creating my first babysitting club business or something like that. It was so cute because we literally had to totally shift gears from all this science and everything. We were like, well, let's look at what would we have to do to be officially a business. Then our meetings evolved and we met every week again from the time and the way they do it, you got to wait those three months to get your exam results. So we kept meeting and every week we were like, okay, well, let's dig into what would this look like. I had to really shift out of all this sciency stuff and realize like, oh my gosh, to do this for real, you got to think about all these other things. That was so eye-opening because it was certainly not anything on my radar up to the day I took the test. I wasn't even thinking about that.

Annie: I mean, you can't really while you're studying for that test and you and I both took the test again this spring for our 10 year recertification. I was like, I don't know how to help you right now. I would be sitting with a client and I would be like, that is so fascinating because did you know, then I would drop random facts that I was trying to memorize for this exam which I would never go down this rabbit hole any other time in a console except for right now. So you can't think about anything else. For me, sounds like your previous partner took a really more thought out approach to it where you were like, okay, but this is a business and we have to do X, Y, and Z. The place that I was in my life at the time as I was going through a major kind of life and career transition, I had been working towards one thing, which I thought I was going to become a big time screenwriter, movie producer. I had some jobs and each one I thought I was like now this is it, Hollywood is going to start calling., my ship is going to come in. My career never really took off as a screenwriter. Then I was like, okay, I have nothing right now. I don't have this job. Now I have a baby. I can't even fathom the work that it takes to pursue a career in screenwriting with a baby and I know people do it. But for me, it was like how am I going to leave my baby behind to fly to Los Angeles, do pitch meetings. My husband works in film production so that we also have to find the money for childcare because he can't take off work for me to do this plus pay for it. We have no money because I have no screenwriting job. So I was in this kind of death spiral of like anything is better than what I have right now. I could either go negative and blow out our whole financial future trying to pursue this dream that I'm no longer in love with in the way that I was before I had kids or I could follow this path where I'm like, this is meaningful work, this is babies. I was helped so much and let me start by figuring out how at the very least, I can make it so that I'm contributing something to the household income. I was very fortunate in terms of our financial situation at the time because my husband was killing himself working 18 hour days on film sets so we could get by on one salary, one income family. My goal was just not to take away from that. But I wasn't really thinking at the beginning about how it could be an actual business. I was like, let me just figure out how to do this. So a lot of you know the kind of main things that you need to be a business owner which is having your set policies and procedures and knowing how to comply with all the HIPAA and stuff and actually having a plan to be profitable. Those were not on my radar. When I first started out, I was like, let me just do the bare minimum to be a private practice lactation consultant, and there also wasn't a lot of guidance out there 10 years ago either, one book that was like, well, maybe nobody will ever make money at this, but it's still fun. I was like, okay, I guess I picked a glorified hobby and never really sat right with me.

Leah: Yeah, yeah, I agree. I know, people were out there doing it, but it definitely wasn't in the circles of lactation. I feel like the ones that were there at the time, 10 years ago, it just wasn't really a conversation that people were having, like, what are you doing with your private practice? How are you building it? What's happening? It was just not a conversation, not these wonderful conversations you and I have, hence the reason why we do what we do. It was really when I went into it at the time, I was a stay-at-home mom kind of doing some odd jobs here and there. I worked in some business-to-business sales stuff, but I again was similar to you, like, was fortunate in the sense that I didn't have to, I needed to contribute, but I didn't have this huge financial burden behind it. I really hadn't even thought about the money aspect. I was more like, well, let me make sure the legal stuff is taken care of properly because I'm a rule follower, that was kind of what was on my mind first, but even HIPAA stuff, I feel like 10 years ago, we knew, okay, we've got to have general privacy stuff, but to the level that I understand now, nobody was talking about that in private practice 10 years ago. It's been such an evolution. It's been such an evolution but I think when we started out, we might have had this nice little business plan and everything, and we did our steps. We made our LLC and took care of the rule following but we jumped headfirst into the pool of people and just gave all we were just like, I will do whatever anybody asks me to do because I am here to help all the world and I will sacrifice anything at the cost of being available for all the people at all the times because I guess in my mind, that was just kind of what you did as a lactation consultant. Nobody had ever talked to me about having a boundary around this because La Leche League, I know that's where you came from too Annie, and I feel that was pretty boundaryless. I remember talking, being on the phone with moms like 10pm at night, nursing my own kiddo trying to talk a mom through something because it was just a mom talking to a mom. It just felt so do whatever you got to do whenever. I just kind of drew that right into my private practice, and just put everybody first. Kind of then it was like, okay, well, my business is set up. Here I go full force into doing the work. I don't know if that was the right mode that I would recommend for everybody because it definitely made it to where I had some really hard lessons along the way of like, oh my gosh, if you're going to run a business, you can't just be serving your clients, you have to also run a business and that was a hard lesson.

Annie: Totally the same for me. I had no idea what I was supposed to do. I think I had this idea that like, okay, they're going to come to me, they're going to have problems, and then I'm going to help them until they don't need my help anymore. That's what they're paying me for because I was also just starting out, I really felt like I need to make sure that people really feel like I help them. I couldn't think of any way to do that other than to just have no boundaries. Like you were saying I can remember and definitely agree about La Leche League. It was like when they called you answered, that was that. Whatever time they need your help, and really, really feeling all these things are so urgent, and not really having a healthy sense of that respect for myself as a person in this. I mean, I didn't have a lot of confidence in my clinical skills either and so it was kind of like well, let me under-promise and over-deliver, which is sort of how I operate in a lot of ways and starting to realize maybe that's not the best, it's all complicated. It feels really selfish. I mean, because it feels like first of all, it feels like great to help other people. When you're like that feels good, what's wrong about that, that feels like the most virtuous step to take is the step that puts the other person first. It also feels really selfish to be like, well, I have to put myself first above somebody who needs me. That's really hard for me. The way I've been socialized and conditioned and I don't know my therapist certainly has thoughts about why I'm like that, but I really do like to see their needs as more important than mine as a clinician, like it's about you. And there's that goal centered care and I want to work and meet you where you are but at the end of the day, I'm like whatever you need is more important than what I need in the moment when you need me.

Leah: I think the work we do feels urgent. I mean, you're thinking about a baby getting fed. I mean, that feels like, you can't put that off for weeks be like, oh, I can see you in three weeks. Sorry, you feel like your baby might not be eating. The thought of that or like, oh my gosh, your nipples are cracked and bleeding, just feels so urgent because I've been in that situation before. I know how horrible it felt. So it just felt right to always say like, oh my gosh, I will drop all the things and come rush to your doorstep, even if it's 8pm. Because I can't imagine leaving you hanging by any means. You know what I mean? I think our work just leads us to that sense of urgency and it really is a unique piece of our work. I don't know that there's other because we don't really have a safety net, a doctor can be like, hey, if it's that urgent go to the ER. It doesn't feel like that would be the same, oh, your nipples are bleeding,well, if it's that urgent go to the ER. What is the ER gonna do for bleeding nipples? They're gonna be like, okay, don't breastfeed, you know what I mean?

Annie: Then they do say stuff like that, oh, we want them to get the right information. We really want to protect them from the harm that could be done to them. When they get the wrong information. It's hard.

Leah: It is a really hard situation to be in for sure. But I think we come back to like, well, what are the things that we tell our clients when they're feeling so overwhelmed? Everything's so urgent, and they're like, I can't get to all my kids, everybody's crying at me and pulling at me. What do I do? You got to put your oxygen mask on first before you can help anybody else because without you, you can't help anybody. I remember that. We tell that to our clients all the time. But from this perspective of thinking about that, in being the business person who is feeling like, oh my gosh, all these urgent cases are pulling at us and what do I do? What do I do? We don't turn that advice to us. Why is that? Things we need to dig into with our therapists, right?

Annie: For real. I'm thinking I'm actually digging really deep into it because in the clinical complexities track that I talked about earlier, I'm developing a one hour, I don't know, if I talk as long as I usually talk about things that may even be more than an hour, I haven't recorded it yet or it's going to be one of the live sessions for ELPAC. That's going to go into some of the research behind why this happens to people in helping professions. Why kind of, in a nutshell, and we don't really have time in this episode to dig that deep into it and that's why we're going to have a deeper dive so that we can really go deep into it and I can bring even more of this research. There's more that's not even going to fit in the presentation that I'm writing. I'm finding so much stuff as I'm really delving into this, is that the problem is self-care. But the concept, the very concept of self-care is a harmful concept. I think any of us working with families understand that, it's ridiculous to tell a new parent, oh, just make sure you take care of yourself. What does that, bubble baths and chocolate in fuzzy socks. That's what our culture says it's gonna fix it all but you're like, ah, that's a bandaid or that's hard. I can't do that. I don't have time for that self-care. Somebody needs to be taking care of me. And you and I both really benefited from the deeper dive we did with Jabina Coleman, the lactation therapist, because her whole message is everybody wants to hold the baby who will hold the mother, and that this is a variation on that concept. First of all, number one, she's absolutely right about what new families need. Then if we look at it, we say like, okay, well, what about us? What about our businesses? Are we taking care of our businesses,

Leah: From the same perspective, I like that, it's like, every lactation consultant wants to help all the mamas, but who's helping us? Who's taking care of us and it's kind of that same concept is our focus is so on helping all the families, but oftentimes that leaves ourselves or our business, truly in a hard place where it's not getting the care and attention that it needs.

Annie: Definitely. That's where that whole idea of a circle comes into play is, first of all, you start out your business, there's a lot of work you need to put into it at the outset. But the goal is to create a business that is going to take care of you and that's the circle. That's the start of the circle. It's that movement. It's like I'm putting into my business because what I put into my business, my business is going to give back to me. My business is going to take care of me, it's going to take care of me financially, it's going to take care of me reputationally, it's going to take care of my need for intellectual stimulation and my need to be creative and my need to have meaning in the world. My business is going to do that for me. It also needs to then sustain itself without effort from us. When we do that for ourselves, we take that circle and we say now I'm sustained I'm nurtured by my business. Now I have what I need to nurture these families and then I can really show them, I can really believe when I talked to them, yes, you need to build this circle of care for yourselves. I'm here to help you do that. I'm the beginning of your circle of care for your new family. I'm going to help your pediatrician be part of the circle of care. I'm going to help your OB be a part of the circle of care. Those family members that want to come visit, I'm going to teach you how to talk to them so they can be in your circle of care because you don't have to take care of yourself. You need to be taken care of. That's sort of where I go with stuff because it's just a big hug. I'm gonna make my business hug me, that give lactation hugs to my clients and they can hug their babies, and then their families are hugging them and I just picture this big cuddle pile.

Leah: It's interesting because kind of one of the things I picture when I see that is if you drop a rock in the center of a lake you know the ripples come out in circles and it's like one just goes to the next and goes to the next and you see the circle gets bigger and bigger and bigger, it's this ripple effect. By nurturing our business, we're going to have this ripple effect that's just going to keep going out and keep going out and reach further and further out into the world to the universe but I gotta tell you coming into this concept took a lot of evolution. For us, because you hear where we started out we didn't start out with this idea this awareness of how this could actually be. I love that you really came up with this concept because I think this concept was hard earned. Being in the trenches and doing it all kind of backward and maybe not in a healthy way in the beginning and learning the hard way through burnout and exhaustion like, oh my gosh, if I'm gonna keep this up there has to be a better way. It was like burned in the fires that we started thinking, or you too, to come up with this concept but I know we've talked about it a million times is like it was through all this trial and error, trial and error, burnout, burnout, exhaustion, about to throw the towel in, no I love this job too much keep tracking on figure this out, there has to be a way, hill climbing this treacherous mountain, that we came to these ideas of like wait there has to be a way. I love that you've come up with this really almost a visual concept around it so that we can really help other people get this so that you guys don't have to be burned in the fires of burnout and treachery and have to go through all that to figure it out. It's been 10 years for Annie and I in this business, in this world. I feel there's, last couple years, have we actually gotten to this moment of like, wait a second there’s another way.

Annie: It's been in talking with each other. There's a reason this podcast always needed to be a conversation, it was never not going to be a conversation. That's how you and I've always approached it. In the deeper dives that we developed, their conversations like we need to talk about this stuff. So if you want to join a deeper dive into nurturing your private practice and expanding the circle of care, it's inside Clinical Complexities for Private Practice. Registration is open now at paperlesslactation.com/course. In the next episode coming out in two weeks, Leah and I are going to really build out this idea of the circle of care and take a look at what does that actually look like in clinical practice and in the work we do with families. So thank you so much for being here today and Leah it's amazing as always to talk with you.

Leah: And I’m so happy to be back together. I love these conversations. They just fill me with so much excitement and I feel on fire for our businesses and sharing these ideas. I can't wait to have this conversation just grow and talk to more of you guys about this. So jump on those deeper dives. I can't wait to get to chat with you all.

Annie: Me too. All right, bye, Leah. Bye, everybody.