How to Incorporate Independent Contractors

hiring practice management support Oct 12, 2023
 

One of the biggest issues that I see providers face when they open up their own membership practice is that they feel like they need to be everything to their patients, meaning they either need to be the one educating them with a pre-recorded series, or they need to offer weekly live office hours, seeing them every single month because patients are paying monthly. And what that may do is eventually lead to burnout for the provider. It also—I don't think—is as healthy for patients, because patients do well when there are other people involved. There are other perspectives, and there is other help out there that can help patients heal. 

At Origins Incubator, we give you the proper steps to onboard outside help and show you how to hire independent contractors. Today's blog just gives you a little taste of that process.

Independent Contractors

When you're first starting out, you may not have the funds or the capital to hire a nutritionist, hire a therapist, hire an athletic trainer, and hire all these people that may be helpful to involve in your membership model. So, a solution to that can be to hire wonderful independent contractors.

Keep in Mind

There are many things to be mindful of when you hire an independent contractor.  

Independent contractors set their own hours. You often do not have a say when it comes to telling them how to work, when to work, things like that. It's important to keep that in mind.

But with independent contractors, the beauty is that they get paid when services are rendered. You are not paying someone to work 9-5, daily. Rather, you will pay for the exact time and/or service provided. 

Choosing Independent Contractors

In my practice, we have a health coach and nutritionist, as well as a therapist included in the membership model, and they are independently contracted. I say to my patients, “You know, in my experience, patients did well when they also had these visits. So, that's why it's built in. You can always choose to not see them if you wish.” But that is just a boundary that I set, because I need to be able to outsource certain things that are either out of my scope of expertise, or I just need that kind of support. I don't have time to go through a nutrition plan line-by-line with somebody, or I don't have time to go through the personal care products and tell them which ones are not good for them, which ones are estrogen mimickers, etc. That's why I choose to have these independent contractors built in. 

Setting Up Independent Contractors

How do I set this up?  For my health coach, my membership includes three visits with a health coach throughout the year. It can work well if the patient sees the health coach in between each appointment with you. When I first started my practice, I saw the patient five times throughout the year, alternating between the health coach and myself. But as I got down the road, we moved to three appointments with the health coach, and then I had one 90-minute appointment with the therapist. When you work with me in the Incubator, we discuss which course of action is best for your practice. 

Let's look at a specific example...say I will see the patient and say the patient had some gut issues where a low FODMAP diet trial is recommended. I will give the patient initial resources explaining to them why. I am in charge of the theory: why I'm recommending this diet, why I think it's important, how I think it may impact him or her, certain things that he or she may feel, if it's working or not working, et cetera, et cetera. And then I will say to the patient, “I would like you to set up an appointment with our nutritionist, so you can go through the logistics of it and really understand how to implement it, going through the plan line-by-line.” So, I will set up an appointment with our nutritionist at the end of my appointment with the patient. 

Nutritionist

How that works from the independent contractor standpoint is our nutritionist will give us her availability a month out. So, by June 1st, I need July's availability. Then either my assistant or myself will say to the patient, “Okay, we need to set you up with a nutritionist,” pull up that nutritionist’s schedule, and that patient will be placed into it based on the nutritionist’s availability. If my nutritionist is on vacation for a week out of the month, or she is blocking days for holidays or personal things, that's fine. She's just giving us her availability, her schedule. We would put this patient in for an hour of that time. At the end of every month, the nutritionist will then invoice me.  Because the nutritionist is an independent contractor, she has her own business or own entity. She bills me an invoice, and she might say, “You know, I saw 10 patients this month, 10 appointments.” I would cross check to make sure that that was true on my end as well. And then I'd pay her for that time. That's how we set it up. 

The beauty of this is that you can set that up from day one, because you will have included the price for the independent contractors into your membership model, so that you are already collecting that money for them. And then you're going to go ahead and give it to them as those services are rendered. I do not recommend paying them ahead of time. They get paid once they see the patient. 

Therapist

Now with a therapist, when somebody is typically in therapy, the therapist might see the patient weekly or every other week. I cannot assume how much somebody might need that kind of service. So how I typically work it out is including one 90-minute appointment with a therapist at any point throughout that 12-month membership. What I have typically found is around six, seven, or eight months, sometimes my patients will either start bringing up things from their past that need to be processed, or as they're developing this healing healthy lifestyle, they start to notice toxicities within their relationships to self or relationships to other people, what have you, things that are outside of my specialty, needing a mental health therapist to help them work through that. I keep that therapy appointment as “kind of in my back pocket.” When these things start to come up, I say, “You know, now it'd be a really great time to discuss this with our therapist.” And then they will have that 90-minute appointment together from there if they decide. The therapist might say, “No, it’s an initial consult, not an official therapy appointment.” They will then discuss the patient's issues together. If it is time for that patient to embark on that journey with the therapist, then they will decide that together and the patient will pay the therapist directly, going on from there. 

Recommendations

At Incubator, this is generally what we recommend to the physicians that we work with. We do work with each physician individually, and we get very specific with each. Below are just some general principles.

  • You serve as a connector. 
  • You identify needs and help connect to patients to whom they need to be connected with. 
  • You do not have to solve all their problems and be the “be-all and end-all for them.” 
  • Everything does not need to be included, because if it does, your membership prices will just keep growing, and that can be difficult. 

This gives the patient the ability to say, “Okay, I understand I need therapy, but it's not urgent. I'll do that in a few months.” You're helping connect the dots for them a little bit. 

Conclusion

That is a gist of how I recommend incorporating those independent contractors into your membership business. You do not have to go into debt, paying for services and things when your business hasn't really grown to that point yet. Please reach out to us anytime for more guidance with this and all matters concerning your practice. 

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