It’s all about Behavioral Health – Stan Monroe of Carolina Partners

Stan Monroe, President of Carolina Partners in Mental HealthCare

Stan Monroe, the President of Carolina Partners in Mental HealthCare, grew his company’s revenue from $8.5m in 2014 to $13.8m in 2017, a 63% increase, and now they’re on track to hit $15m in 2018.  

Carolina Partners provides mental health services throughout North Carolina with 37 locations.  

In this interview with Eversprint‘s Malcolm Lui, Stan shares how he and his team accelerated their high value sales by:   

  • Executing their business plan successfully across all fronts, from opening new branches to hiring clinicians to marketing to generate referrals and new patients.  
  • Marketing across a diverse array of channels, including internet, radio, print, direct mail and physical liaisons.  Internet marketing is their biggest single source of new patients.  
  • Developing their tele-health service to patients who are home bound, a segment with attractive long term growth prospects.  
  • Taking advantage of their scale (they are now one of the largest providers in the US) to expand into other states.  

Carolina Partners Interview - (computer generated transcript) (transcribed by Sonix)

Download the "Carolina Partners Interview - (computer generated transcript)" audio file directly from here. It was automatically transcribed by Sonix.ai below:

Malcolm Lui: Welcome to the High Value Sales Show of Eversprint.com. I'm Malcolm Lui, the Managing Member of Eversprint, and today we're speaking with Stan Monroe, the President of Carolina Partners in Mental Health Care, a fast growing provider of mental health services with 37 locations throughout North Carolina. Welcome to the call Stan.

Stan Monroe: Thank you. Glad to be here.

Malcolm Lui: Stan, you grew your company's revenue from $8.5 million in 2014 to $13.8 million in 2017 a 63% increase. And now you're on track to hit about $15 million in 2018. To get to where you are today, what's the one thing your team had to consistently execute over the past few years?

Executing everything right over the past few years was key to the success.

Stan Monroe: Well the short answer is everything right. Because

Malcolm Lui: Okay

Stan Monroe: For a company for companies to be growing it has to execute on its core business pretty flawlessly. Business is difficult. And to keep revenues ahead of expenses is very difficult. So the answer to that would be to have a business plan. You know we had we had a business plan for it for expansion and we paid rapt attention to it and focused like a laser beam on it. And that's how we did it.

Malcolm Lui: Okay. So t Sheriff me maybe you know how many how many locations you had back in 2014 if you recall that

Stan Monroe: I don't buy it. But I can estimate that we probably had about 20 something 22 to

Malcolm Lui: Okay.

Stan Monroe: Go that

Malcolm Lui: And way back in 2014 and ended early this year the metric that makes sense. How many how many patients that you have and the clients that you have. How would I measure that in terms of the number of people who your firm has helped

Stan Monroe: Well I mean right now we're doing 13 14000 patient encounters a month. So about one hundred and what's that about 170000 accounts a year. I think that that's about 30 thousand unique patients. Is that true per year. No it's about 15 unique new patients a year and then and then existing patients from former years that have continued their their treatment

Malcolm Lui: Look at. Yep. And this is in 2018

Stan Monroe: There.

Malcolm Lui: Right now

Stan Monroe: Again that's 2018. So in

Malcolm Lui: Okay.

Stan Monroe: 2014 you just you just operate.

Malcolm Lui: Right

Stan Monroe: You don't. That was was 60 percent less.

Malcolm Lui: Right. OK. So can you maybe share how your company was able to increase the number of patients that you've been able to help.

Stan Monroe: Well we've been you know we've been in business 24 years. So there's nothing fast about about our growth in that 24 year period. We were able to out distance our competition by quite a bit and over a long period of time you know since we started 1994 and by 2004 we were way out in front of our competition for a variety of reasons. So it's an enviable position for a business to be in to essentially not have a lot of competition or at least no no competition that's concentrated in a single or two or two competitors. So we were able to to to to increase our market share basically just by by breathing. Right. So we were just we were marketing more than our competition. We are doing more outreach than our competition. And if you put time and effort and money into those things you're going to gain market share as long as your goods and services are are good.

Malcolm Lui: Now can you share in what ways that Carolina partners is different from the competition such at such that you say that you don't have competition that you have a blue ocean in front of you.

Stan Monroe: Yeah I mean it's somewhat market particular being in our patients psychiatry it's traditionally and still is a very fragmented market mostly consisting of companies with two three four you know a big company in our niches is 10 or 12 or 15 providers. So we've got one hundred and thirty five providers. So we're just you know there's no comparison between us and these other guys. What the question how did we do that

Malcolm Lui: Or just just questions is how what set yourself apart such that you know in your mind you don't really see yourself having much competition and one of

Stan Monroe: Now.

Malcolm Lui: It's the scale

Stan Monroe: Well

Malcolm Lui: Right. You have a lot more providers

Scale is everything. More resouces, more connections, better contracts.

Stan Monroe: Yes escape yes scales scales the big one right. I mean scale is everything. We have more resources and more connections and where we're able to to make better contracts because of where we're providing accessibility to care to more people. So size was the single biggest one mission is the other one. Right. We've been very focused since our inception very very mission focused on providing patient care and in order to do that you sometimes have to make sacrifices as a business our particular sacrifice was accepting insurance you know basically all major insurance plans and the insurance discounting that goes with that. So we we accepted a lower price in return and made a high volume play and in return for for four more patients

Malcolm Lui: Right. In hindsight now do you wish you were to start over again with what you know today would you have gone a different route and maybe not accept insurance

Stan Monroe: No. No. That that's that's why we we just we're able to sell 60 percent of our company. This last September when we closed. And the reason that we got that we got a private equity investor interested in us is because of our ability to influence so-called population health in other words we have a real shot at and claim to be able to influence the health of lots and lots of people. And so in the nature of big data when we can keep track of all this and sort of prove that we're making people healthier it makes us very valuable to all the big stakeholders in healthcare. Hospitals governments things like that. So no I would I would I would double down. I would have I would have done more of it.

Malcolm Lui: So a sacrifice in some ways but also the right move as well as to fuel the growth and for you where you are today.

Stan Monroe: Well I mean when I say sacrifices because we were accepting a lower price right. So

Malcolm Lui: He

Stan Monroe: When you know when we do we don't have basically control over our prices very very well because insurance companies and Medicare and Medicaid are setting our prices.

Malcolm Lui: Right.

Stan Monroe: So in return we had to be hyper focused on efficiency and get really good at being a business. Now that was a good discipline to be to become good at you know where the margins were higher than you can be a little bit sloppy and not worry so much about expenses. And and that's not going to you know you never scale with that business model.

Malcolm Lui: Right. OK. And in terms of finding new patients you mentioned doing some marketing to find new patients. Can you share what the marketing programs that you had executed to to grow your patient base

Stan Monroe: Sure. Yeah sure. I mean it's multi private. We we do anything and everything. So you know we started back in the day we were doing print advertising that's all there really was. They branched out into doing radio advertising both on public radio and commercial radio. And then

Malcolm Lui: Okay.

Stan Monroe: In the Internet age of course we're doing all kinds of Internet advertising we're doing direct mail or doing outreach. We have a we have a physical liaison operatives you know kind of like farm reps that are going around and talking to referral sources. So it's one of the things that we are able to do because of our relative size and scale. So we can throw more resources at the marketing component to do anything and everything

Malcolm Lui: Ok. Now who are you marketing to exactly. Who's your who's your your customer avatar that you're focusing on

Three customer avatars

Stan Monroe: Well is different. That's a good that's a good question. There are different groups of stakeholders. One is the consumer right. The patients the way to get to them is to market directly to them or to market what we find is that a lot of people into our system because they're being asked to by a third party like a spouse or a parent or an employer. So we do some marketing to these third parties and then half of our referrals come from the medical community in other words are being referred by primary care doctors or hospitals. We do a lot of marketing to that cohort for poor patients. And then we do a lot of we've got to around here it's all behavioral health man. So you know since everybody has their real health challenges and princes depression is the single biggest cause of loss of production in the American workplace. We do direct to employer marketing for corporate wellness programs that we might have or you name it we could basically throw your line in the water. You know when you're when you're selling health services you throw your line in the water and there's going to be somebody there to bite at it.

Malcolm Lui: Right. So of the of the three segments you mentioned to me the director the consumer the patient's direct to the medical community for referrals and direct to employers for marketing. Which of these three segments has been the best source of new business for you.

Stan Monroe: It's evenly split between the medical community referral sources and pay direct marketing to patients and their caregivers. Their you know their support systems

Malcolm Lui: For the direct

Stan Monroe: Evidence

Malcolm Lui: Marketing to the patients and their and their support systems and what channels have you found to be most effective their

Stan Monroe: Let's see. Well now it's all FCO it's changed I mean I've been in business for 24 years it's changed markedly over that period of time right now. By far the biggest single source of patients are these are you know setting up funnels on the Internet and bringing people into landing pages on the Web site to Internet advertising.

Malcolm Lui: Ok. And how are you generating the traffic. Are you using paid advertising means is it through ACL getting them that way organically. Is it through email marketing or something different.

Stan Monroe: We're not doing a lot of email marketing but everything else. Anything anything you could you can think of

Malcolm Lui: Okay.

Stan Monroe: All the above

Malcolm Lui: How about half right. Is there any particular channel that really stands out as one that you've been that you could invest more in because you're just getting a fantastic RSI from it.

Stan Monroe: You know you know the the the route the referrals are remarkably well distributed among no referrals medical community referral sources we've got thousands and thousands of referrals sources that we've built up over the years. But I think our top referral source is giving us about non hospital referral sources giving us about 15 a week. Right. So that's not that many from one person. So it's remarkably well distributed. No no one thing is working. Yes. We have to do everything

Malcolm Lui: Mm hmm. Okay. It's nice having a

Stan Monroe: We

Malcolm Lui: Lot

Stan Monroe: Need

Malcolm Lui: Of different

Stan Monroe: A lot

Malcolm Lui: Channels.

Stan Monroe: Of patients. I mean we had to fill up a huge footprint here. So so we had we cast a wide net.

Malcolm Lui: Yeah. So from a patient relationship perspective how long do you help them. Typically

Stan Monroe: Well that's all over the board too depending on the illness and the patient.

Malcolm Lui: He

Stan Monroe: But I believe our average length of stay for therapy patient is about is between six and 10 visits and the medication patients are measured more and can he here is because basically once they stabilize they just come in once every couple of months or once a quarter and so they'll they'll stay for four years for basically maintenance therapy.

Malcolm Lui: Ok now is it hard to get them to come back. I mean do you need to send them reminders to bring them in regularly. Is it easy for people to just

Stan Monroe: We

Malcolm Lui: Not

Stan Monroe: Do

Malcolm Lui: Keep appointments right.

Big in tele-health now.

Stan Monroe: Here we go. We do all that stuff. I center reminders we used to call them. Now we use an automated you know texting and emailing service. We do that. We've got a 92 percent show rate. So one thing I would say is that the people who are walking through our doors really need our services and are highly motivated to to come in and access them more than you would think because you know you you think of let's say a depressed patient is being very very difficult for them to get in the car and drive to an office park and get into your office. But they seem to manage because I think the alternative is so is so terrible you know that they're suffering in their lives and they need they need to alleviate that suffering. We're also big into telehealth now that's just two or three years old. So one thing we do is if somebody can't come in or doesn't want to his or is homebound for some reason and we've got a solution now it's you know telehealth

Malcolm Lui: Yeah I know how my insurance carrier offered that too is quite nice. I can make an appointment for me to do speak with a doctor. Right so if I had some small issue. Right. You know if I bruise my toe or something I don't need to make an appointment go in. I can set up a call and then I can talk a doctor in a couple hours. I found to be fantastically helpful

Stan Monroe: Oh yeah. And in behavioral health it's the the outcomes data is showing that that being treated the telehealth is is basically just as good the outcomes are just as good as if you're in a bricks and mortars. Bricks and mortar office. So we're we're really gratified by by how successful it's been and when we're thinking that this is going to fuel a lot of our future growth.

Malcolm Lui: Does that mean that you might slow down your opening at new locations and build up your telehealth practice

Stan Monroe: Not yet. Ultimately it all comes down to our footprint. That's why get the bricks and mortar stores are still why we have such high value in the marketplace. However I see over a period of years telehealth making inroads on that just hasn't happened yet. So yeah we have not had to make that decision yet.

Malcolm Lui: Now in terms of a normal regular business. My general business perspective right. Ways to grow your business would be getting new customers in your case new patients and then another way to grow your business is retention. And it sounds like your retention rates are really high from what you shared. So far right

Stan Monroe: Well there are industry standard anyway. Yeah.

Malcolm Lui: Okay. And then I guess the third way to grow your business would be perhaps to

Stan Monroe: And

Malcolm Lui: Somehow do more business with them do more transactions with them in the healthcare industry in the segment that you're in. Is that an opportunity or are there ways to provide more services to your patients.

Stan Monroe: That's a great question. Yes is the answer.

Malcolm Lui: Okay

Stan Monroe: Our slogan as I pointed out is it's all behavioral health now. So every every person that we touch needs a universe of services. As do we all by my theory is that all human beings you know from the time we wake up until the time we go to sleep or managing our own mental states write our own anxieties our worries tired are our real illnesses for some of us. So there's there's endless opportunities here to to touch patients multiple times all and in my business we've got this great synergy right. How many businesses can you say that the more you get to the more you sell to one of our patients the more you more services that you convince them to to access and pay for the better off they are and the better off the businesses. So we've got this great parallel synergy going on with the patients. Yeah we pay a lot of attention to trying to make sure that once and once we once a patient is in our system that they're accessing all the care that they need.

Malcolm Lui: Right now does the insurance become a limiting factor as to what they're able to engage with you on in terms of additional services.

Stan Monroe: Depending on the service. Absolutely it's a factor. One of the one of the reasons that this is a growth industry is because of insurance. You know a lot of people are anti insurance I'm very positive. I am very pro charts because it simply because it makes the services affordable to the typical consumer. Now is there a perfect record. No. For instance we are offering a transcranial magnetic stimulation now or so-called M.S. which has been shown to be extremely effective for depression treatment. It's a very intensive six week program of you come in and you sit in a chair and there's a helmet to put on your head and then it shoots magnetic pulses into your brain and it's just it's wild stuff super effective. Well it took the insurance industry at least 10 years to get used to it and to start really paying for it. Now they are paying for it now but 18 months ago insurance wouldn't pay for it or they'd fight like like like hell you know they'd pay for it but only if you had peer to peer between your medical tractor and their medical director you know submitted a letter they just made it very difficult to access the service so insurance is always a third player in a lot of our interactions with the patients and we're always thinking about insurance.

Malcolm Lui: Okay. So what you see are the opportunities going forward and in your segment that either can one positive trends that can help your business grow and at the same time maybe on the flip side some negative trends that you want to position your company to avoid.

Behavioral health care is now being integrated into the health care system.

Stan Monroe: Luckily it's mostly positive. It's a big reason why the PE firm is interested in us because of the very rosy upside to being into health right now and that's because society has finally gotten around to figuring out that it's all behavioral health. We've known it forever but now society has done a lot of testing clinical testing and academic tests about the positive effects of integrating behavioral health care into the rest of the medical continuum and the results are fantastic. If you integrate behavioral health into everything else then the American health care system which by the way as you know probably is the single largest industry in America. Three point seven trillion annual spend simply by integrating better by health care in in just one place with chronic disease management. So the management of diabetes COPD hypertension and obesity that the entire system could save up to I believe it's one hundred twelve billion dollars so that is starting to get very interested in behavior health right now right. Because the there's almost a revolution in American health care revolution that's been right. And the reason that there's a revolution is because it cost too much right. Not only does it cost too much. It also doesn't work right. They're paying a huge amount of money by world standards by any standards and not getting very good outcomes. Right. Terrible. You know we we we can't let that go on. Employers are enduring double digit increases in their insurance premiums every year. I mean what other expensive businesses like you know our health insurance plan for our employees is our second biggest line item after after the labor cost itself. So intelligence is one reason why the huge employers like Wal-Mart and Amazon you know they're they're they're devising schemes to go around the insurance industry and and put together their own medical networks.

Malcolm Lui: Any

Stan Monroe: And that's why it's too expensive. So it's to size it doesn't work. So there's a revolution in order to succeed in their revolution. They have figured out and proven by now that the overall health care has a very very important place in that formula. So everybody is really interested in what we have to offer right now. Albeit they don't exactly know exactly how to do it. So so one of the things that we have to do it's incumbent on us is to develop the way in which the health care is going to integrate with everything else at present it's sort of as a favor complete two to an insurer or two or two a government and say you know we know this stuff works. You don't have to worry about it we got this. And so

Malcolm Lui: Eddie

Stan Monroe: That's basically what we're doing now where

Malcolm Lui: Right.

Stan Monroe: We're working on those platforms

Malcolm Lui: So you him just now but

Stan Monroe: As

Malcolm Lui: Yes sir.

Stan Monroe: Well go ahead. Well you asked about negative stuff too.

Malcolm Lui: Oh yes

Stan Monroe: You know the negative stuff about behavioral health and so it's always been the poor cousin of medicine. Right. So relatively low cost. As a consequence. There's a there's a pretty big shortage of psychiatrists out there. So 1 1 1 significant bottleneck is that you know where we're competing for a psychiatrist with you know with all the big hospitals around here but that that's really the only side it's hard to find enough people to do the services.

Malcolm Lui: Right. I imagine with the growth in telehealth that might help a little bit. Right. You can find a psychiatrist all over the nation needs to do that segment of the business

Stan Monroe: Yeah yeah yeah. We're not we're not despairing or anything and we are good people you know plenty of people through the door but the fuel and we were talking about you know one hundred percent per year growth targets for the next three years so that's a lot of new recruits. So

Malcolm Lui: Right. And actually I have two questions now. First let me follow up on your conversation. What you mentioned before about how the bigger companies like the Wal-Mart of the world are coming up with their own alternative insurance program right. Because the traditional insurance is just getting

Stan Monroe: Right.

Malcolm Lui: So expensive now. Will you be able to work within those programs as well for your company.

Stan Monroe: Yeah absolutely we were already doing a lot of that. You know where we have our footprint. We are essentially the only outpatient behavioral health asset set for the CEOs. We're doing some risk based contracting that nobody else can handle. And the big deal is there is a big move to so-called value based payment systems from insurance companies. That's all based on value right. Well the thing when you talk about value is how do you measure it. And it looks like you can't really measure a value in health care without resort to behavioral health. Right. If you're no matter what kind of medical discipline you're you're going to for services when they ask you how it's going. One of your answers is going to be well I feel better or I have more functionality now than my my broken leg has been set and now I can go for my walk. And you know behavioral health is such an essential component of outcomes measures. They can't do value based payment without it. So that's a really big opportunity for the future for us.

Malcolm Lui: Ok great. In terms of opportunities in the future this year you're on track to do a hit about 15 million in revenues. What's your target for next year in 2019

Stan Monroe: Twenty five million is the official target

Malcolm Lui: Ok. And what's

Stan Monroe: But I

Malcolm Lui: The

Stan Monroe: Think

Malcolm Lui: Plan

Stan Monroe: We're going to exceed that

Malcolm Lui: Awesome and what's the plan to go from 15 million to 25 million in one year

Their plan to grow from $15m in 2018 to $25m 2019.

Stan Monroe: Recruit a bunch people put him in put him in offices fill them up with patients. We there's a pretty simple business plan for that. For that part of it we're lucky because there is almost as far as we can tell as far as we can measure there is an unlimited consumer demand for our services. So what business wouldn't kill for that. Right. So all we really have to do is find the providers the clinicians that's not so easy because we're competing now. We're not really competing with the small private practices but we're going head to head with the big hospital systems around here

Malcolm Lui: Okay

Stan Monroe: For psychiatrists and they're really you know they have lots of resources but so that's a bottleneck. But as long as we can recruit people will rent or buy properties stick them in those rooms. So in other patients

Malcolm Lui: Ok

Stan Monroe: Just as we can.

Malcolm Lui: So opening new locations is fairly easy then right. Relatively speaking.

Stan Monroe: Well it's simple conceptually yes.

Malcolm Lui: Because it don't sell like you have a huge amount of equipment necessary for each location.

Stan Monroe: Yeah exactly where we're also lacking behavioral health that it's you know we don't need a lot of big fancy equipment although there's more and more of that in every aspect of medicine. But know relatively we don't need much of that we are office space needs. That's that's relatively simple too. So it's conceptually simple you know as always it's always complicated and there's always a ramp period rides a lot of money upfront and then you have to when you stick a provider in a room it's not like they're busy the next day you've got a two or three month ramp up period during which you have to pay your providers even though they're not bringing in enough revenue to cover their costs and by a while. So it has to be carefully managed. But with our new resources we've got a bunch of you know we've got the private equity money. We we afford it. And so we're going to go as fast as possible.

Malcolm Lui: Right. Can you elaborate on how you're going about finding psychiatrist to join your team.

The hiring side of their growth plan.

Stan Monroe: Well it's a core competency for us. So we have an internal recruiting department and which is which is a very smoothly operating we've been doing it a long time. We do basically in marketing for the so-called active candidate that is people who are actively looking for jobs it is the biggest source now is indeed dot com you know with a little backup from Zip recruiter and a few of the other online sites. So we do a lot of advertising there. Plus we are contracted with tons of recruiters who work on a contingency and a couple who are different different payment alternative but basically recruiters and indeed

Malcolm Lui: Ok so you use the existing platforms that are out there. You don't do perhaps direct marketing to psychiatrist and you've created your own funnel of sorts to get people to raise their hand as a radical or more about career opportunities at at Carolina partners like you

Stan Monroe: Yeah

Malcolm Lui: The

Stan Monroe: We do all that too. Yeah we sponsor career we do our own career events and career fairs and co-sponsor pharmaceutical dinners to direct mail to direct e mail. No stone is left unturned. But the the the assets are so rare that we get the biggest bang for our buck from from active candidates coming to us through to basically indeed dot.com right now

Malcolm Lui: Right now. The the rule of thumb though is that the best candidates are the ones that aren't looking for a job right. Right. I

Stan Monroe: Guess.

Malcolm Lui: Mean is that

Stan Monroe: Yeah well sure. Are you sure your first question is you know if you're so great why do you why don't you have a job. Some of them say well I'm moving here from California which is fair enough

Malcolm Lui: Right

Stan Monroe: But yeah for a local candidate that's that that's one of the first questions we ask. So we do have it. So we are thinking about those so-called passive candidates. You know people who are not necessarily looking for jobs but if they knew about us they might be interested.

Malcolm Lui: Right.

Stan Monroe: That's just a longer. That's a longer term play right there's general marketing. It's actually why I'm on the phone with you right general marketing positioning some of our executive and top clinicians as thought leaders doing interviews getting the word out there in a lot of general marketing just not targeted but just general out there marketing TV commercials that kind of thing about you know it's great to be in behavioral health and we're the best at it. So you know. But not a direct sales pitch

Malcolm Lui: Yeah. So what's your wish for you to go from 50 million to 25 many. How many more psychiatrist you need to hire to do that.

Stan Monroe: Not as many as you would think we need to do we need to to net out another 50 clinicians but only six to eight of them need to be psychiatrists none of them can be. We hire plays and nurse practitioners are supervised by physicians here.

Malcolm Lui: Ok

Stan Monroe: It also appears D level psychologists and Master's level therapists. So we are recruiting target isn't really to medication providers. They can be psychiatrists or mid levels and three therapists per month net per month for 2019.

Malcolm Lui: In my net you mean to the people leading your firm. You make sure you replace them. And yet in the show 2 or 3

Stan Monroe: Well net of attrition right. So

Malcolm Lui: Okay

Stan Monroe: You know where we are you know in a business that treats that about 20 percent. So we have to figure that in and then go positive above that.

Malcolm Lui: Right. Okay. And has it have your programs as your recruiting team and all the work that you're doing it has been hitting those targets consistently or is it. Are you finding it difficult challenge

Stan Monroe: Well like I said we only closed in September right. Since September we have hit that hit that hit our target. Yes.

Malcolm Lui: Like awesome

Stan Monroe: So we're we're feeling good about that one

Malcolm Lui: Yeah. Another maybe is not a bottleneck or not. I mean I can terrify with you. You said I when you open opening a new branch you know fairly relatively easy in the scheme of things although there are a lot of details to it but keeping it out in the open the new branch and you have conditions there right. You don't have like a line of patients ready to go in right away. Right. How

Stan Monroe: Well

Malcolm Lui: Do you ramp up that flow for the for the new outlets the new branches

Stan Monroe: Depends where it is right. So. So when we open new practices in our existing markets then it goes much faster because we've got you know we've got a 500 person waiting list and we can just fill up people really really fast when we open in new markets even inside of North Carolina right. New Market. Then it can take. Yeah. Would you have to do a lot of advance work it's expensive you have to do a lot of advanced work. So when we're scouting for the real estate and upsetting and figuring all that stuff out while simultaneously going to the insurance companies you know all the referral sources in the area medical community referral sources and starting up that marketing campaign in that area. And if you do all those things effectively you can still get you know within it within six months you can you can have a pretty well functioning practice in a new location but six months is very expensive right to carry a practice for six months.

Malcolm Lui: Yeah

Stan Monroe: But then from there there afterwards it's good.

Malcolm Lui: Right.

Stan Monroe: You need to grow you need. You need to be capitalized. That's why we went out of capital markets last year because we saw that we could not meet our our scaling. You know we we we we fueled our growth with with cash flow and debt. You know for 24 years

Malcolm Lui: Right.

Capitalizing on their size

Stan Monroe: But we saw that if we really want to achieve what we want to achieve. You know we we are the largest private outpatient payroll health practice in the United States right now. So we want to capitalize on that position that market position quickly and that's going to be very very expensive right to get across state lines and establish a regional presence and then try to roll out a chain of clinics maybe even beyond the region in three to five years. So we we saw clearly that that our choices were to go find some money or to scale back our ambitions.

Malcolm Lui: Right. Yeah. And there's opportunity costs right. You don't want. You don't want a competitor to come in and who is better capitalized and goes on an acquisition and acquisition spree and all of a sudden you're no longer the biggest in the nation right.

Stan Monroe: Exactly we've got a couple like that and they would they might even claim that they're the biggest in the nation. It's so you know I've actually backed up on that and I've been saying we're among the top two or three of the nation

Malcolm Lui: Yeah

Stan Monroe: Because here's a couple of ivy campus. Now what I would say about that is that they're highly capitalized. They've been able to throw cash at you know in some states and gather up some psychiatrist to work for them but they're not a fully integrated business right. They don't have a real brand mission focus know a lot of stuff that we have. So I'm saying that even if they're bigger we're still better.

Malcolm Lui: Yeah yeah. Exactly. Two last questions where you stand. Who

Stan Monroe: Sure.

Malcolm Lui: Are you're up. Who are your ideal patients and what's the best way for them to get in touch with you and your team

Their ideal patients

Stan Monroe: Well it's I'll be a real help. We're we're not doing Medicaid right now in our core market. So there's certain kind of there's a certain insurance requirement there. But other than that and we are we are looking for ways to get back into into the public sector gracefully. It wasn't really our fault that we're not doing that. So is our ideal patient is anybody who who needs us. And it's so universal. It's all behavioral health everybody has issues. 60 million Americans suffer from depression in any given year 60 million so far as we can tell. The the aggregate consumer demand is there's no limit to it now. An estimated only only 25 percent of the people who need treatment for mental health problems are receiving that treatment. So that's the that's sobering and also an upside right. Sobering because you know we have to go and knock down some walls that are getting the keeping those people out of out of care. But also it adds to the upside because if we figure that out then there's you know a market that's four times as big as the current one that's already kind of overwhelming our assets. So our our favourite patient is anybody who needs us. Come on in and we'll help the way that they're accessing us is multipronged again. We've got to you know they can come through our website they can sell schedule to our telehealth platform. They can come into a telephone intake services they can walk in although they don't do that very often send us a letter you know email one of our executives you know know somebody who is either been a patient or works here they're there they're coming in from every year driving from miles away and they're coming into every avenue

Malcolm Lui: For those who are listening to the podcast. What is the Web site the best Web site for them to go to to reach out to your team.

Stan Monroe: Carolyn partners dot com.

Malcolm Lui: Okay great. Fantastic thanks for joining us today Stan in sharing how you accelerated your company's high value sales.

Stan Monroe: It was my pleasure Malcolm. Keep up the good work. Anything else you need from me. You know where I am.

Malcolm Lui: All right. I definitely will reach out to you when I when I do need something from you guys but hopefully not for the behavioral health side of things.

Stan Monroe: Hey you and everybody else. Don't worry about it.

Malcolm Lui: We've been speaking with Stan Monroe the president of Carolina Partners and mental health care about his company's rapid growth for interviews with other fast growing high value sales companies or to learn how we can accelerate your firm's high value sales through automation. Is it ever Sprint dot com.

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