Scale, Sell, or Stay: How to Know What’s Next for Your Practice

Aug 26

When the walls feel tighter than ever, that crossroads of deciding to scale, sell, or stay is real - and confusing.

In this episode, we unpack the deeply personal, strategic, and emotional decision every practice owner faces: whether to scale therapy, sell, or stay - and how aligned practice management can help you make the right call for your life and your business.

We share the truth about what happens when your practice feels too big to manage but too valuable to walk away from. We talk about what it means to evolve as a clinician-turned-CEO, how to lead with clarity instead of burnout, and how strong clinic practice management can shift the entire trajectory of your career.

In this episode, we explore:

Why “freedom” isn’t just about income or time - and how to know if your practice is helping or hurting both
The signs it's time to scale therapy, shift your model, or step away entirely - and how to trust yourself through the process
How poor practice management can make scaling impossible - and what changes when your systems finally match your growth
What we’ve learned from staying too long, scaling too fast, or selling too soon - and why we don’t believe in “one right answer”
How our therapist identities have evolved - and how being a CEO therapist doesn’t mean abandoning your clinical heart

Feeling stuck between craving growth and needing rest? You’re not alone - and you don’t have to decide blindly. Join us for an honest look at what’s possible when you scale therapy practices with intention, alignment, and just a little more permission to change your mind.

WATCH THE FULL VIDEO EPISODE HERE!

[00:00:11] Colleen Long: For me, it started to feel like the walls were closing in. I could see the writing on the wall. VC backed companies were paying top dollar because they weren't beholding the insurance. Sometimes they were the insurance companies, or at least in bed with them.

[00:00:25] Erika Bugaj: And that's the reality for so many practice owners. One day you look around and you realize you're not building freedom, you're building a cage. The question is, do you double down or do you walk away?

[00:00:37] Jennifer Politis: And what no one tells you in grad school is that scaling, selling, or even staying the course, those are all CEO decisions. They're emotional, financial, and deeply personal. If you don't stop to think about them, the system will make the choice for you.

[00:00:53] Colleen Long: So today we're unpacking the question. Every practice owner eventually faces, should I scale, sell, or stay? And how do you know which choice is the right one for your business, for your life, and your sanity?

[00:01:05] Colleen Long: what we're talking about today is scaling, staying, or selling. And I'm gonna talk at the end about the, the selling piece because I did recently just sell my practice.

[00:01:16] Colleen Long: Um, but I think, well this is kind of where we. All hope to get at some point is the scaling side of things. If we are a little bit of an entrepreneur or business owner, and at least when. I think about the people that listen to this podcast or that will listen to this podcast.

[00:01:37] Colleen Long: I'm thinking there's two types. There's gonna be people that are pure clinicians and they just see patients right now, and they're still maybe in that tra traditional model where they've got, you know, 25 patients a week or whatever. And maybe they're working for someone or they're not necessarily having to deal with all the admin aspects of practice and somebody else is taking care of that, but maybe they're thinking about going out on their own.

[00:02:01] Colleen Long: And then there are the people like us that own group practices. And I think maybe have this freedom practice in mind, at least I did when I was scaling mine, where I thought, well, I'll just have everybody else see clients and then I'll just manage the business side from them and I won't have to work as much.

[00:02:21] Colleen Long: And it ended up being. My Freedom practice ended up being more of a prison practice for me. So then you wanna talk about what it's like to not live in a, a prison and, and how you've scaled and uh, and um, just sort of where you've gone from there.

[00:02:39] Jennifer Politis: So I think scaling gets glorified in our field, but I think the truth is growth can either give you a lot of freedom or it can multiply your burnout. For me, I learned that the hard way. I opened multiple locations. We have three locations currently, and we added more therapists, and from the outside it looked like success and we were growing.

[00:03:00] Jennifer Politis: You know, our calls were increasing, but I think behind the scenes I was completely drowning because all it did is multiply my burnout. I was more stressed, had more payroll issues. Uh, you know, the emotional toll was just a lot for me and the constant pressure to kind of keep it all afloat. So for me, it wasn't freedom when I was scaling, it was really burnout multiplied.

[00:03:26] Jennifer Politis: And I think the thing practice owners, you know, so many practice owners believe the myth that scaling means more money and less work. First of all, as I have grown in scale, there has been a direct correlation of making less because you just have more expenses. So as you're scaling and growing. at least my experience, that was not the case.

[00:03:48] Jennifer Politis: And if your systems aren't strong and if your people aren't supported, growth just makes the cracks in your practice wider. So the more locations you have, I feel like it's just easier to kind of see where you need more help. I think if you think about it, if your business doubled tomorrow, would it give you freedom or would it just double your stress?

[00:04:08] Colleen Long: Mm.

[00:04:09] Jennifer Politis: You know, could your phones even handle, handle ringing off the hook if that even happened? So I think what I learned, and one thing that I want you to hear today is that scaling only works in the right order. And again, this is just my experience. It has to be systems first, people second, and growth third.

[00:04:30] Jennifer Politis: Now I did the opposite. I was focusing so heavily on the people and the therapists and all of that, and that order just did not work for me. Um, so I think that's my biggest takeaway, and I've had time to reflect on that over the last few years. When you get that order right, growth can finally give you freedom that you imagined.

[00:04:50] Jennifer Politis: So when I talk about scaling now, I don't mean chasing size for the sake of it. I mean intentional scaling, scaling only what's profitable, what's joyful, and what's sustainable. Sometimes people will ask me, what's one thing I wish someone told me before we first expanded to our second location? And honestly, it's a few things.

[00:05:11] Jennifer Politis: You know, again, first, I know I'm always saying this, but first is really truly you have to get your systems in place because if you don't expand until all of your systems can run without you. When I opened my second location, I thought more space equaled more success. But the truth was I hadn't even built out strong processes of what we were doing yet.

[00:05:34] Jennifer Politis: I had sticky notes on my desk, my laptop, my phone everywhere, my notepad. I had all the systems in my head. Um, I did not write everything down at that time, and even at the time, our scheduling system needed to be perfected. You know, we didn't have a CRM at the time. We just answered each call and email with no process, no way to track the data, right?

[00:05:58] Jennifer Politis: It was just like, it's also COD. Things were just kind of happening fast. So we were just kind of figuring it out as we went. But if my office manager was out sick or on vacation, it was me who jumped back into cover and to answer phones or to verify insurance. So the expansion didn't fix that issue. It just made the cracks impossible to ignore, and it magnified every weakness that we had in the business at the time.

[00:06:21] Colleen Long: Yeah. Yeah, I think that's, uh, something that people don't talk about enough. And Maureen Warbeck, she, uh, she's with the group practice Exchange and she really helped me during that phase where she was able to, and I don't know, maybe she adopt, adapted this from somebody else, but it was a model of when you get to about 40 clinicians or 40 employees, um.

[00:06:52] Colleen Long: That's when you sort of like, it's going like this, you know, it's going in this sort of upward trajectory. And then at 40 it really starts to just bottom out and you've got this flat line because the amount of capital and systems that need to be in place to make that work is a different level of growth.

[00:07:11] Colleen Long: And most people, most group practice owners, that's sort of the valley of death is where, uh, people go, oh, this isn't right, or This is too hard, this is not what I wanted. And they stop and they, and they sort of scaled back. So did you feel like that was your experience, that when you started to hit 40, that was when you started to feel the, the pain a little bit more and not as much output for what you were putting in?

[00:07:37] Jennifer Politis: right. So we have 25 therapists. So for me, I noticed a really big shift around 15 when we hit like, I wanna say 18 to 20 therapists. That's when like we're going here and then I feel like we flatlined at 20 for me. And again, maybe that's the area I'm in geographically and and whatnot. But, um, but I definitely felt that,

[00:08:01] Colleen Long: Yeah.

[00:08:01] Jennifer Politis: you know, because you're paying for more then you need more people to supervise.

[00:08:05] Jennifer Politis: You now need, you know, you have multiple locations, you need more oversight at each location.

[00:08:11] Colleen Long: Yeah. When you were scaling, was there something that you had successfully delegated out? I, I always hear the best CEOs just know how to hire really well. They hire people that are smarter than them in all the other areas that they know that their strengths aren't aligned. So were there certain people that maybe you put in charge of being the CFO or the COO or the marketer?

[00:08:38] Colleen Long: What things had you successfully hired out?

[00:08:41] Jennifer Politis: So at that time, I had a great, and she's still with me, office manager, so that was a fantastic hire and she definitely does all the billing and all the scheduling at that time. I had one that was kind of doing it all based on our numbers. And then I had someone that was starting to be, she was someone who had worked with us for a while as a therapist, and she was, I made her director of operations, so then she was taking that piece off my plate.

[00:09:07] Jennifer Politis: Um, but I didn't do this. I, in retrospect, I wish I did all this sooner. You know, and again, I know I'm, I'm kind of explaining in order, if I had the processes in place first, then I would know what I needed. So, you know, I, I kind of was learning as we all do on the fly of like, okay, well now I need this, so then I would hire for this.

[00:09:31] Jennifer Politis: Well, I was hiring before I had the process even in place. So then I would change it because, you know, a few months later I'm like, wait a second, we don't need someone at that location over overseeing. They're gonna go to all three locations. It doesn't make sense to have, you know, so it's like a learning process.

[00:09:48] Jennifer Politis: So. I think for me, the second piece with people is definitely the right people matter more than the right building. You know, I assumed if I had the space that the therapist would come and they did. And I have great, a great team, so I don't wanna, you know, say that I don't, I do. But hiring fast just to fill rooms definitely backfired at times for me.

[00:10:11] Jennifer Politis: You know, I remember hiring a therapist just to kind of fill the chair and within months they had poor boundaries. Cr, you know, created more fires than I could put out. So it's easy to think a warm body solves the problem, but the wrong fit will cost you so much more than an empty office. You know, the wrong hire can impact your work culture, which you work so hard to maintain, and you work so hard to, you know, make it a positive, loving, supportive environment and a wrong hire if they can't retain clients, you know, to be honest, they're like a ship with a hole in it.

[00:10:43] Jennifer Politis: It's just like, you know.

[00:10:45] Colleen Long: Mm-hmm.

[00:10:46] Erika Bugaj: true.

[00:10:46] Jennifer Politis: you know, I'm the first, I'm the first person to be like, it's all about the right fit, right? For the client and for the therapist. You know, I never want something to feel forced, but honestly, at the reality, you are a business owner. Like you need a therapist who has good retention and who can hold onto their clients.

[00:11:04] Jennifer Politis: So I've learned that, you know, there's been maybe some great therapists that I personally really liked and valued, but if they can't retain clients, you know, what are we doing here? So, and then I think, and then a third area that I think I, I, you know, if I could think back, is really looking at the money and the financials.

[00:11:26] Jennifer Politis: I mean, expansion eats cash before it makes cash. You know, the furniture alone, I remember spending like $34,000 on furniture for the new locations, putting it on, you know. A credit card and it didn't even include the, you know, decorations and the artwork. And we repurposed a lot of things from our initial, office space.

[00:11:47] Jennifer Politis: Meanwhile, I'm paying rent on therapy rooms that sat empty for months while the main office was like bursting at the seams. So I wish I had proper financial runway savings at the time instead of just thinking the new space is gonna pay for itself. It does eventually, you know, but it does take a lot of time

[00:12:07] Colleen Long: There's so much that comes up for me as you're saying that one is. That difference between execution and strategy. And I don't know about you, but for me, my strong suit was always the execution. Like we, we need another office building done, but the strategy or the rollout, so who's the first person that goes in that building and what does that look like on day one and how do we staff that and how do we make sure that we're balanced now between both buildings and who is going to repurpose the furniture?

[00:12:37] Colleen Long: Is that you at night, in the middle of session? You know? So what about that? Did you learn about yourself as a practice owner? Were you struggling more in that area of strategy of like, wait, I didn't even put a system in place. I've got a second building and I don't know how we're gonna get there.

[00:12:55] Jennifer Politis: Yeah. 'cause I'm like you, I, I am queen of momentum. You know, you give me a task. It is done early, you know, and so I'd be like, and I found joy and the creativity of like, we're opening a new location, you know, it's a new project for me. Let's run with it. So, but again, I did not have the strategy at the time.

[00:13:14] Jennifer Politis: You know, I didn't even think like, okay, where are we getting our leads from? Just like today, just networking in the community. There wasn't a full strategy involved at that time. So that is something that I have spent now a lot of my time and energy on, is learning those things since that's something I didn't know at the time.

[00:13:31] Colleen Long: Mm-hmm. I, and I remember, so my practice was a, a testing practice, so a little bit different than the traditional therapy model, but for years my focus was always on getting more psychologist. And our model is a newer model where, um, we use psychometrist to administer the testing. And that really was, you know, sort of how we scaled was.

[00:14:00] Colleen Long: Um, being able to leverage Psychometrist to expand in locations and put our psychologists essentially, where they couldn't be, you know, they couldn't be in four different places at the same time. Well, now they could because we, you know, CMS started to allow the use of psychometrist and it was only year seven, I wanna say that I realized the high value appointment was not the psychologist appointment, it was the psychometrist appointment.

[00:14:29] Colleen Long: That was the high value appointment. So I needed to be focusing on getting more psychometrist this whole time, not psychologist. They were my most expensive hire. And they were doing, you know, the intakes and the feedbacks. But the test administration itself, that's where the, you know, that four to five hour appointment came in.

[00:14:49] Colleen Long: And that's really what I think, um, scaled our business finally was. Having a more strategic systems based look on, well, what are your high value appointments? Just do more of that.

[00:15:02] Jennifer Politis: Yeah. And I think the fourth area for me that I wish I learned more about initially was just about leadership. You know, expansion demands, more leadership, not more therapy hours. At the, you know, at the time I tried, at the time I had a, a small caseload and I was doing that, managing, you know, the multiple locations, and it completely broke me.

[00:15:21] Jennifer Politis: I had no more time in my day. I was so overworked. And one day I realized my business can't function without me at all. If I took a sick day or I came in late, or, you know, if I would come back in, I just would come into a bigger pile of work. You know, no one was coming in and taking anything off my plate.

[00:15:41] Jennifer Politis: So if nobody could step in as me and pick up any slack, I was like, what am, what am I doing? What's the purpose of this? So for me, that was a big wake up call because I realized the expansion, isn't it? It isn't just a business move, it's an identity shift. Now I'm no longer a therapist. I have to step more into a CEO role.

[00:16:01] Jennifer Politis: Whether I'm ready for that or not, I have to just kind of embrace it and make changes. So if someone had told me all of that upfront, I probably would've ran away. Um, I would've slowed down and I would've just built a better foundation first and scaled more intentionally, because that's what I want other practice owners to know.

[00:16:23] Jennifer Politis: Growth can be beautiful, but only if you're ready to hold it, because if you're not ready to hold it, your business ends up holding you. And that's not why we became therapists. So scaling should give you some of your life back and it shouldn't take from it, you know? But scaling isn't the only path. You know.

[00:16:42] Jennifer Politis: Erica, I know you've run a group practice for over a decade, so why did you decide to stay, I guess, where you're at currently?

[00:16:51] Erika Bugaj: Well, I've had a couple of changes in the practice over time. One, I started off with contractors that were fully licensed and it was an e easier way to build and, um, it required less oversight from me with independently licensed folks. Uh, it was only just a few years ago now that I made a pivot to having W2 employees, which is a larger financial investment.

[00:17:20] Erika Bugaj: And, you know, it also broadened my horizons in the sense that I could hire graduate level or, you know, lgs, Ws lws, um, folks working on obtaining their license licensing hours for. Independent licensure. Um, so I think within the umbrella of my practice, there's been a few different iterations and, um, those changes have come slowly, but I think have been made a positive impact you, um, on the way we operate.

[00:17:58] Erika Bugaj: So in, in some ways it's a younger, newer practice for the model that I'm operating with now in other ways, we've been around for a while and I've been doing this for a while, if that makes sense.

[00:18:10] Jennifer Politis: Yeah. What year did you switch to W2?

[00:18:13] Erika Bugaj: Uh, we opened as a group practice in 2014, and I think I hired my first W2 in 2021. So, you know, it's been for almost five years of having employees now.

[00:18:30] Jennifer Politis: Yeah.

[00:18:30] Erika Bugaj: And I do think it works better as a business model, um, for, for us. Um, but it's definitely, I've had to do a lot of learning on my feet to grow this model as opposed to the old one.

[00:18:46] Jennifer Politis: I started as 10 99 as well and we changed in 2022, but it does, it completely kind of changes your whole business.

[00:18:53] Erika Bugaj: Yeah, it really does. It really does. I think, you know, while owning this practice, I had a second child, I went through a divorce, I, we survived COVID. Um, there's been a lot of changes in my personal life and adjustments and, you know, in, in therapy practice ownership circles, I hear lots of different types of stories, like folks whose partners, you know, co-own the business with them and help to manage it.

[00:19:27] Erika Bugaj: And you know, I think looking at capacity, it's kind of like working with clients. You know, each, group owner is going to have a particular capacity, like for what they have time for, what they have emotional, uh, bandwidth for to handle. And you know, my practice perhaps has grown a bit on the slower side, but it's because I've also been very devoted to my role as a mom and, you know, worked through some of my own personal challenges alongside owning the practice.

[00:20:04] Erika Bugaj: So I thought of this quote, I really like that. I often say to clients, and I think it's applicable to therapists and practice owners, which is don't compare your insides to other people's outsides.

[00:20:17] Colleen Long: Oh.

[00:20:18] Erika Bugaj: Ann Lamot. Well, I really like Anne Lamott, the writer, and that's what that quote is from her. And that's really been kind of a mantra for me in terms of owning this practice.

[00:20:32] Erika Bugaj: Like I'm moving at my own pace and speed and, you know, keeping in mind my own capacity for what I can handle. Uh, and that's mostly kept me in line.

[00:20:44] Colleen Long: Yeah. I think that's so true is you, you do have to put the blinders on when you're building your practice because you can't possibly compare yourself to someone else's outsides. It's, you know, you have no idea what their struggle is, what cross their battling that day. And you know, it's like, like when I think about your style versus Jen's style or my style, to me it seems very different.

[00:21:14] Colleen Long: But I think a great way to show that you don't have to be a one size fits all cookie cutter. Leader for it to scale, for it to grow and for it to be successful. To me, when I ask about your culture and you've had people that have stayed with you for a long time, really good retention, you've got this very relaxed approach of like, oh yeah, we'll do like bullying, or we go and we do the, you know, like, you have all these great things that you do with your people.

[00:21:45] Colleen Long: And it, it felt to me like that was really natural for you, Erica. And I'm not sure if that's true or not, but um, I could see Jen left me and being like, okay, we have 8.5 people. We need one more person in here for it to be successful. And for you, Erica, I could see you like meeting someone at a coffee shop and being like, do you wanna work for me?

[00:22:06] Colleen Long: And then them coming to work for you for like 15 years.

[00:22:09] Erika Bugaj: Oh, well, I mean, I do need accountability too in my work. So I have found that in having a coach and you know, some peers that I can talk to about my practice, uh, because yeah, with the approach you're describing that I may or may not have, everything could go off the rails pretty fast.

[00:22:30] Colleen Long: Mm-hmm. Yeah. But I also think that's what makes people want to work for you, right? It's like you have to be a leader, not just a manager. And there's a big difference between managing people and leading people. And not everyone has that unique ability to get people motivated enough to want to continue to work for them.

[00:22:54] Colleen Long: And I know we all say it's with them, but I think at the end of the day, you're working for someone, you know that, that there's a certain percentage of what you're taking in that that group is taking. And uh, I think that there is sort of a unique personality. That can leverage culture enough in this day and age that people are like, I know I could make more elsewhere, but I really, where else where to go?

[00:23:20] Colleen Long: Like, this is where my heart is.

[00:23:22] Jennifer Politis: Did you have other roles that you were in where you were maybe leading naturally? You know, in retrospect, like looking back.

[00:23:29] Erika Bugaj: maybe I, I guess, you know, I was a teacher, that was my very first position outta college. So leading classrooms of seven and eight year olds for a few years. Um, I did have the camp counselor role, you know, early on and, um, kind of youth leader type role early on in my life, and that's maybe what led me to social work.

[00:23:53] Erika Bugaj: I, I have invested in learning how to be a leader. I also have a best friend that is, has an MPA and is a manager by trade. So, um, I get a lot of helpful hints from her. Um, yeah. But in terms of leadership, it's been steady growth and a lot of inner work as well in order to balance the empath and people person aspect of who I am with having accountability and, you know, rules and guidelines.

[00:24:28] Erika Bugaj: Um. Another quote I like or something similar from Brene Brown is that, you know, having boundaries is kind. And so I try to extend kindness to my team by having boundaries and and expectations for them that that's, you know, something that's ever evolving. But, you know, I, I think I may have picked that up from, uh, Brene's leadership book, um, that I read some years ago.

[00:24:59] Erika Bugaj: But yeah, I mean, it's, it's kind of a conglomeration of factors I think that's made me who I am as a leader.

[00:25:08] Colleen Long: Yeah. And you hit on that piece that at least I struggled with when becoming a group practice owner, which was why would anyone wanna work for me? It felt strange. I had like a whole self-esteem issue I think I was dealing with. So it was hard for me to put boundaries or expectations out there. I think I was so shocked that anybody would wanna come work for me.

[00:25:34] Colleen Long: So that was the hardest thing I think for me is a little bit of an imposter syndrome of like, who is gonna, I've always felt like a 7-year-old in a 45 year old's body, you know? It's like, who's gonna listen to me? Uh, you know, alright. Kids we're all getting together, you know? I just didn't ever feel like a leader and I really struggled with that imposter syndrome with my people.

[00:25:58] Colleen Long: I mean, group meetings, I've said before, group, our all hands were like, the biggest nervous point for me was every, all these eyes looking at me like, where are we going? What are we doing? Are we, are we looking good this quarter? You know, that sort of thing. I was just like, why am I this person that's in here?

[00:26:15] Erika Bugaj: Yeah, there's definitely some imposter syndrome that comes along with the leadership role. I, I agree with that. I think particularly that can come up for women in leadership roles too. and, you know, something I've had to work through as well, so I relate to that.

[00:26:33] Colleen Long: Yeah, when I was in Vistage, and I highly recommend that for anybody that's a group practice owner that just feels sort of alone in scaling their practice. Vistage was really helpful because it's sort of like this group of other CEOs and they've got different programs and stuff, but I, I joined the, I think it was called like the Keyman group, and everybody had different businesses, right?

[00:26:58] Colleen Long: So this person could own, let's say a fire hydrant business, but they had the same pain points that you had. Everybody has the same people problems, the same growth problems, systems, problems, numbers, problems, and so. That was really helpful for me to see other people in these leadership roles that also struggled with imposter syndrome, that were just in there trying to figure it out every day.

[00:27:20] Colleen Long: It also became a, like resoundingly clear to me that there is a big difference between a CEO and an entrepreneur, and I started to feel much closer to that entrepreneur. That's where I identified versus the well, the well-heeled, CEO, the person that could be, you know, sort of like, I think of it like a person that would be a president.

[00:27:46] Colleen Long: You know, you're diplomatic, you're not gonna say anything wrong, you're not gonna offend anyone, and yet you're a culture builder and you can see the big picture and the vision and the strategy, and you enjoy that leadership piece. But you are also great at not just the execution, but the strategy. Do you feel like.

[00:28:05] Colleen Long: You've kind of got that finally, like you've hit your stride in that role. Either you, Erica or Jen.

[00:28:12] Jennifer Politis: I think it's still a work in progress for me. I think I'm, I'm in a better place, but I think that's an area that I'm always trying to excel and I'm always trying to learn

[00:28:21] Colleen Long: Yeah.

[00:28:22] Erika Bugaj: Are you talking about the CEO role or the entrepreneur role

[00:28:27] Colleen Long: Well, for me, the CEO role was something that I just realized, oh, that's why something feels off. Because I don't feel that my strengths are aligned with being someone that's very measured, well healed, sort of, um, thinks about things. You know, you, what, what's the saying? You measure twice. Cut once. That's how I picture a CEO to be is someone that's like, well, we'll see next quarter that's gonna work.

[00:28:58] Colleen Long: And meanwhile I was like up in the middle of the night like, guys, I've changed our entire EHR and frustrating everyone around me.

[00:29:07] Jennifer Politis: But I do think a CEO in our industry is very different than maybe, you know, somebody in a different type of industry. And I think now that I've coached many different practice owners, I think everyone has their own little, you know what a C, who A CEO is to them is a little bit different. You know, they take a little bit of their personality, how they like to run things.

[00:29:29] Jennifer Politis: Um, so I think there's a little wiggle room there.

[00:29:32] Colleen Long: Mm-hmm.

[00:29:36] Erika Bugaj: I don't think I've ever really identified with the CEO title. I've not used it. I think I call myself the owner of the practice at this point and do a lot of director type type, you know. Have director type roles. I mean, technically I suppose I am the CEO of this practice. Um, but something about that title feels a bit intimidating and maybe that's imposter syndrome at work.

[00:30:04] Erika Bugaj: Um, I do have a lot of ideas for business. Like I could see myself really enjoying just being part of a think tank or, you know. Somebody who generates ideas for businesses but doesn't necessarily execute them all. Um, I, I think that aligns with having a big vision. Like I have this big vision and it's taken work to kind of keep myself aligned with what I actually have capacity for, you know, resources for tools, you know, 'cause I can think really big and I can also, you know, in, in therapy we talk about falling in love with potential.

[00:30:47] Erika Bugaj: You know, um, people fall in love with potential a lot. And I think I could be enamored of the potential of my business, but not necessarily that doesn't help with dealing with the reality of it. So it's kind of a constant, uh, readjustment that I have to do to keep myself from trying to go beyond what the current.

[00:31:12] Erika Bugaj: Structure framework is

[00:31:14] Colleen Long: Yeah, I think about when you were making the decision to have more kids, like I remember I had my twins and my twins are boy girl. And I thought, okay, well I guess like this is it. Like that's really it all you need. You got one boy, one girl. You're good. You're all set. And I remember talking to my husband about, do we want a third and. For me, bigger was always better, more, more. But for him, less was more. And he had a really good or shift in perspective, which was like, if we have a third, we then are taking away that time and love from our other two because now we've got to manage our attention and divide our attention between third child.

[00:32:04] Colleen Long: And so that to me was like, oh yeah, that sometimes more is less, it's not. More is not always more. And of course we had our third, seven months later, so none of that mattered. But man plans that God laughs.

[00:32:22] Erika Bugaj: I've always heard once you have three, they outnumber you, and that's a point to consider. I just have two, but since I'm solo with them, they outnumber me, so I.

[00:32:35] Colleen Long: It's, uh, yeah, they, I think the basketball analogy is the zone defense. It's zone defense. You're just like kind of managing, but you no longer have the man on man.

[00:32:46] Jennifer Politis: Right,

[00:32:46] Colleen Long: Well, I really like hearing these stories and just, you know, how you guys approach this. And I really am hopeful for our listeners too, because I don't think it's a one size fits all, and I think someone could easily listen to me or they could listen to Jen or they could just listen to Erica in isolation and go, oh gosh, I'm not like that.

[00:33:09] Colleen Long: Like I know. I certainly would probably compare myself to you, Erica, and be like, man, that's the kind of person that keeps people around, you know? She thinks about it. She thinks about something before she just does something. I'm driving all my people nuts. So I'm glad that we have such diversity of experiences and approaches because I don't think that it's a one size fits all when you're scaling and growing.

[00:33:37] Colleen Long: Just like in any business, every leadership style is different. Um, you know, and I ultimately made the decision to sell. And I think that's your third one. You know, you think of a, know when to hold 'em, no, when to fold 'em. And I was at a point where I had major senioritis, I was ready to go. And if you read any of the books out there, you know, uh, built to sell, uh, Skelly Success, Rockefeller Habits, all of those, it says you're, you're building your practice to sell.

[00:34:11] Colleen Long: Like that's really the mind mindset that you should be in all the time. So it was only until I started to talk to other potential buyers. That I started to think about my practice the way that other buyers might think about a practice. So someone that's coming in that has more business training and less clinician training is gonna look at your margins.

[00:34:35] Colleen Long: They're gonna look at your top line revenue, they're gonna look at your profit. They wanna know how much are you looking at your profit? Do you know what profit is versus revenue? Are you looking at your p and l? How do you find your p and l? Is it on QuickBooks or is it on a bunch of paper spreadsheets?

[00:34:51] Colleen Long: You've got somewhere crunched up under your Rolodex. how is your system run? Right? Um, and and it's interesting when you go, and for a while there I was looking at buying other smaller practices and looking at how people were sort of running their houses behind the scenes. It's, it is all very different.

[00:35:12] Colleen Long: And so I did start to think about my business, like a business only when I was starting to think to sell and. The questions that they were asking of me, I had never asked before, but it made my business better. So for instance, they would say, how much are you in the chair? And I was like, what does that mean?

[00:35:37] Colleen Long: How much am I in the chair? And I realized they wanted to know how integral am I to the revenue of that practice. If they bought tomorrow and I walked away, what would that practice look like without me? And for some people, I think they've gotten to the point where, like you were saying, Jen, you, you have, um, managed the details of your practice so well.

[00:36:03] Colleen Long: But if you took a sick day, everyone would, would feel your absence. They would know that you weren't there. Right. And. While I think that calms some of our anxieties as we're doing that, it then makes it more difficult to sell if you're looking to sell your practice later on, when a buyer's coming around and vetting whether or not they would be able to take this from you.

[00:36:24] Colleen Long: If you're in the day-to-day and the doctors are like, oh, I only refer because of, you know, Dr. Long, I don't, I don't even know. I didn't know she had other people working for her. That's a problem. And so that was the next step I started working on. So I think even if you're not thinking about selling, you always need to think about if you sold it tomorrow, is it ready?

[00:36:48] Colleen Long: Do you know your books? Is your, is your profit growing? Or are your expenses growing? Are your people staying? Or do you have a huge turnover problem? Um, what does the industry look like? What's the ham? You know, these returns that were just being thrown around that I'm like, what? Um, so that's where I was.

[00:37:10] Colleen Long: And honestly, I would say I was toying with the idea for a while and then I got to the place where the practice started to feel more like a prison, and then I was ready to go. And that's not where you wanna be when you're selling because it can put you in sort of a, a worse position, right? You're desperate, hungry people make poor shoppers.

[00:37:33] Colleen Long: That's sort of the same. And so, um, I was tempering the mental head space that had been, really stressed and underwater with, and you might have to keep on doing this for another couple years and be okay with that. Um, and so. For me, the decision to sell was really starting to look at the market conditions and seeing VC or a venture capital backed tech platforms coming in, sort of posing like a therapy office or practice and starting to feel like the yellow cab in the age of Uber.

[00:38:23] Jennifer Politis: Yeah, that's a good analogy. Yeah.

[00:38:25] Colleen Long: it was like, um, someone would call the practice and then you're like, yeah, I can get someone out to you in about an hour. Sheila, who do we have, you know, like. What, that's how our therapy practices are run. And meanwhile you've got Talkspace better help whom whomever's out there, um, doing this where if someone wants a therapist, they click and they get that Uber right away.

[00:38:49] Colleen Long: Someone pops up on their screen in 20 minutes and they figured out how to do it and they have the tech backing to be able to hi, hire for that. And these tech companies weren't reliant on insurance raises, which we hadn't gotten in 15 years to hire their people. They had VC money, right? So I started to see the clinicians leaving because, you know, they could afford to pay them 90 an hour and I could only afford to pay mine 70.

[00:39:19] Colleen Long: So what was I gonna do? How is this gonna go? And when I felt like the yellow cab of this thing, I was like, this is not who I wanna be. Like I don't wanna be here. The yellow cab as Uber's coming in, So I guess I started to see the writing on the wall, and I don't necessarily think that that is the writing on the wall for our field.

[00:39:43] Colleen Long: I don't know that it's the end of the story for our field. I don't know that it's like an Uber that just comes in and then all of a sudden that you don't have Yellow Cab anymore. I think we're also starting to see some cracks in that idea of access. Yes, we figured out the access problem. People can access therapy within five minutes of thinking that they need a therapist.

[00:40:10] Colleen Long: But who's your Uber driver? Who's gonna, who's gonna work like that in that space? Right? Who's there? And it's not as, as, uh, straightforward as an Uber drive. You're, you, that person now is in charge of your mental healthcare. So I. There's gonna be some cracks in this, and as time goes on, we'll see how this all shakes out.

[00:40:34] Colleen Long: It was just for me, I started to feel like, man, I don't wanna be, I don't wanna be the guy at the, like, the end of the table with like a landline connected to a wall and everybody else has a cell phone. Like, I, I just didn't wanna do that. And, um, and so I also found myself really craving creativity. Like I was doing like paint by number and watercolor and piano.

[00:41:03] Colleen Long: I was so thirsty for some creative pursuit, and my practice really became about numbers and yeah, the p and l and uh, you know, just having to do all that all the time. And it was, it was not me. It was not, that was not where my strengths were aligned. And, um, and so I realized. I don't know that I have the bandwidth to build culture in a way that's gonna compensate for what's out there, what people could go to the, the glossy paycheck, that sort of thing.

[00:41:40] Colleen Long: And I, I just was like, I need to pivot. So sometimes that question's always like, did you feel like you were failing when you were selling? And it was like, I didn't feel like I was failing no more than maybe if you're selling your house, you know, you think I was selling your house. Usually it's a, you, you're either upsizing, right?

[00:42:05] Colleen Long: It's an upward move, and you're like, yay, we're going to this like, nicer house. Or you are downsizing maybe because you're like, I don't need that much space anymore and I'm excited to live closer to the beach. Um, so I didn't feel that sense of failure. And I guess as like a seven on the Enneagram, I. thrive on change.

[00:42:24] Colleen Long: I, I'm excited for this new chapter. someone said, you're gonna have to like, do this thing for another five years, I would've been like, just kill me now, honestly, just kill me now. I was like looking up like makeup artist, could I be a makeup artist? Could I, could I drive an Uber? Could I DoorDash?

[00:42:42] Colleen Long: Like I just, anything sounded good other than being a therapist, uh, and a clinician. And um, and so that's when I was like, alright, it's time to pivot. It's, and, and so, um, you know, I'm sure we'll do a, an episode one of these days of really like all the nuts and bolts of the sale and all of that. But when I was thinking about listeners today and like, what might people wanna know about selling?

[00:43:06] Colleen Long: one of the biggest questions I get asked is, how did you find your seller? Um, so that was just biz buy sell, that's, I, I went on biz buy sell and it felt a little cheesy to me to put my practice on biz Buy, sell. Um. But I had worked with several different brokers and or advisors and nobody was able to generate the type of deal heat or interest all at the same time.

[00:43:32] Colleen Long: The way that biz buy sell is, and I don't know if that's the same for other industries, but I was getting, you know, 60 to 70 inquiries a month, um, of people that were interested. And of course a lot of them are looky-loos that are just kind of wanting to see what. What's going on and don't necessarily have the funds to buy.

[00:43:52] Colleen Long: So I had to come up with a whole system to actually vet potential buyers and things like that. And I could talk about that a different time, but that was where it started. And I think if anybody's interested in just dipping their toe and seeing what the market's like, what the demand is like, I would recommend just opening up an account and you can do it anonymously.

[00:44:11] Colleen Long: That's what I did, you know, I didn't wanna, like, scare my clinicians. and just kind of seeing like, what are they looking for? Who, what is the market like in, you know, DC or New Jersey or Cincinnati? What does it look like around me? And um, and so what do I need to think about if I'm not ready to go right now, but maybe I'm ready in three years, that's the time to start thinking about it.

[00:44:35] Jennifer Politis: You know, Colleen, something you said really resonated with me about, um, that I had a similar experience with. That I got to the point where, um, when I met with people to, to look into selling. That actually transformed my business because then I was able to think of my business completely differently. You know, really delve into the p and l, um, really think to myself, oh, I need to be more like a CEO.

[00:45:00] Jennifer Politis: I can't just be a therapist here trying to run this. So I, you know, I enjoyed hearing that from you because that, in retrospect was probably a really big point of my, a point of change for me as a business owner when I considered selling to then know what I need to do to get out of the chair.

[00:45:19] Colleen Long: Yeah. Yeah, I think that's where it's really helpful is, you know, even if you're not thinking about selling right now, just understanding how people look at your business. In any regard, you know, if you're selling your house, what do they look like? Okay, well that's probably only gonna make your house better when you're making those improvements.

[00:45:35] Colleen Long: So that certainly was the big key for me. Um, and I, I will say being now post exit after the sale, the psychological piece that has been nice is sitting in these meetings where some vendor is trying to pull some nonsense as they do, and me going, oh yeah, that's not my thing anymore. Like, I don't, ha, it's not my battle.

[00:46:07] Colleen Long: I don't have to talk to this person about that anymore.

[00:46:10] Jennifer Politis: do you feel more free?

[00:46:13] Colleen Long: Mm-hmm. For sure. Yeah. And I mean, I'm not, I'm not, uh, in a deal where I could have just. Walked away. I think that's most of the deals these days now, which is the most buyers of any sort of healthcare practice, want you to have some skin in the game post-close.

[00:46:32] Colleen Long: Right. So my deal is set up like an earnout where um, we have to still meet some numbers for it to be the full deal for that to be realized in year one and year two. And I get that. I understand that. You know, I, I would, I think it would be strange to hand this off to someone and just walk away and not to have any transition.

[00:46:55] Colleen Long: So there's still skin in the game for me post close in this practice and that obviously I wanna see it do well and um, I'm still doing some clinical hours, nowhere near what I was doing before, but there is a definite moment where it. Sets in finally. And I mean the day of, like the day that we closed and signed the documents.

[00:47:21] Colleen Long: I remember my friend was sitting next to me and she was like, do you feel different? I was like, no. Like it doesn't feel like I don't feel any different. I don't really know what to feel. And in the weeks post close it's, it has been like, oh yeah, that's not my decision anymore. And that has been super freeing.

[00:47:42] Jennifer Politis: Yeah, because I think that's the hardest part is having that emotional, I always feel like it's the emotional tie to parts of my practice that's the hardest for me to deal with. So you having that disconnect now, I, I would just imagine it's, it's amazing and it's freeing, so,

[00:47:59] Colleen Long: Oh yeah, the decision fatigue is real. You know, the amount of decisions you have to make a day. Yes. Every day the amount of decisions you're having to make. Do you want them to do this? Do you want them to do that? Do you want her to do this, do you, and it's like, oh my God. And you're, you have to make the decision.

[00:48:17] Colleen Long: It's not, you know, that it all rests on your shoulders. And some of it is scary. It's like, oh gosh, I gotta do this, review and if I don't do this peer review this, all these services aren't gonna get authorized again. And what does that mean for working with this insurance company? And so now it's like I can show up and do that, but I'm not feeling like the practice is on the line by every move that I make. So whether you scale, stay, or sell, the real question is, are you making the decision from alignment or letting the system make it for you?

[00:48:56] Erika Bugaj: I have worked for a couple of those, you know, companies that you named earlier, Colleen, and I think you're absolutely on target with comparing it to. You know, Uber or, um, you know, DoorDash even. Um, because I, I really do think those companies are trying to, you know, package up therapy services into a particular, you know, corporate little nice package with a bow on it and optimize and, you know, have, you know, ratings and, you know, target numbers.

[00:49:41] Erika Bugaj: And what it does is it, it, this is a profession that, you know, folks pour a lot of, as we know, time, effort, money degrees, additional professional trainings beyond a master's degree like postgraduate. I've done at least three years of postgraduate psychodynamic therapy training. You know, there's, you really can't put a price tag on the investment that therapists put into the work they do because we are the tools of our trade.

[00:50:16] Erika Bugaj: So, you know, it doesn't really work to package it in the way that many of these companies are trying to package us. And it, what it does is it takes that creativity away from the therapist, the professional who is there to work with a person, another human sitting across from them. And I think that I, I'm not sure you know, if it will.

[00:50:44] Erika Bugaj: Work or last in the long term, like you said, but there's something about all of that that doesn't quite add up for me. And it didn't work for me because I didn't work all these years getting all this training in order to be treated like, you know, many years ago when I was a teenager working in a grocery store or at a restaurant, you know, doing a menial, uh, minimum wage job.

[00:51:14] Erika Bugaj: So,

[00:51:15] Colleen Long: a widget. You were being treated like a widget.

[00:51:17] Erika Bugaj: exactly. Yeah. And, and a, a client's rating is going to make or break you, which I'm not even sure if that's ethical in our, in our profession, you

[00:51:28] Colleen Long: right. Well, and I liken it to if you showed up at a hospital and the, the, these tech companies have now just packaged up surgeons, they're like, alright, here's your surgeon. And then you're just with a surgeon and they're like, we're gonna open you up and see what's going on in there. Hopefully I know how to fix it.

[00:51:46] Colleen Long: And like, that's what, that's what this model is like. Okay, great. You guys have figured out access, but we've got no treatment plan. We've not matched anyone with the right person. So like, let's just open 'em up and like see And like hopefully it's the fit and you know, and example I can give of that in our field, especially where we do assessment is, um.

[00:52:08] Colleen Long: We test people before we treat. So just like if you are going in for surgery, the doc's not just gonna open you up and be like, well, let's see what we find. They're gonna do an X-ray first and go, oh, you got, you swallowed a. and we need to get, it's over there. I need to go in there and get it.

[00:52:25] Colleen Long: Like they're not gonna just open you up and just like dig around. And that's really what I think these companies think you do as therapists is like, it doesn't really matter what your specialty is or like your training. It just, I mean, everybody's the same. You just talking to a human and like eventually it'll just be a bot bot.

[00:52:41] Colleen Long: No, it doesn't work like that. Access, yes, they solved for that, but the care and the treatment planning, the assessment, that's what, that's what dictates outcomes. So if I've got a patient and, um, they have now been on one of these sites talking with someone that, let's say is psychodynamically trained. I don't know that anyone's psychodynamically trained is gonna work for what these companies pay them, but let's say that, and they're conceptualizing their hypomania as like some sort of transference issue. This person's gonna keep on cycling. As they're dealing with the psychodynamic therapist that is completely conceptualizing it in a way that is not helpful for the patient versus if you are going in and you get assessment first off, and we accurately go, well, this is an A DHC, this is bipolar two, this person has clear mood cycles, they've got hypomania, they're non-functional when they're going into these bouts and then they come out of it and then they've got depression that's lasting for two weeks.

[00:53:45] Colleen Long: You don't wanna treat them with an A DHD Med. That's just gonna make things worse. We actually gotta get them on a mood stabilizer. Okay, well how's that patient going to look differently when Dunking Donuts sends them to us, their employee, and now we've actually got a treatment plan and we know in four to six sessions we can get them to see a psychiatrist that's gonna get them on the mood stabilizer and they're gonna return to work versus they, yeah, they got access in five minutes from their lunch break. They're meanwhile doing psychodynamic conceptualization of hypomanic bipolar.

[00:54:20] Jennifer Politis: Yeah.

[00:54:21] Colleen Long: So yeah, I think it's a, it's, it's not going to be the end of our profession. And I think that's where we're realizing, okay, they did solve for one problem, which was access. But our, our people are people and they're unique, and each person's treatment plan isn't gonna just be, you know, humanistic therapy is, is good.

[00:54:50] Colleen Long: And I think it's helpful and a lot of people need that connection in the healing that comes through that. But there's also people that need a certain type of treatment that we know is best practice for whatever that diagnosis is. And so, um. I think that that is gonna be something that helps sort of save the profession as well as understanding that this is a nuanced profession.

[00:55:15] Colleen Long: It can't be commoditized in the way that Uber was.

[00:55:18] Jennifer Politis: Right.

[00:55:19] Erika Bugaj: agree.

Off the Chair Podcast

Scale, Sell, or Stay: How to Know What’s Next for Your Practice

In this episode, we explore:

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Colleen Long, Psy.D.

Jennifer Politis, PhD, LPC

Erika Bugaj, MA, MSW, LICSW

Episode Transcript:

The Realities of Being a Mom Boss

Scaling Without Selling Your Soul: Building a Business That Loves You Back