Transcript

[Transcript] Episode 430: You’re Considering Selling Your Practice – What You Need to Know

 

Evan Dumas 

You’re listening to Group Practice Tech, a podcast by Person Centered Tech, where we help mental health group practice owners ethically and effectively leverage tech to improve their practices. I’m your co host, Evan Dumas.

 

Liath Dalton 

And I’m Liath Dalton, and we are Person Centered Tech.

 

Liath Dalton 

This episode is brought to you by Therapy Notes. Therapy Notes is a robust online practice management and Electronic Health Record system to support you in growing your thriving practice. Therapy Notes is a complete practice management system with all the functionality you need to manage client records, meet with clients, remotely, create rich documentation, schedule appointments and bill insurance all right at your fingertips. To get two free months of Therapy Notes as a new Therapy Notes user go to therapynotes.com and use promo code PCT.

 

Liath Dalton 

Hello and welcome to Episode 430: You’re Considering Selling your practice. What You Need to Know with special guest expert Gabrielle Juliano-Villani from Medicare Consulting for Therapists and many other wonderful things that Gabrielle does to support and resource the professional community. Gabrielle, it’s really wonderful having you here. Thanks for joining us.

 

Gabrielle Juliano-Villani 

Thank you for having me back, and I am very excited to do a deep dive on this topic.

 

Liath Dalton 

Yes, well, and you have first hand experience of what it is like, because you first of all, built up your own successful group practice that you ran for a number of years and then sold it. And so following having that direct experience, you’ve also been providing consulting and support to other practice owners in navigating that process. So I’m just delighted to be able to get your perspective and guidance and insights, because I know you know, it’s a huge undertaking, right? And folks have misconceptions or like, coming out the other side of it, there might be things you wish that you’d done differently, or would advise other people to do a certain way, not do a certain way, etc. So what would you kind of share about your own experience, first and foremost, and then we can dive into all the other bits and pieces of it.

 

Gabrielle Juliano-Villani 

I think it’s still kind of weird to be on the other side of this. I never, ever, ever, ever thought that this was something that I was gonna do. And I just remember even starting my practice, I, you know, like a lot of us, I was working another job, and I said, when I get to 15 clients, I’m going to quit my corporate job, and I’m going to have my little Private Practice with maybe 18 clients a week. But because I had such a needed niche, I got full really fast. And then, you know, hired somebody. And then, of course, that snowballed, and soon I had 15 people working for me.

 

Gabrielle Juliano-Villani 

And I just, again, like never saw myself as like a business owner in that way, and I didn’t even know that selling was an option. I didn’t think that people bought like smaller mental health practices. So I’m grateful for the experience, and I also wish that there had been somebody like me around when I was thinking about selling because I was doing lots of Googling and in Facebook group searching, and I couldn’t find anybody who had sold to a bigger entity. I had found a couple people who sold to another clinician, like a private, smaller situation, but nobody who had gone through what I had gone through. And it is, you do need that support when you’re doing this for sure, you don’t want to do it alone.

 

Liath Dalton 

Absolutely. And just for context, when were you first approached about selling your practice, and then when did the sort of initiation of the sale commence, and then conclude?

 

Gabrielle Juliano-Villani 

So it all kind of started with an idea that my friend slash mentor gave me in, I think, the spring of 2021. I was feeling very burnt out. I. And there were just so many changes that were happening, of course, during that time, like still sort of post covid, but not really, still in the thick of it, and a lot of just a lot of upheaval. And I was just, I didn’t really see a way out. And so my friend, who’s in a different field. She was like, why don’t you sell? And I was like, didn’t know that was a thing I could do.

 

Gabrielle Juliano-Villani 

So we sat down and we ran some numbers, and of course, I was like, that doesn’t seem like enough money, because it never seems like enough money. And I just kind of put it on the back burner and started doing some other things to try and help manage the burnout, by delegating a little bit more and putting some different systems into place, but it was still in the back of my head. And then the first vacation I took since like 2019, I was in Hawaii in July of 2021 and I got a voicemail from somebody, and they said, we represent these people who are interested in buying your practice give us call back.

 

Gabrielle Juliano-Villani 

And I was like, that’s totally spam. Like, I’m not gonna call these strangers back. My friend was like, No, that’s how these deals happen a lot of times. Like, just call them and Google and do research, of course, and make sure they’re legit, which I did. And so I called them back, and we set up a meeting, and they were legit, and then we met in person, and we decided to go under contract and move forward. And that was also a different time in the mental health space as well. My sale happened very quickly. That call was like, I want to say was like July 16, 2021 or something like that. And we signed the papers, it was a done deal on December 31 2021.

 

Liath Dalton 

Wow. Yeah, I mean, because imagining that part of the process entails a whole lot around valuation and like due diligence and then hammering out the details of the contract terms and so on, that does seem like a quick turnaround for something that is that big of an undertaking.

 

Gabrielle Juliano-Villani 

It was very fast and very stressful.

 

Liath Dalton 

Imagine it felt a little whiplash-y, right?

 

Gabrielle Juliano-Villani 

It did. And it also was, again, just like, surreal. Like, I was like, Am I really doing this? And I would go back and forth a lot. I’d be like, I don’t want to do this. Yes, I do. I want to get rid of this thing, if somebody gives me $1 I’ll give it to them. And then I will be like, no, what am I going to do with my life, what am I going to do if I’m not in Simple Practice, doing the billing and looking at people’s schedules every day, like, what is my identity going to be if that’s taken away from me?

 

Gabrielle Juliano-Villani 

And I was given advice by my broker, who said you’re looking too, like narrow. You have to zoom out and look at the big picture. Like this is, think of your whole life, and this is one stepping stone to get you to the next thing, where you want to go. And that just very small shift helped me so much, like that really got me through it, and I still use that advice when I feel directionless.

 

Liath Dalton 

It’s really good advice.

 

Liath Dalton 

Well, I know part of what’s different in the the mental health field and just our kind of like context right now, at the time of recording in August 2024 versus summer of 2021, and I kind of saw this similar trend continuing through 2022 before it really shifted, was that just about every venture capital group in existence was like, oh, wow, mental health care is this huge kind of sector within the economy that has tremendous potential, and there’s this increased demand, which we don’t see diminishing, and so let’s get into this space.

 

Liath Dalton 

And you know, and along with some assumptions that they could make the bottom line be more profitable because of their business sense, right? Like, Oh, these practices aren’t as profitable as they could be because they just don’t have the business and understanding. And I’m sure there were, you know, degrees to which some of that is true, but I also think there was a lot of overestimation of so much more profitable practices could could be made to be by just taking a different approach, like a purely business approach.

 

Liath Dalton 

But I mean even PCT was getting loads of unsolicited emails and calls and inquiries during that same timeframe of kind of late 2021 into and through 2022 and then we know from a lot of our group practice clients that they were also getting that that sort of offers, so that that piece has shifted now quite a bit, right?

 

Gabrielle Juliano-Villani 

It has, yeah, that was like a hot time in 2021 and 2022 and so you’re absolutely right. I think they didn’t realize. I think it’s easy to see it from the outside, right, as somebody who is a VC or a private equity firm and not understand more of what it’s actually like to deal with insurance, or like just knowing even state by state. Like that was something that came up because I, my practice was in Colorado, and they were in a different state, and in their state, the insurance landscape looked a lot different. It paid a lot more, it was easier to hire there. Colorado was a little bit more unique with with hiring and saturation and things like that. So those are all kind of things that they they might not really understand or know about.

 

Liath Dalton 

Yeah, absolutely. But people are still selling group practices today, right? It’s just not in the the same kind of hot market that it was during that window of time. So what does the current landscape look like, from your view?

 

Gabrielle Juliano-Villani 

What I’m seeing is interest in practices that are insurance based still, and interest in practices that are multi-specialty and maybe offer some things, like, I don’t know, TMS, or something else besides like regular talk therapy, or they have prescribers, I’m definitely seeing more interest in that type of a practice. And not to say that you can’t sell, I think that, if you don’t have that.

 

Gabrielle Juliano-Villani 

I do think there is a buyer for everybody, if your practice is profitable and efficient, and you know, all those things that it needs to have, I think that anybody can sell, but it definitely takes a lot longer, for sure. And I think that there are more people now wanting to sell than there were in like 2020-21 and kind of the beginning of 22.

 

Gabrielle Juliano-Villani 

I’m definitely seeing that trend as well, because when I sold, there weren’t many people doing it that I knew of, and the conversation that I saw a lot online about it was like, you’re a sellout if you do that, and like this, entrepreneurs do, you just gotta, like, ride the wave, and you need to keep it and like, why would you do that? And lots of, like, more negative, shame based talk. And now everybody’s like, oh, actually, I want to get out.

 

Liath Dalton 

Right, right? Well, I mean, I think it is, of course, going to be something that’s so personal and and context specific for every practice owner and some people who consider it or presented with an opportunity for it, when they’re looking at that larger context of their life and what stepping stones they want, this is a stepping stone that they want to be present for for a while, right? And maybe have multiple iterations of it.

 

Liath Dalton 

And then there are others who determine that it really is right to to step out, and when you have invested so much, not just financially, but your your heart and soul, and so much of your life into it, just closing your practice, or like returning to private practice, which is a consideration I’ve been hearing kind of crop up more and more recently as well, is both the wait, I don’t think I’m, you know, want to continue with a group, necessarily, right? But when they look at at their revenue and expenses and they’re thinking wait a minute, I am making maybe less than I was when I was a solo practitioner, and I’m more stressed, and so I want to shift. I mean, but you selling, if that is the case for someone, I would think that selling the group route and then going out into solo practice on their own would be a more beneficial way to to manage things, when they put that infrastructure and team and client base and, you know, all the kind of support systems that make a practice work in place.

 

Gabrielle Juliano-Villani 

I’ve also seen some talk more and more about people wanting to merge with other practices to manage that too, which, of course, brings other unique challenges, but also strengths. I mean, you don’t, you don’t get to share all the money, but you also don’t have to share all the stress.

 

Liath Dalton 

Right. That does make sense. And then, you know, I would think in a partnership consideration, what you’re looking for, in part, is going to be, you know that who you are partnering and merging with, that there is a diversity among the those leadership kind of team members, or co-owners, partners, in terms of what hats each person wants to wear within the management of the practice going forward, right? So everyone isn’t wanting to do the same thing and not wanting to do the same things, and then you just kind of have some of the challenges that are present pre merger magnified a little.

 

Gabrielle Juliano-Villani 

Exactly. We don’t want that.

 

Liath Dalton 

So you said that, going back to the kind of differences in the landscape now versus the timing or around the time when you sold, that we’re seeing less venture capital groups and private equity firms. So what, who is the kind of most likely buyer in the event that someone is wanting to sell their practice?

 

Gabrielle Juliano-Villani 

I think other larger group practices and health systems, like hospital systems, I think also there is still maybe not as much venture capitalists, but definitely private equity. It just isn’t as much. And it’s not as it’s not like these big like Refresh and Lifestance. You know, I think they’re being a little bit more choosy. And instead of just like for a minute there they were just plucking them up all over the place.

 

Liath Dalton 

Right, right, right. Yeah.

 

Gabrielle Juliano-Villani 

I think that’s still happening, but on a very lower scale than what it looked like before.

 

Liath Dalton 

So if someone wants to sell and they haven’t been approached like  you were, by a buyer. What is the process that you would recommend for, sort of putting their for sale sign out there, determining valuation? How should they approach it?

 

Gabrielle Juliano-Villani 

You definitely want to get a valuation first, so you want to know how much your practice is worth. You can kind of do that on a very high level yourself by looking at your P and L statements and looking at your net profit, and with that number, if your practice is has less than a million dollars in revenue, you can take that net profit and times it by 4 or 5. 5 would be on the very high end, probably closer to like 3 right now is what you would get. And over a million in high times, you could get your EBITDA times 11. Now probably not, but that can give you sort of a high level overview.

 

Gabrielle Juliano-Villani 

But you can get valuations, because there’s other things that bring value to your practice besides money. So like for mine, it was because we accepted Medicare, and that was something that the buyer was interested in, because they worked in skilled nursing facilities. So you can get evaluation from a broker or your accountant and some attorneys, some merger and acquisitions attorneys will do them as well. So that’s a good starting point, because you just need to know where you’re at, and if you don’t know, then you can’t make an informed decision. So that’s really the first step. Because I get that question a lot too, is like, how much is it worth, how much could I sell it for? And you just need to know. So just get that information. It’s just information.

 

Gabrielle Juliano-Villani 

And from there, I would suggest working with a broker. They do take a percentage, so there’s that. So just be prepared, if the sale goes through, you’re going to have to give them some money. But if you don’t have connections with people, and if you do, you can use those, but that’s where the broker comes in. They have done all the legwork to have those connections, and they will put it up on, they all do it a little bit differently, but essentially, they look at your practice kind of like a house when you’re selling a house, and you see, oh, you know, we have a new roof in 2016, hot water heater is new, and we have these beautiful hardwood floors, it’s in a nice neighborhood. They do the whole thing for your practice just like that. We’re gonna say, you know, mental health practice in a busy location. It’s been there for 5-10 years, whatever. They’re gonna make, put like a little fact sheet together, and then they put it on the market, so to speak.

 

Gabrielle Juliano-Villani 

And so and they, you know, using a broker in this field is helpful, because they’re the ones that have the leverage and connections. But you can also do that work yourself. If you have connections, or if you think of somebody you know or in your community, you could reach out to them directly. Or like me, I did use a broker because I wanted, I had never sold a business before, so I needed somebody to tell me, you know, this is what to expect, this is normal, this is not normal. So I just paid them like a flat fee for consulting, essentially. Usually, their real job is to find you a buyer.

 

Liath Dalton 

Well, that’s great to know that it is an option to also just do the kind of flat rate consulting if finding a buyer isn’t part of what you’re needing and you just need that experience and insight and someone who can really, like you said, tell you what is normal, what’s not normal, make sure that you aren’t getting taken advantage of or or in a position where there are kind of, you know, hidden terms or terms that you don’t fully understand what the impact of them is going to be.

 

Gabrielle Juliano-Villani 

Yes.

 

Liath Dalton 

I am kind of alluding to something that I’ve seen, seen a lot, which is the you know, requirement when selling a practice of the practice owner staying on for a period of time to continue to manage the practice, manage the practice through the transition, but then answering to the buyer and having the buyer as a boss.

 

Gabrielle Juliano-Villani 

You want to make sure you like them, because that is also common. I did that. I stayed on for a year. I’ve seen people negotiate that down to six months. And I’ve even, I think I even saw somewhere that Lifestance was saying you didn’t have to stay on at all, which is really, wow, surprising to me, and I don’t know that that’s really a good way to handle a big transition like that. If you sell any business in any field, you’ll be expected to help with that. You can’t just, like, dump it into somebody’s lap and expect them to know how to run things.

 

Liath Dalton 

Well, I would imagine that that would create a high attrition rate for staff.

 

Gabrielle Juliano-Villani 

Yeah.

 

Liath Dalton 

For all of your your team members and clinicians, and that if the transition isn’t made smoothly, that you could also have a attrition rate of clients.

 

Gabrielle Juliano-Villani 

Yes, and the clients are what brings them the revenue, and the staff.

 

Liath Dalton 

Right.

 

Gabrielle Juliano-Villani 

And so you don’t want to lose either one of those things, either after a sale, if you can help it. Although that’s pretty common too, is there’s going to be a dip, because it’s it’s a big transition. But, yeah, I think, and I think that’s smart to stay on anyway, for the clients and for the staff. I mean, it does make it, it makes it smoother. And it’s also like, I’m still here, you know, so you guys can be here too, like, it’s safe, I’m still gonna manage you, I’m still your point of contact, like, all of those things.

 

Liath Dalton 

Absolutely, yeah, making a warm handoff seems very, very important. So you worked with a broker. How did you find your broker?

 

Gabrielle Juliano-Villani 

Also, through my same friend. So that friend that I was talking about earlier, she is in a different industry, but works, she has an MBA, her dad is an entrepreneur, and her dad is actually the one who introduced me to this broker. So otherwise, I probably would have just googled, but that’s how I found him, and that was really nice that I did, because like having that connection was good, I knew that I could trust him, and that’s what I needed, because you cannot talk about this with anybody, it’s confidential.

 

Gabrielle Juliano-Villani 

So when you sign the LOI, which is a letter of intent that basically says, like, we’re gonna do this, or we’re thinking about doing this, you can’t, that’s it. You gotta shut up. You’re, you cannot tell your staff. You really have to keep it to yourself, and that’s very, very challenging. So you need somebody that you can trust and that you can lean on, and that can advise you. Because again, we’re not attorneys, we are not a Harvard MBA, most of us, we’ve never sold businesses before. There are little things in those contracts that do have big implications that you would think you would just kind of scan over it and read it and think it’s not a big deal, but it could impact you in the future, and you want somebody on your side who can help you go through all of that make sure that everything is the way it needs to be.

 

Liath Dalton 

Absolutely. Now, with the broker that you selected, had they done with like healthcare practices, something that was in their specialty, or?

 

Gabrielle Juliano-Villani 

You know, it wasn’t he had sold, I think healthcare practices before, but it wasn’t like his bread and butter. But I just trusted him, and he had been doing this for, like, God, over 30 years, I think.

 

Liath Dalton 

Oh, wow.

 

Gabrielle Juliano-Villani 

I was like, I think you’re the person, you are the man to help me.

 

Liath Dalton 

Nice. Now, with the the practices that you’ve supported in or provided guidance  around this whole consideration and process for, have they worked with with brokers that do specialize in healthcare practice or mental healthcare practice, sales in particular? Or do you think that finding a broker who you may just like feel a good rapport with that has a good general track record is is more important is the way to go?

 

Gabrielle Juliano-Villani 

I think it’s better to have good rapport, because some of my clients have worked with brokers who did specialize in healthcare, and they ended up not using them and went with somebody else, because of that. They were like, I feel like they don’t really have my best interest, it’s like, just another deal to them, and it doesn’t feel like there’s a good connection there. So I think the rapport is more important, and having a really good attorney who does specialize in mergers and acquisitions. So if you have, if you have a good attorney, you will be good. And then a broker who just understands buying and selling, has done it before, has the expertise that you trust, like those two together will keep you safe.

 

Liath Dalton 

That brings up a really great point, though, that there are costs involved in this process and undertaking this consideration, and that needs to be factored in, right? You don’t, you don’t want to embark on a sales exploration or potential contract for sale without having that expert guidance and support, particularly on the legal side, and that’s not something that the buyers just going to cover.

 

Gabrielle Juliano-Villani 

Yeah, not the way it works.

 

Liath Dalton 

So what would you kind of guide someone who wants to begin a exploration of this, of some sort of like minimum ballpark that they should anticipate needing to allocate funds wise towards initiating this, and, of course, knowing there’s going to be a whole continuum based on size and complexity and, yeah. But just the like, if you want to do an exploration of this, be prepared to, you know, allocate at minimum x amount or something like that.

 

Gabrielle Juliano-Villani 

Yeah, you’re gonna have to think about, I mean, for your broker, you usually pay them after the sale is completed, and they take their commission, and that can be, I think 8% is kind of normal, 8, I’ve seen as high as 15. So

 

Liath Dalton 

Wow.

 

Gabrielle Juliano-Villani 

somewhere between there, you can expect to pay for that, of the sale. You’re going to need an attorney that, of course, depending on how much back and forth there is on things, how big your company is on the low end, I would say to expect on the low low end, probably 8000, but probably more than that, once everything kind of goes through. What other expenses – taxes. You’re gonna have to pay, taxes, you have to pay capital gains taxes.

 

Liath Dalton 

Ew!

 

Gabrielle Juliano-Villani 

It sucks. So there are expenses with it. And I know that’s another thing that I’ve heard a lot too, is people trying to minimize those like, do I really need an attorney? Yes, you absolutely, absolutely, 100% do. It’s going to cost money. That is just the way that it goes. And it sucks when you have to write that check for a couple thousand dollars, but you want to protect yourself. This is a big deal, and you don’t want to get wrapped up and sign something where you’re giving away your intellectual property, where you’re didn’t realize you were signing a non compete, or a non solicit or something like that. You really want to protect yourself, and that’s just kind of the costs that are associated with it. And, you can get around using a broker. I mean, there are ways that you can do that, and you don’t need one, but you definitely 100% need an attorney, right? There’s no getting around that.

 

Liath Dalton 

That’s an absolute non negotiable. And you want, not just a general business attorney, and you’re not going to be using your HIPAA attorney, or employment attorney, you you specifically want, need the mergers and acquisitions,

 

Gabrielle Juliano-Villani 

Yeah.

 

Liath Dalton 

specialized, uh, attorney.

 

Gabrielle Juliano-Villani 

Yeah.

 

Gabrielle Juliano-Villani 

I mean, you’ll probably have to pay your accountant too. I know I had to do that because there were some things that her and I needed to discuss. She actually my accountant specifically, is in she’s a CPA and she’s an MBA, and she also specialized in mergers and acquisitions, which was really nice. So she helped me with some consulting as well. So that was like another cost that came through for me. For them, there’s other things. Like they oftentimes will do an audit, of your practice, so they’ll come in and look and see, you know, it’s just like if you’re getting audited by insurance, but it’s by the other party, but you normally you wouldn’t be paying that.

 

Liath Dalton 

If you had to do it all over again, would you still sell?

 

Gabrielle Juliano-Villani 

Yes, 100%

 

Liath Dalton 

That’s wonderful.

 

Gabrielle Juliano-Villani 

I think, I’m just feel a little guilty, because I do think that sometimes my staff, who used to work for me, comes across these and might listen to this, and it really had nothing to do with them. It was really a me problem. And also just realizing that, like, I didn’t want to do this anymore. It just wasn’t for me. There were other things that I felt pulled to do, and I also knew that if I wanted to keep growing that business, I couldn’t do it where I was, and like, financially, I just couldn’t. Like, I needed more help, so I 100% would have, would do it again,

 

Liath Dalton 

Is that something that you see being the kind of predominant takeaway for the folks that you’ve provided support to in this process, for their own practices as well, or?

 

Gabrielle Juliano-Villani 

I’ve seen some regrets, but mostly about how the sale went, or who they sold to, not the actual selling and like moving on, but how the new buyer, the new owner like what they did once it was theirs. I’ve seen regrets with that for sure, and that that is a risk that you have to be willing to take, because it’s not your practice anymore.

 

Liath Dalton 

Right, right? Letting, letting go is the big part of it. Well, if you were to kind of guide someone who’s got at least an inkling that they want to consider this, or explore this for their practice, are there some key questions that you would recommend they they ask themselves and and find answers to?

 

Gabrielle Juliano-Villani 

Yes. So some of those would be, what are your personal values, and how does this business align with that? And does it or does it not, or maybe it’s shifted, which is fine. And I also think it’s important to ask yourself, like, if you’re thinking of your dream life, your ideal day, your perfect day, a year from now, 2, 3, 4, 5, years from now, how does the practice fit into that? Does it fit into that?

 

Gabrielle Juliano-Villani 

That will give you, I think, a good starting point. And I also just encourage people to just get the information. So somebody that I was consulting with recently on something else, she was like, you know, this company reached out to me, and she was like, I can’t believe they did that, and why would they do that? And I don’t want to sell. But then she was like, but maybe, I don’t know. Maybe, maybe there’s something to this, but I don’t even think I could sell my practice. I’m like, just talk to them. Just have a conversation. If you’re just talking to them, you’re not signing anything, you are not giving anything away. I think it’s always good to just ask questions, because something that comes out of it might surprise you, and especially you know, with that particular person I’m thinking of, they then got a valuation which also surprised them. So you never know.

 

Liath Dalton 

Have you ever seen the valuation be higher than I anticipated and then lead to someone determining they don’t want to sell? And like, oh, maybe I can actually make this more sustainable than I was anticipating? Out of curiosity.

 

Gabrielle Juliano-Villani 

I I think usually the valuation surprises people. I think it’s usually worth more than they think it is. But then what ends up happening – it, well, I have seen it the evaluation, and they’re like, yep, that’s too low, not going to do it. I’ve also seen it where it’s like, wow, that’s surprising, and I’m going to keep growing it so I can get more.

 

Liath Dalton 

Well, I think those, those questions to consider, are really helpful, and should have asked those last instead of my my next question. So we’re ending on a positive note. But are there sort of misconceptions or lessons learned, or kind of cautionary pieces that you would want people to bear in mind as well if they’re going to undertake this consideration?

 

Gabrielle Juliano-Villani 

I think just being open to it and not thinking, Oh, these are the bad guys, but also just thinking, you know, how can this increase accessibility? That’s how I saw it. I was like, they can do more than I can, and we already are serving such a needed population that we literally, I could have hired 10 people and given them full case loads, like in a month with the amount of referrals we were getting, and I just didn’t have the bandwidth to recruit and to hire and to find those people.

 

Gabrielle Juliano-Villani 

So I think just don’t be so narrow minded. Be open to the possibilities. Get help. Don’t do it on your own. You need professional help as you’re moving through it. And really, I think it taught me a lot about myself, you know, from like, a more vulnerable standpoint. I mean, I was sitting in a room with, like, Harvard MBA dudes, and I’m, like, thinking of myself as, like this little baby social worker, and it was like a fake it till you make it situation. I was like, I gotta walk in here like a bad bitch, like a business owner, like I know what I’m doing. I think is really what helped me also get to what I’m doing now, and to, like, move through the imposter syndrome that I’ve always had.

 

Liath Dalton 

That’s amazing. I mean, it then actually became its own stepping stone, like the act of of selling became a pivotal stepping stone for you.

 

Gabrielle Juliano-Villani 

Yeah, it totally did.

 

Liath Dalton 

so, so glad that it did, and like, in part selfishly, because I know you wouldn’t have, had you not sold, you wouldn’t have the capacity to be doing what you’re doing now, and providing the sorts of resources and support, or, you know, getting to collaborate with me and from time to time, and other awesome folks in the community or do the consulting work, there wouldn’t have been that, that bandwidth. So I think you know all finding our unique ways to contribute and follow our paths and realize that just because we’re on a particular path at one point doesn’t mean that that’s going to be fixed. And we can’t,

 

Gabrielle Juliano-Villani 

Yes.

 

Liath Dalton 

can’t, there can’t be bends and curves and kind of trajectory change, right?

 

Gabrielle Juliano-Villani 

Exactly. And I think it’s also helped me be a better consultant to group practice owner. So people sometimes are surprised that I still do that, and they’re like, Well, you burnt out, and you sold your practice, why would you want to work with us? But it’s helped given me that perspective to go through the entire cycle, and also to say, like, you know, from it from a consultant’s perspective, from an outsider’s perspective, here are things that you can do to, you know, help prevent your own burnout and to help make your business more profitable. And if you do want to sell like, here’s some things that you can still, you know, start to put into place to be able to do that. So it’s definitely helped me, I think, just grow in so many ways. And I can do that now, because before I was trying to do that. And to your point, I was super burnt out and I didn’t have the bandwidth, so people were coming to me and saying, help me build a group, and I’m like, don’t do it. Now that’s shifted.

 

Liath Dalton 

Well, I know we are, we are all glad that that is, is the case, and in terms of for folks who maybe are listening to this and thinking, ah, I do want to explore and consider this, amongst the the different sort of recommendations that you’ve made in terms of valuation and broker and attorney, I also know that you do provide consulting and support around this. So what is sort of the pieces that you specifically will provide guidance to focus on through consulting, or what’s the best way to to make direct use of your insight and expertise on this?

 

Gabrielle Juliano-Villani 

Yeah, so I can help group practice owners scale and do that in a streamlined and efficient way, and put systems into place to have more efficiency if you’re thinking of selling. Even if you’re not thinking of selling, I always say this too, like you should pretend that you’re going to, because you will be more efficient and more profitable if you in that way. And I help group practice owners add income streams. I help them prevent burnout, and I run retreats. And then on, like a totally random other thing, I also help people with Medicare and Medicaid compliance too. So I offer a lot.

 

Liath Dalton 

You must need a big hat rack with all the hats.

 

Gabrielle Juliano-Villani 

I do.

 

Liath Dalton 

Thank you so much for sharing your experience and this guidance. I have no doubt that there will be folks listening to this, who feel just kind of seen and heard and like, ah, okay, I can, I can explore this consideration if it’s one that I’m feeling called to,

 

Gabrielle Juliano-Villani 

Yeah.

 

Liath Dalton 

So, thank you.

 

Gabrielle Juliano-Villani 

There’s lots of options out there. So I think really that’s something that we tend to do sometimes, is to hold ourselves back, or we think that we have this dream and it’s stupid, or my life could never look like that, and you just never know.

 

Liath Dalton 

That’s a great place to end. All right, thank you. We’ll chat to you next time, everybody.

 

Gabrielle Juliano-Villani 

Thanks.

 

Liath Dalton 

This has been Group Practice Tech, you can find us at personcenteredtech.com. For more podcast episodes, you can go to personcenteredtech.com/podcast or click podcast on the menu bar.

evan

Your Hosts:

PCT’s Director Liath Dalton

Senior Consultant Evan Dumas

Gabrielle Juliano-Villani, LCSW

Welcome solo and group practice owners! We are Liath Dalton and Evan Dumas, your co-hosts of Group Practice Tech.

In our latest episode, we chat with Gabrielle Juliano-Villani, LCSW of Medicare Consulting for Therapists about what to consider if you’re thinking of selling your group therapy practice. 

We discuss Gabrielle’s personal experience selling her practice; how the market for selling a practice has changed since 2021; what types of practices are getting a lot of interest currently; who is buying group practices right now; what the process of selling looks like and where to start; valuing your group practice; working with a broker and an attorney; staying on during the transition; costs to keep in mind when selling; and questions to ask yourself if you’re considering selling your practice.

Resources are available for all Group Practice Tech listeners below:

Therapy Notes proudly sponsors Group Practice Tech!

TherapyNotes is a behavioral health EMR/EHR that helps you securely manage records, book appointments, write notes, bill, and more. We recommend it for use by mental health professionals. Learn more about TherapyNotes and use code “PCT” to get two months of free software.

*Please note that this offer only applies to brand-new TherapyNotes customers

Resources for Listeners

Resources & further information

Resources:

PCT Resources:

  • On-demand trainings (not designated as CE) presented by Gabrielle: Introduction To Medicare And Medicare Credentialing and Medicare Billing
  • Group Practice Care Premium
    • weekly (live & recorded) direct support & consultation service, Group Practice Office Hours
    • + assignable staff HIPAA Security Awareness: Bring Your Own Device training + access to Device Security Center with step-by-step device-specific tutorials & registration forms for securing and documenting all personally owned & practice-provided devices (for *all* team members at no per-person cost)
    • + assignable staff HIPAA Security Awareness: Remote Workspaces training for all team members + access to Remote Workspace Center with step-by-step tutorials & registration forms for securing and documenting Remote Workspaces (for *all* team members at no per-person cost) + more
  • HIPAA Risk Analysis & Risk Mitigation Planning service for mental health group practices — care for your practice using our supportive, shame-free risk analysis and mitigation planning service. You’ll have your Risk Analysis done within 2 hours, performed by a PCT consultant, using a tool built specifically for mental health group practice, and a mitigation checklist to help you reduce your risks.

 

Group Practices

Get more information about how PCT can help you reach HIPAA compliance while optimizing and streamlining your practice.

Solo Practitioners

Get more information about how PCT can help you reach HIPAA compliance while optimizing and streamlining your practice.


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