Selling a group practice with Danielle Hayes
In this episode (quick summary):
Selling a group practice becomes far less risky when you treat it like a values decision, not a price decision. Danielle Hayes (Therapy Austin; now Clinical Strategy Advisor at Mindfully Behavioral Health) shares what it took to scale from two clinicians to nearly 150, and how she approached buyer fit, leadership retention, and culture protection during a major transition.
TL;DR:
If you want your practice to outlast you, choose alignment over urgency and build the systems that keep mission “in the water”.
What you’ll learn:
- Why locally-owned, mission-driven practices can deliver more consistent, relational care
- How to scale without watering down clinical quality and clinician support
- What to look for in advisors and buyers who truly understand mental health businesses
- How to think about leadership retention when selling (and why it changes everything)
Danielle Hayes’s quote: “I really want the model I built… to carry on.”
Best for: group practice owners considering an exit, partnership, or acquisition; founders scaling beyond the “small practice” stage; leaders trying to protect culture through growth.
Key terms: selling a group practice, group practice sale, values-aligned buyer, leadership retention, culture integration, locally owned practices, patient care/client care, counselling/counseling, organisation/organization, programme/program
Selling a group practice: how to protect culture when the market is moving fast
“I really want the model I built… to carry on.”– Danielle Hayes
Danielle Hayes, Co-founder of Therapy Austin andClinical Strategy Advisor at Mindfully Behavioral Health, has lived the full lifecycle of group practice ownership: building from the ground up, scaling through multiple growth thresholds, and then stepping into the complexity of selling a group practice without losing what made it work. Her perspective is grounded in real operator trade-offs—clinical quality, staff sustainability, and the daily friction of running a people-first business while the wider market becomes more financialised.
Early in the conversation, Danielle makes a strong case for locally-owned, mission-driven practices. Her view is that clients often find the “highest quality, most compassionate care” when founders remain close to the work and build teams that care deeply about long-term outcomes—not just throughput. That stance isn’t anti-growth; it’s a reminder that growth needs design. As she puts it, scale can water down intention when decision-making shifts away from clinicians and toward purely commercial incentives.
What makes this episode especially practical is Danielle’s description of how her practice grew organically over a decade—from two clinicians to nearly 150 across five locations—without a formal business background. Each step up required a reset: new systems, new roles, clearer policies, and stronger cultural transmission. The underlying question was always the same: are we still serving clinicians and clients well? That’s the mindset that separates “bigger” from “better”, and it’s also what keeps a practice attractive to future partners.
Danielle also speaks candidly about support systems. Back in 2012, she couldn’t easily find mentorship specific to therapy businesses, so she relied on trial and error—and, at times, bad advice. Over time, she built a values-aligned network of professionals (accounting, banking, real estate) who were willing to learn the nuance of mental health operations. Her point is simple: advisors who talk in generic “widgets” won’t help you build a durable agency. You want people who understand your cashflow patterns, staffing model, compliance constraints, and the human reality of clinician wellbeing.
Then comes the turning point: selling a group practice. Danielle explains how the pandemic changed the landscape overnight—suddenly there were countless inbound buyers, many of them misaligned “flippers”. She and her co-founder wanted more than a transaction; they wanted continuity for the model, the team, and the community impact. Her approach reframes the buyer search as relationship due diligence: you’re effectively “dating” a future partner, stress-testing values, expectations, and conflict resolution before you sign anything. If you’re building for longevity, she argues, leadership retention and cultural integration are not optional—they’re the mechanism that protects quality during transition.
If you’re thinking about your next chapter—whether that’s practice growth or strengthening clinical leadership—this episode gives you a clear, values-led lens: don’t wait until you’re exhausted to start planning. Give yourself runway, get educated, speak to owners who have been through it, and build a support network that can help you choose the right path and the right people.
Takeaways
- Design culture intentionally as you scale: policies, onboarding, and leadership rhythms should carry mission “in the water”.
- At each growth threshold (10, 25, 50+ clinicians), pause and rebuild systems before pushing for more volume.
- Choose advisors who understand therapy-business nuance (staffing mix, referral flow, compliance constraints, and clinician sustainability).
- Don’t rush selling a group practice: create a plan, clean up financials, and build buyer conversations well before you “need” an exit.
- Treat buyer selection like relationship due diligence—values alignment, expectations, and conflict resolution matter as much as valuation.
- If legacy and quality matter, prioritise leadership retention and a realistic integration plan (culture doesn’t survive hand-offs by accident).
Transcript: selling a group practice with Danielle Hayes
“I really want the model I built… to carry on.” — Danielle Hayes
Read the full transcript
Dan King:
[0:00] I am delighted to be joined by Danielle Hayes. She's the founder of Therapy Austin and today the vice president of Clinical Partnerships for Mindfully. Danielle, welcome.
Danielle Hayes:
[0:09] Hi, Dan. Thanks for having me.
Dan King:
[0:10] It's so good to be with you again. I notice, I want to start out with, I notice in your LinkedIn headline, you say that you're championing locally owned mental health practices. Tell me about the significance of that.
Danielle Hayes:
[0:22] I am a former founder, a founder of a locally owned mental health group practice and ran one, started one and ran one for about 10 years. And even though I sold my practice and now work for a larger company, it is still rooted in small practices that have come together under Mindfully Behavioral Health, where I am working today. And I think they are just, this is where I think clients are going to find the highest quality, most compassionate care. Really, you know, there's people out there who are super dedicated to the care they're giving, and they're allowed to, in these smaller practices, give that type of comprehensive long-term relational care. Yeah. Regardless of the constraints of insurance or whatever else, these types of practices are really mission-driven and founder-driven, and I think that's where you're going to find the real juice. It's not just always quantity. The quality is important, and I want to make sure consumers know and that group practice owners are supported.
Dan King:
[1:21] Could you say more about that? Why is it that patients are really going to get the best quality care there?
Danielle Hayes:
[1:26] I think because in the types of environments that clinicians, you know, a lot of group practice founders or owners are clinicians, right? And these practices are started on a dream, right? They want to build something. Either their own practice grew because of the word of mouth and quality of care they're providing. Often they have a passion for teaching and training others and increasing access to care. Their caseloads are full. And I think that transmits they care for their employees as the client,
Danielle Hayes:
[1:56] the employees and counseling employees are a client to those agencies. And they're always thinking deeply about ways that they can continue to grow and teach those clinicians. We know that the work we do is very difficult as clinicians, and they are aware of that and always looking for ways to support those clinicians and helping them sustain the practice and the type of practices they want to provide. All of that can get watered down. As things scale, you have to be thoughtful about that. It's not impossible, but that can get watered down. And when you start introducing non-clinicians into most of the decision-making, a lot of the quality of that starts to disappear because the decisions are being made without thoughtfulness and intention behind how it affects the service that you're providing.
Dan King:
[2:40] Now, with scale, there can also be certain advantages, though, too, right? So that ability to offer different services, potentially serve a wider variety of patients, there's trade-offs, right?
Danielle Hayes:
[2:51] Yeah, and I think that's one of the tricks. Like, we scaled, you know, just started two clinicians wanting to give back to the community and help people really in the post-graduation during your licensure years and ended up growing organically, you know, over 10 years to almost 150 clinicians here in Austin with five locations. And what we found is that there were more and more people who wanted to work for us, who wanted to stay working for us, more types of clients we can serve, different parts of town, different areas of specialization. And the trick is, you know, even at that scale, trying to make sure that that message and the mission is transmitted through every employee and that your agency policies and procedures and all of that, that it's basically you want that in the water and throughout the culture of
Danielle Hayes:
[3:35] the agency you're building so that it's transmitted as every new employee comes in.
Dan King:
[3:39] Noticing that you said you had a co-founder, how should a practice founder, let's say I'm starting a practice, how should I go about that decision of deciding whether to have a partner or not?
Danielle Hayes:
[3:48] You know, that's a tricky one. I mean, I think for me, that's how this all began was building a dream. You know, it was an office mate and we started talking about ideas and building the dream. I think for everybody, it's a little different. I do think it can be a relief to have a co-founder, to have a partner. In all of this, you can take turns and help each other out. It's also challenging. in some ways, but I'd say generally it was helpful to have somebody who, you know, could, we could take turns. We could spell each other out a little bit. And so you're not shouldering all those decisions on your own. I've run into a lot of group practices that are owned by like a husband-wife team, which has been an interesting, I really love those dynamics where one person's a clinician and the other has a business background.
Danielle Hayes:
[4:33] And that looks really cool to me too. And I'm often impressed with how they navigate all of that.
Dan King:
[4:38] Was your intention from the beginning to grow to the level of 150 clinicians or did that just evolve naturally?
Danielle Hayes:
[4:45] It just evolved. It was a process like I think for us at certain stages, you hit a new level of growth. I don't have a business background. I'm a social worker. My co-founder was as well. So I didn't even know a lot of the time, you know, like we went on our instincts, we followed our values, right? But every time we had a period of growth, you know, at 10 clinicians, you kind of have to decide, are we doing this? Are we continuing at, you know, 2025, you know, you have to start to build new systems at each stage. So at each stage, we would have to kind of take a pause and step back and reflect. And like, what are the tradeoffs, you know, the pros and cons of taking that next step of growth. But some of it is the timing. The model we built filled a particular niche in our area at that time. So we had an abundant referral flow and we had a lot of clinicians who they didn't want to leave. They wanted to stay. So we built based on that of saying, well, you know, this is good. It's good for clinicians. It's good for clients. It's serving our community.
Danielle Hayes:
[5:49] And we just kept taking that challenge.
Dan King:
[5:51] And did you find sort of mentors or coaches along the way who could help you understand what you needed to do differently at each of those growth thresholds? Or did you really mostly figure it out on your own?
Danielle Hayes:
[6:02] It's a lot of trial and error. I think when I look around today, I'm so impressed and won away by how many different types of mentors and even services are available for group practice owners. To my knowledge, that doesn't exist back then. This is 2012. Simple practice started the same time we did and we grew up together, right? HIPAA was new, right? There was a lot of things that just I think today, looking back, it was difficult to find those mentors. I found myself trying to talk to people in kind of similar businesses, but didn't quite get it, like veterinarians or dentists. And it was hard. We also got a lot of bad advice, you know, but little by little, we found a team of support professionals that really helped us. It took a while. We found a great accountant. We found a great banker. We found, you know, good real estate person, commercial real estate person, and people who were beginning to understand our industry and the constraints that we have that are unique to our type of business. Who also were values aligned, right?
Danielle Hayes:
[6:58] Yes. And so we built that and a lot of it was trial and error. But today I look around and I think, oh my gosh, there's all these great incubators, these services, right? There's a lot happening in this field. I just don't know that there was a lot of awareness when we started. I don't think there was another group practice like this in Austin. We were certainly one of the first and grew to one of the largest.
Danielle Hayes:
[7:20] It was scary to take on W-2 employees at that time. We didn't ever do 1099, right? It was a lot of that business risk. And then, of course, systems developed like RingCentral and Simple Practice that made it easier, that didn't exist or were emerging at that moment.
Dan King:
[7:36] So with all of this complexity in the business, you're, I think, bang on that you need great advisors. But one of the tricky things, I think, for a lot of practice owners, and I know for me in my business, is given that the professionals know more about what they do than I do, how do I interview them thoughtfully? How do I interview an accountant? If I'm a social worker, how do I know who the best accountant is?
Danielle Hayes:
[7:57] Well, what my instincts tell me is get to know them as a person, get to know their values and ask them questions about your industry and the type of like, you know, the way our income flows, right? Depending on, of course, if you're cash, pay insurance, all the other factors. But getting a sense, are they talking to you in widgets and things that don't make sense for our business? Or like, why don't you just do this? You know, you're like, well, let me explain all these rules that we have to follow. So some of it is just integrity and character, a willingness if they don't already know much about our field, a willingness to really learn about it and understand with curiosity. I think trust is a big piece of that, developing a relationship. And I found as we found the right people, there were people I could go to about all kinds of things and they would point me to someone else, right? And having that network of people that, you know, I don't mind explaining something to someone, but I need to have some sort of values alignment and some understanding of, why our business is different from most other types of industries, you know, when you look at service provision and things like that.
Dan King:
[8:55] I think that makes total sense to me. And as we talk about this journey of scaling group practices, one of the things I realized I noticed when I was hearing you just speak was social workers make up about a 35% or so of mental health clinicians, it's something like that. And yet, the vast proportion of really interesting group practices that have scaled that I come across are led by social workers.
Danielle Hayes:
[9:17] I don't know if you.
Dan King:
[9:18] Necessarily or have any thoughts on that?
Danielle Hayes:
[9:20] No, that's surprising. Now I'm going to ask you a million questions about that. But that's interesting. I'm curious. I mean, my gut instinct would be that we tend to train broadly in macro and micro systems and that perhaps have a little bit more orientation to that. Social work is a broad field, right? And so, you know, it tends to be that it doesn't draw people who just want to be clinicians as much as LPC or LMFT does. And so it could be that, And we tend to work in a lot of settings, right? So it might be that, but that's interesting to me. I didn't, I hadn't thought about that.
Dan King:
[9:53] I hadn't thought about that until I heard you just speak. And then it occurred to me when you reminded me you were a social worker and I was going through my memory banks thinking about it.
Danielle Hayes:
[10:01] We tend to be advocates and passionate about change. And so many group practice owners I talked to really start with saying, I wanted to build the thing that I thought was missing or that I wanted to see, or I wished I'd had. It really is coming from a place of authenticity. And when you talk about from a business perspective, filling a niche, well, that is it because they're filling the thing that they wanted, right? And there are others who want it too.
Dan King:
[10:24] We can't underestimate both, I think, the educational experience of being interdated in leadership and working with other change makers, right? And it's also the people that choose to go through that educational experience are themselves self-selecting.
Danielle Hayes:
[10:37] Yes. Yes, indeed. And I think group practice owners in general are a breed of clinician. Like, we're a certain type, right, personality type, that it's hard enough running private practice. And a lot of clinicians right there have a hard time making the transition from employee to running our own business. And more than ever, right, people have, again, access to information at their fingertips. There's all these Facebook groups, all this stuff. That just stuff wasn't out there, right? So you had to go talk to some business advisor and hope they understood your model. We're a funny field, right? Like, I had an agency filled with part-time W-2 employees. There are not a lot of places like that, right? And so when you talk HR, you talk about other things, you're really balancing a lot of things. Fee setting was very much up to us. What does the market bear? How well trained are our clinicians, right? Where are we reinvesting money? When you're a clinician practice owner, I think you really make those decisions based on, it felt like a rotating, you know, the practice would need support. The clinicians would need support. Co-founder and I would need support so that we could keep growing because we started with full caseloads. And I still, to this day, maintain a caseload of five. And I've always had a caseload throughout this entire process because I wanted to stay connected to the clinical work that I do. And there's a way in which that really supported everything, right?
Danielle Hayes:
[11:58] Yeah, a lot of trade-offs and decisions. You know, are we going to hire more administration or do our clinicians need to be fed?
Danielle Hayes:
[12:05] Did the cost of living just shoot through the roof? Yeah. You know.
Dan King:
[12:09] Yeah. What kinds of support systems could be helpful for practice owners? So we're talking a lot about how support systems are more robust today than they used to be. Yeah. What's still missing, do you think?
Danielle Hayes:
[12:19] I don't know. I just learned about a conference that you shared with me that is a group practice owners conference. And I'm learning. I'm seeing some of those popping up. I think that's really cool because we don't have like a professional organization or anything where we all come together. We're all from different disciplines. Right. So there's not and our boards aren't really focused on this kind of stuff. And there's a lot happening right now in our field that will affect all of this. So it's happening too fast. So I do think places where we congregate, share ideas, support one another, find partners, you know, investors and people who are aligned. Understanding what's happening in this marketplace is hard it's a full-time job right and so i think part of like in the the gift i'm getting right now is getting to kind of really step back and use that macro hat and look at the landscape and figure out you know what kind of support is needed and i think what you're doing is amazing some of the facebook groups some of the paid services are really good but then it comes down to fit right where if you're going to invest time and money, into, you know, who are the best people to do that? Who's established? Where are you going to get the value for your money? What I chose to do in this role was start a networking group as I'm meeting different practice owners, talking about mindfully, looking for people who might be interested in joining this family and understanding what we're doing and are the right fit.
Danielle Hayes:
[13:39] I realized like I was sharing the same thing over and over with different practice owners. And I started seeing different archetypes of practice owners. And I was like, I've loved a place where we could all kind of come together, support each other, whether you're trying to get to 10 or you're, you know, established and at 20, but dealing with insurance callbacks or whatever it is. There's this kind of brain trust. And so I did a free networking group that meets once a month. And I bring in sometimes some speakers. Hopefully you'll be one of them that come in and just allow a more intimate Q&A to kind of pick your brain and help feed their practices and just trusting that when you have the collective, the hive, I'm a group therapist as well, you know, and so having the hive mind and these are folks who are really collaborative from all over the country and all different types of practices. But I'm always amazed at what comes out of these meetings where there's connections that are made and support systems that are being built more just organically. And that's helping people choose which, oh, you did this incubator. OK, tell me more about that. And people can go offline and talk about it or whatever.
Danielle Hayes:
[14:43] And for people who are contemplating selling their practices, that's a whole other arena with all kinds of pitfalls. And those of us who made the leap and sold our practices, I think coming forward and talking about what we learned, what worked, what didn't work, and helping educate our peers so that they are, you know, I have no business background. That was, I'd never sold anything before, like, other than a house. I don't know, right? And so it's a huge education curve, and I think that can be helpful for our community to get educated and understand if they're looking to sell or partner with somebody, what are they looking for? What's a good fit? Who are they? Each of these practices is so individual. Are you looking to retire? What phase of your career are you in? What are your goals? Do you want to stay? Do you want to go?
Dan King:
[15:33] You make me think that maybe we need an industry association functions.
Danielle Hayes:
[15:36] That's a great idea, Dan. Are you going to do that?
Dan King:
[15:39] Yes. Yes. At the end of this podcast, we're going to create one.
Danielle Hayes:
[15:43] Support you.
Dan King:
[15:44] There you go. Thank you. So tell me, tell me about that decision to sell your practice. What was it that sparked the, I think I'm going to do this?
Danielle Hayes:
[15:54] For me, it was a couple of factors. I didn't have a plan. I think in hindsight, that's one of the main things I'd say to somebody is have a freaking plan. No, we were on the road. We were on the roll. Everything's good. We're getting tired, right? 10 years is a long time. My kids, I'm 53. My kids are, you know, launching out of the house. Pandemic hits. Suddenly overnight, we flipped to a telehealth practice, which was not common at that time. We hired people for two years that we never saw in person. There was all kinds of things, right? For us, for clinicians, we worked really hard through the pandemic, right? Like it was not any kind of arrest. And so we got through all of that, supported our people, really proud of how we handled all of that.
Danielle Hayes:
[16:41] And I think on the tail end, as things were shifting again, we had built another location so people could come back in person and given more space for people to congregate. And that was really great. But I think I started feeling the shifting sands again. And I was like, OK, everything during the pandemic, I got an email every day from someone who wanted to buy my practice. I had never gotten an email like that before. And it was all kinds of random people. And clearly something had shifted.
Danielle Hayes:
[17:12] I was too busy in the pandemic to even look up and think about it. But as we as we wound down and I started seeing kind of some writing on the wall, I was like, oh, this stuff coming in. I had witnessed the consolidation of the treatment center industry about 10, 15 years ago. I'm an eating disorder specialist and I watched all these mom and pops get bought into larger companies and absorbed and they disappeared. And it left a big gap in quality care and finding places that we're really going to see something through with a client versus just discharging because your insurance is up and you're on a plane. And so I kind of had a sense like, oh, I see what's coming. This is going to be challenging. My partner and I looked for a year, worked with a broker. We're really disappointed with what we found. Kind of gave up. You know, we're like, OK, we got to figure something else out. Feeling pretty tired and like, okay, I'm ready to, this industry is, you know, our profession is filled with feast and famine and all these changes. And I was like, oh man, do I have it in me to do this again? And then we got introduced word of mouth to Mindfully and, you know, through a local agency, ADBTA, that had partnered with them a few months prior and they're a sister agency to us. And it just felt like, okay, this could work. These are the kind of people, the way they work, what their goals are, are aligned. And we made the leap.
Dan King:
[18:28] So were you thinking about selling prior to receiving one of those pandemic emails, or did one of those emails plant the seed in your mind?
Danielle Hayes:
[18:36] I think that we had talked about this with valuation and things like that because we grew big, right? And so suddenly it became clear to me like employees can't, I think early on we thought, well, we'll hand it over to our employees. And then it was too big for that. It was too much of a burden. We didn't have anybody who could do that. So I think I started realizing we'd kind of boxed ourselves in, right?
Danielle Hayes:
[19:00] And prior to the pandemic, I thought, well, who on earth could possibly buy us? What did I know? Not a fellow clinician at this size, not our employees. So what do we do? The pandemic, what changed was all of a sudden there were thousands of buyers coming out of the woodwork. Most of them didn't make any sense to me. And I wouldn't sell my practice to that type of entity. But I realized, oh, there is a marketplace all of a sudden for this. Private equity woke up and realized there was something to make money from. And a lot of people we talked to were flippers, right? And so we were like, well, I don't want my practice bought just as a part of a roll-up for it to be sold off. I really want the model I built, I believe in, and that has worked for a decade, and I do still believe is very relevant for the clinicians and clients to carry on. And so I want someone who comes in and doesn't just start looking at, oh, well, how do we just roll up, add more sessions and, you know, extract more out of this. And I wanted someone with sophistication around the changing marketplace around, you know, marketing a practice today is very difficult compared to it was easier when there weren't so many practices and the ones that were other private owners, you know, like us, we were, you know, the competition among the local practices was doable. And there was room for all when you bring in that the type of money that you know, private equity can bring in that really is just buying up market share. It becomes very difficult to compete. You just don't have the dollars to compete with that. The Google ad prices rise.
Danielle Hayes:
[20:27] So it just becomes kind of hard, right? We see that in all kinds of industries, right? And so I think that all those realizations where we needed to, for this to preserve and protect and be intact, we needed to find the right kind of person who maintained the values and keep running it as a sustainable, viable business, but not just try to short-term, yeah.
Dan King:
[20:48] I hear you. I hear you. And you guys were self-pay, if I remember.
Danielle Hayes:
[20:53] Yeah, it is still a cash pay practice. We had our niche basically is bringing in, you know, clinicians who are new in the field and offering lower fees. And as they season up, their fees go up to, you know, match their expertise and their specialization. But having a balance, a healthy balance in the practice of enough of the lower fees and the high fees subsidize those lower fee clients. And so I watched carefully. We started out, I mean, when I think about 10 years ago, like with, you know, a $55 spot up to maybe $125 or $150 at that point. And today it starts at $110 and goes up to $225. And we do have an intern program that can offer $65 services. But it's self-select. There's no income screening. Look at the website. If they want to work with a highly specialized, like an EMDR provider or eating disorder provider who has a lot of training invested, they are asked to pay the higher fees to work with a specialist, but they really can choose. Pick your fee. And I find that people understand, right, that if people have more, they tend to give a little more. And so it works out that we can have a large number of low-fee clients, which our clinicians love to work with, and it's offset by the people who can afford to pay more and are willing to.
Dan King:
[22:12] There's so much to impact there, too. It strikes me that probably a minority of businesses are truly cash pay, right? 100% cash pay. And so you really need the right buyer who understands the differences, right? Right. And then you need to be even more selective, perhaps, in other practices in terms of. Right.
Danielle Hayes:
[22:32] Because on the system's end. Right. And that has been one of the challenges is that the practice Mindfully Behavioral Health started in Ohio in an insurance market. And but here in Texas, both of the practices they acquired are cash pay. And so, you know, having a they're very supportive of both models. And but it's required on the back end more work for them because it's you can't streamline all of that because it's very different. Right. Thank you.
Dan King:
[22:56] The marketing is so different, right? And you talked about marketing earlier and marketing a cash pay practice.
Danielle Hayes:
[23:03] Right. And they're having to provide infrastructure for insurance and for cash pay. But fortunately, they bought healthy, established practices and retained leaders. So there's not been, you know, there's a level of expertise and education around all of that that we can provide. And they have three clinicians on their executive leadership team who are speaking up and they've retained good clinicians who understand all of these things and they listen and do the best to navigate all of that.
Dan King:
[23:36] Well, let's talk a little bit with our time remaining about leadership retention. I think that's really important. Most buyers, I would say, are still in the 100% buyout, replace leader mode. And it's very different when you retain leadership. So if I'm a practice owner, I'm considering selling, I built a business to the size where it makes sense to sell it. How would you go through that dilemma? First of all, you know, we, I think we need to educate practice founders in general, if this is even an option, because I think more and more practice founders know that I can sell a hundred percent of my business and leave, but there's this other option. So how should I go about it? If I'm a practice selling, how should I think about that dilemma?
Danielle Hayes:
[24:15] Well, here's here. I mean, here's the, let me start with Dan. Like I had the opposite experience that at that time, right. It was different in 22. Nobody was interested in selling if we didn't stay.
Danielle Hayes:
[24:26] So complete opposite experience. I have heard what you just said from other group practice owners, but that is not at all what I experienced. I think, you know, I think so much comes down to the relationship. What are you as a practice owner looking for? Are you looking for an exit? There are, you know, even mindfully, we'll consider that and work with someone retiring, that type of thing. But I think what practices like these are looking for are people who understand, they know they don't know all of that. They don't want to wipe the slate and just start They want to build on what's there. So I think that in general, I'd say if you have a practice that's sellable and you're done, you find a buyer that matches that. And that's what they're looking for. But if you want to maintain your culture and your baby, which most of us have built these babies and grown them, right? And you want to hand your baby off, you know, and launch it in a beautiful way, you're looking for a partner. So it's like a relationship. You're dating, you're sorting out. Who is this person? Does it do their values match?
Danielle Hayes:
[25:24] When would there's conflict? How are we going to resolve it? Are we aligned in expectations? And to have those conversations ahead of time, there's the money side of it. And obviously, today, more than ever, you can get your business evaluated. There's so much more information today about what practices are worth and so many options for what sale looks like. So just talking to other people.
Danielle Hayes:
[25:48] Don't just talk to brokers, right? Talk to other people, get word of mouth, talk to people who have sold, talk to people like you.
Danielle Hayes:
[25:56] Find out, get educated, and then think about what you want in your life. Where are you? Do you have it in you to stay? That's hard. It's really hard. I agreed to stay for at least three years. And the first challenge is all the change and integration. It's culture, right? Shifting culture, integrating culture, believing in what you're doing, getting through the rough spots, right? Right. Getting through that, I think, like a marriage, getting past year two, where everything blows up and then deepening and settling in with a new purpose and just expecting there'll be some of that, but also keeping your eye on the bigger purpose and what you want out of this. And if you're heart centered, I think that's what I come back to over and over again is this is part of a fulfilling of a larger mission, right, of having this thing survive and thrive and grow in a new era.
Dan King:
[26:49] Yes. And that alignment in anything, you know, we're talking about integration, we're talking about buying and selling businesses, that alignment is so crucial, right? It's the case in any, we're going to keep going with the marriage analogy, which I think is a really apt one. It reminds me of a brilliant coach. Years ago, I was looking for my first business partner. And he told me, it's a very simple test. Would you marry this person? Right? Yeah. And it's a very high standard, but you should apply a high standard, right? You're a baby. It's your purpose in the world. If you're not aligned, it's going to be a disaster. The odds that it will be a disaster are very high.
Danielle Hayes:
[27:25] Yep. I agree. I agree. And I think it's worth doing the due diligence. You know, it's not just deciding, oh, I want to sell my practice. And then, you know, it's spending, in hindsight, spending some time. I think, you know, things kind of came together for me in a way that everything's aligned in a certain way. But it's work, you know, it's also... Work out as it needed to, right? And I'm happy with where I am and in the role I get to play now. And with the women who are, you know, people who were with our company for years are now running the organization, which feels really good and aligned, but they don't have the burden of ownership. At their stage of career, that was too much, but they've risen to the occasion and I still get to be, I'm behind the scenes, I'm coaching, I'm supporting them, all of that. So it's been really nice. Yeah, but it's a lot of work. It's a lot of work.
Dan King:
[28:18] That is a lovely note to move us towards the end of our time together. I have just a couple questions left. Well, what insights would you leave group practice owners with? I'm a group practice owner. I see the challenges that you're talking about. The marketplace is getting more complicated. I'm getting tired. I may or may not want to sell my business. I got to find a values aligned partner if I do. Looking back on your experiences, what would be the top sort of one or two insights that you might share with group practice owners thinking through those dilemmas?
Danielle Hayes:
[28:46] I would seek more support and it's more readily available today. So I would reach out like this podcast, the group practice owner conference, get connected with other people who have sold, come to something like the group practice owner networking meeting I'm doing, connect with other people. Everything's changing. The M&A market is also changing all the time. So you need to also have some place to get trusted. I know there's some thought leaders on LinkedIn and stuff. To connect with what's happening and where the market is. Get some coaching and support and it doesn't have to all be paid, right? It's hard when you're busy and you're running your business and you're trying to do all these things, but prepare in advance. Maybe give yourself a year to get your financials together, to understand what buyers are looking for. Do some of the word of mouth introductions. Meet some people, right? Meet a few different buyers. Get a feel for that. We did take a year to do that. It just, I learned a lot in that process that I probably could have short cut a little bit if I had understood more and what's available today, right? There are group practice owners who have been through this and who are happy to share and point towards the pros and cons of various models.
Dan King:
[29:58] Yes. So when you're not doing this important next phase of your career journey with Mindfully, what do you do for fun?
Danielle Hayes:
[30:06] I have a giant goober yellow lab that I love. Like I said, my kids are launched. So that's my baby. And we have play dates. I volunteer in my community. I'm part of like an alignment committee in my neighborhood. I've been here in this neighborhood for 20 plus years. And so helping neighbors meet each other and connect. There's more turnover in our neighborhood today because of, you know, jobs and people coming and going. So connecting with people in the area, providing things that where people can get together. I like building connection.
Dan King:
[30:40] I can see that right away. Danielle, thank you so much for sharing your insights. It's really awesome to get the chance to connect. And you built a really spectacular practice. It's a tremendous achievement to move it on to a buyer who is going to continue that legacy. It's a beautiful thing. And it's so awesome that you're in this mode of wanting to give back. So that is the best. You're the best. And thank you again.
Danielle Hayes:
[31:02] Thank you. It was great to see you.
Transcript: selling a group practice with Danielle Hayes
“I really want the model I built… to carry on.” — Danielle Hayes
Read the full transcript
Dan King:
[0:00] I am delighted to be joined by Danielle Hayes. She's the founder of Therapy Austin and today the vice president of Clinical Partnerships for Mindfully. Danielle, welcome.
Danielle Hayes:
[0:09] Hi, Dan. Thanks for having me.
Dan King:
[0:10] It's so good to be with you again. I notice, I want to start out with, I notice in your LinkedIn headline, you say that you're championing locally owned mental health practices. Tell me about the significance of that.
Danielle Hayes:
[0:22] I am a former founder, a founder of a locally owned mental health group practice and ran one, started one and ran one for about 10 years. And even though I sold my practice and now work for a larger company, it is still rooted in small practices that have come together under Mindfully Behavioral Health, where I am working today. And I think they are just, this is where I think clients are going to find the highest quality, most compassionate care. Really, you know, there's people out there who are super dedicated to the care they're giving, and they're allowed to, in these smaller practices, give that type of comprehensive long-term relational care. Yeah. Regardless of the constraints of insurance or whatever else, these types of practices are really mission-driven and founder-driven, and I think that's where you're going to find the real juice. It's not just always quantity. The quality is important, and I want to make sure consumers know and that group practice owners are supported.
Dan King:
[1:21] Could you say more about that? Why is it that patients are really going to get the best quality care there?
Danielle Hayes:
[1:26] I think because in the types of environments that clinicians, you know, a lot of group practice founders or owners are clinicians, right? And these practices are started on a dream, right? They want to build something. Either their own practice grew because of the word of mouth and quality of care they're providing. Often they have a passion for teaching and training others and increasing access to care. Their caseloads are full. And I think that transmits they care for their employees as the client,
Danielle Hayes:
[1:56] the employees and counseling employees are a client to those agencies. And they're always thinking deeply about ways that they can continue to grow and teach those clinicians. We know that the work we do is very difficult as clinicians, and they are aware of that and always looking for ways to support those clinicians and helping them sustain the practice and the type of practices they want to provide. All of that can get watered down. As things scale, you have to be thoughtful about that. It's not impossible, but that can get watered down. And when you start introducing non-clinicians into most of the decision-making, a lot of the quality of that starts to disappear because the decisions are being made without thoughtfulness and intention behind how it affects the service that you're providing.
Dan King:
[2:40] Now, with scale, there can also be certain advantages, though, too, right? So that ability to offer different services, potentially serve a wider variety of patients, there's trade-offs, right?
Danielle Hayes:
[2:51] Yeah, and I think that's one of the tricks. Like, we scaled, you know, just started two clinicians wanting to give back to the community and help people really in the post-graduation during your licensure years and ended up growing organically, you know, over 10 years to almost 150 clinicians here in Austin with five locations. And what we found is that there were more and more people who wanted to work for us, who wanted to stay working for us, more types of clients we can serve, different parts of town, different areas of specialization. And the trick is, you know, even at that scale, trying to make sure that that message and the mission is transmitted through every employee and that your agency policies and procedures and all of that, that it's basically you want that in the water and throughout the culture of
Danielle Hayes:
[3:35] the agency you're building so that it's transmitted as every new employee comes in.
Dan King:
[3:39] Noticing that you said you had a co-founder, how should a practice founder, let's say I'm starting a practice, how should I go about that decision of deciding whether to have a partner or not?
Danielle Hayes:
[3:48] You know, that's a tricky one. I mean, I think for me, that's how this all began was building a dream. You know, it was an office mate and we started talking about ideas and building the dream. I think for everybody, it's a little different. I do think it can be a relief to have a co-founder, to have a partner. In all of this, you can take turns and help each other out. It's also challenging. in some ways, but I'd say generally it was helpful to have somebody who, you know, could, we could take turns. We could spell each other out a little bit. And so you're not shouldering all those decisions on your own. I've run into a lot of group practices that are owned by like a husband-wife team, which has been an interesting, I really love those dynamics where one person's a clinician and the other has a business background.
Danielle Hayes:
[4:33] And that looks really cool to me too. And I'm often impressed with how they navigate all of that.
Dan King:
[4:38] Was your intention from the beginning to grow to the level of 150 clinicians or did that just evolve naturally?
Danielle Hayes:
[4:45] It just evolved. It was a process like I think for us at certain stages, you hit a new level of growth. I don't have a business background. I'm a social worker. My co-founder was as well. So I didn't even know a lot of the time, you know, like we went on our instincts, we followed our values, right? But every time we had a period of growth, you know, at 10 clinicians, you kind of have to decide, are we doing this? Are we continuing at, you know, 2025, you know, you have to start to build new systems at each stage. So at each stage, we would have to kind of take a pause and step back and reflect. And like, what are the tradeoffs, you know, the pros and cons of taking that next step of growth. But some of it is the timing. The model we built filled a particular niche in our area at that time. So we had an abundant referral flow and we had a lot of clinicians who they didn't want to leave. They wanted to stay. So we built based on that of saying, well, you know, this is good. It's good for clinicians. It's good for clients. It's serving our community.
Danielle Hayes:
[5:49] And we just kept taking that challenge.
Dan King:
[5:51] And did you find sort of mentors or coaches along the way who could help you understand what you needed to do differently at each of those growth thresholds? Or did you really mostly figure it out on your own?
Danielle Hayes:
[6:02] It's a lot of trial and error. I think when I look around today, I'm so impressed and won away by how many different types of mentors and even services are available for group practice owners. To my knowledge, that doesn't exist back then. This is 2012. Simple practice started the same time we did and we grew up together, right? HIPAA was new, right? There was a lot of things that just I think today, looking back, it was difficult to find those mentors. I found myself trying to talk to people in kind of similar businesses, but didn't quite get it, like veterinarians or dentists. And it was hard. We also got a lot of bad advice, you know, but little by little, we found a team of support professionals that really helped us. It took a while. We found a great accountant. We found a great banker. We found, you know, good real estate person, commercial real estate person, and people who were beginning to understand our industry and the constraints that we have that are unique to our type of business. Who also were values aligned, right?
Danielle Hayes:
[6:58] Yes. And so we built that and a lot of it was trial and error. But today I look around and I think, oh my gosh, there's all these great incubators, these services, right? There's a lot happening in this field. I just don't know that there was a lot of awareness when we started. I don't think there was another group practice like this in Austin. We were certainly one of the first and grew to one of the largest.
Danielle Hayes:
[7:20] It was scary to take on W-2 employees at that time. We didn't ever do 1099, right? It was a lot of that business risk. And then, of course, systems developed like RingCentral and Simple Practice that made it easier, that didn't exist or were emerging at that moment.
Dan King:
[7:36] So with all of this complexity in the business, you're, I think, bang on that you need great advisors. But one of the tricky things, I think, for a lot of practice owners, and I know for me in my business, is given that the professionals know more about what they do than I do, how do I interview them thoughtfully? How do I interview an accountant? If I'm a social worker, how do I know who the best accountant is?
Danielle Hayes:
[7:57] Well, what my instincts tell me is get to know them as a person, get to know their values and ask them questions about your industry and the type of like, you know, the way our income flows, right? Depending on, of course, if you're cash, pay insurance, all the other factors. But getting a sense, are they talking to you in widgets and things that don't make sense for our business? Or like, why don't you just do this? You know, you're like, well, let me explain all these rules that we have to follow. So some of it is just integrity and character, a willingness if they don't already know much about our field, a willingness to really learn about it and understand with curiosity. I think trust is a big piece of that, developing a relationship. And I found as we found the right people, there were people I could go to about all kinds of things and they would point me to someone else, right? And having that network of people that, you know, I don't mind explaining something to someone, but I need to have some sort of values alignment and some understanding of, why our business is different from most other types of industries, you know, when you look at service provision and things like that.
Dan King:
[8:55] I think that makes total sense to me. And as we talk about this journey of scaling group practices, one of the things I realized I noticed when I was hearing you just speak was social workers make up about a 35% or so of mental health clinicians, it's something like that. And yet, the vast proportion of really interesting group practices that have scaled that I come across are led by social workers.
Danielle Hayes:
[9:17] I don't know if you.
Dan King:
[9:18] Necessarily or have any thoughts on that?
Danielle Hayes:
[9:20] No, that's surprising. Now I'm going to ask you a million questions about that. But that's interesting. I'm curious. I mean, my gut instinct would be that we tend to train broadly in macro and micro systems and that perhaps have a little bit more orientation to that. Social work is a broad field, right? And so, you know, it tends to be that it doesn't draw people who just want to be clinicians as much as LPC or LMFT does. And so it could be that, And we tend to work in a lot of settings, right? So it might be that, but that's interesting to me. I didn't, I hadn't thought about that.
Dan King:
[9:53] I hadn't thought about that until I heard you just speak. And then it occurred to me when you reminded me you were a social worker and I was going through my memory banks thinking about it.
Danielle Hayes:
[10:01] We tend to be advocates and passionate about change. And so many group practice owners I talked to really start with saying, I wanted to build the thing that I thought was missing or that I wanted to see, or I wished I'd had. It really is coming from a place of authenticity. And when you talk about from a business perspective, filling a niche, well, that is it because they're filling the thing that they wanted, right? And there are others who want it too.
Dan King:
[10:24] We can't underestimate both, I think, the educational experience of being interdated in leadership and working with other change makers, right? And it's also the people that choose to go through that educational experience are themselves self-selecting.
Danielle Hayes:
[10:37] Yes. Yes, indeed. And I think group practice owners in general are a breed of clinician. Like, we're a certain type, right, personality type, that it's hard enough running private practice. And a lot of clinicians right there have a hard time making the transition from employee to running our own business. And more than ever, right, people have, again, access to information at their fingertips. There's all these Facebook groups, all this stuff. That just stuff wasn't out there, right? So you had to go talk to some business advisor and hope they understood your model. We're a funny field, right? Like, I had an agency filled with part-time W-2 employees. There are not a lot of places like that, right? And so when you talk HR, you talk about other things, you're really balancing a lot of things. Fee setting was very much up to us. What does the market bear? How well trained are our clinicians, right? Where are we reinvesting money? When you're a clinician practice owner, I think you really make those decisions based on, it felt like a rotating, you know, the practice would need support. The clinicians would need support. Co-founder and I would need support so that we could keep growing because we started with full caseloads. And I still, to this day, maintain a caseload of five. And I've always had a caseload throughout this entire process because I wanted to stay connected to the clinical work that I do. And there's a way in which that really supported everything, right?
Danielle Hayes:
[11:58] Yeah, a lot of trade-offs and decisions. You know, are we going to hire more administration or do our clinicians need to be fed?
Danielle Hayes:
[12:05] Did the cost of living just shoot through the roof? Yeah. You know.
Dan King:
[12:09] Yeah. What kinds of support systems could be helpful for practice owners? So we're talking a lot about how support systems are more robust today than they used to be. Yeah. What's still missing, do you think?
Danielle Hayes:
[12:19] I don't know. I just learned about a conference that you shared with me that is a group practice owners conference. And I'm learning. I'm seeing some of those popping up. I think that's really cool because we don't have like a professional organization or anything where we all come together. We're all from different disciplines. Right. So there's not and our boards aren't really focused on this kind of stuff. And there's a lot happening right now in our field that will affect all of this. So it's happening too fast. So I do think places where we congregate, share ideas, support one another, find partners, you know, investors and people who are aligned. Understanding what's happening in this marketplace is hard it's a full-time job right and so i think part of like in the the gift i'm getting right now is getting to kind of really step back and use that macro hat and look at the landscape and figure out you know what kind of support is needed and i think what you're doing is amazing some of the facebook groups some of the paid services are really good but then it comes down to fit right where if you're going to invest time and money, into, you know, who are the best people to do that? Who's established? Where are you going to get the value for your money? What I chose to do in this role was start a networking group as I'm meeting different practice owners, talking about mindfully, looking for people who might be interested in joining this family and understanding what we're doing and are the right fit.
Danielle Hayes:
[13:39] I realized like I was sharing the same thing over and over with different practice owners. And I started seeing different archetypes of practice owners. And I was like, I've loved a place where we could all kind of come together, support each other, whether you're trying to get to 10 or you're, you know, established and at 20, but dealing with insurance callbacks or whatever it is. There's this kind of brain trust. And so I did a free networking group that meets once a month. And I bring in sometimes some speakers. Hopefully you'll be one of them that come in and just allow a more intimate Q&A to kind of pick your brain and help feed their practices and just trusting that when you have the collective, the hive, I'm a group therapist as well, you know, and so having the hive mind and these are folks who are really collaborative from all over the country and all different types of practices. But I'm always amazed at what comes out of these meetings where there's connections that are made and support systems that are being built more just organically. And that's helping people choose which, oh, you did this incubator. OK, tell me more about that. And people can go offline and talk about it or whatever.
Danielle Hayes:
[14:43] And for people who are contemplating selling their practices, that's a whole other arena with all kinds of pitfalls. And those of us who made the leap and sold our practices, I think coming forward and talking about what we learned, what worked, what didn't work, and helping educate our peers so that they are, you know, I have no business background. That was, I'd never sold anything before, like, other than a house. I don't know, right? And so it's a huge education curve, and I think that can be helpful for our community to get educated and understand if they're looking to sell or partner with somebody, what are they looking for? What's a good fit? Who are they? Each of these practices is so individual. Are you looking to retire? What phase of your career are you in? What are your goals? Do you want to stay? Do you want to go?
Dan King:
[15:33] You make me think that maybe we need an industry association functions.
Danielle Hayes:
[15:36] That's a great idea, Dan. Are you going to do that?
Dan King:
[15:39] Yes. Yes. At the end of this podcast, we're going to create one.
Danielle Hayes:
[15:43] Support you.
Dan King:
[15:44] There you go. Thank you. So tell me, tell me about that decision to sell your practice. What was it that sparked the, I think I'm going to do this?
Danielle Hayes:
[15:54] For me, it was a couple of factors. I didn't have a plan. I think in hindsight, that's one of the main things I'd say to somebody is have a freaking plan. No, we were on the road. We were on the roll. Everything's good. We're getting tired, right? 10 years is a long time. My kids, I'm 53. My kids are, you know, launching out of the house. Pandemic hits. Suddenly overnight, we flipped to a telehealth practice, which was not common at that time. We hired people for two years that we never saw in person. There was all kinds of things, right? For us, for clinicians, we worked really hard through the pandemic, right? Like it was not any kind of arrest. And so we got through all of that, supported our people, really proud of how we handled all of that.
Danielle Hayes:
[16:41] And I think on the tail end, as things were shifting again, we had built another location so people could come back in person and given more space for people to congregate. And that was really great. But I think I started feeling the shifting sands again. And I was like, OK, everything during the pandemic, I got an email every day from someone who wanted to buy my practice. I had never gotten an email like that before. And it was all kinds of random people. And clearly something had shifted.
Danielle Hayes:
[17:12] I was too busy in the pandemic to even look up and think about it. But as we as we wound down and I started seeing kind of some writing on the wall, I was like, oh, this stuff coming in. I had witnessed the consolidation of the treatment center industry about 10, 15 years ago. I'm an eating disorder specialist and I watched all these mom and pops get bought into larger companies and absorbed and they disappeared. And it left a big gap in quality care and finding places that we're really going to see something through with a client versus just discharging because your insurance is up and you're on a plane. And so I kind of had a sense like, oh, I see what's coming. This is going to be challenging. My partner and I looked for a year, worked with a broker. We're really disappointed with what we found. Kind of gave up. You know, we're like, OK, we got to figure something else out. Feeling pretty tired and like, okay, I'm ready to, this industry is, you know, our profession is filled with feast and famine and all these changes. And I was like, oh man, do I have it in me to do this again? And then we got introduced word of mouth to Mindfully and, you know, through a local agency, ADBTA, that had partnered with them a few months prior and they're a sister agency to us. And it just felt like, okay, this could work. These are the kind of people, the way they work, what their goals are, are aligned. And we made the leap.
Dan King:
[18:28] So were you thinking about selling prior to receiving one of those pandemic emails, or did one of those emails plant the seed in your mind?
Danielle Hayes:
[18:36] I think that we had talked about this with valuation and things like that because we grew big, right? And so suddenly it became clear to me like employees can't, I think early on we thought, well, we'll hand it over to our employees. And then it was too big for that. It was too much of a burden. We didn't have anybody who could do that. So I think I started realizing we'd kind of boxed ourselves in, right?
Danielle Hayes:
[19:00] And prior to the pandemic, I thought, well, who on earth could possibly buy us? What did I know? Not a fellow clinician at this size, not our employees. So what do we do? The pandemic, what changed was all of a sudden there were thousands of buyers coming out of the woodwork. Most of them didn't make any sense to me. And I wouldn't sell my practice to that type of entity. But I realized, oh, there is a marketplace all of a sudden for this. Private equity woke up and realized there was something to make money from. And a lot of people we talked to were flippers, right? And so we were like, well, I don't want my practice bought just as a part of a roll-up for it to be sold off. I really want the model I built, I believe in, and that has worked for a decade, and I do still believe is very relevant for the clinicians and clients to carry on. And so I want someone who comes in and doesn't just start looking at, oh, well, how do we just roll up, add more sessions and, you know, extract more out of this. And I wanted someone with sophistication around the changing marketplace around, you know, marketing a practice today is very difficult compared to it was easier when there weren't so many practices and the ones that were other private owners, you know, like us, we were, you know, the competition among the local practices was doable. And there was room for all when you bring in that the type of money that you know, private equity can bring in that really is just buying up market share. It becomes very difficult to compete. You just don't have the dollars to compete with that. The Google ad prices rise.
Danielle Hayes:
[20:27] So it just becomes kind of hard, right? We see that in all kinds of industries, right? And so I think that all those realizations where we needed to, for this to preserve and protect and be intact, we needed to find the right kind of person who maintained the values and keep running it as a sustainable, viable business, but not just try to short-term, yeah.
Dan King:
[20:48] I hear you. I hear you. And you guys were self-pay, if I remember.
Danielle Hayes:
[20:53] Yeah, it is still a cash pay practice. We had our niche basically is bringing in, you know, clinicians who are new in the field and offering lower fees. And as they season up, their fees go up to, you know, match their expertise and their specialization. But having a balance, a healthy balance in the practice of enough of the lower fees and the high fees subsidize those lower fee clients. And so I watched carefully. We started out, I mean, when I think about 10 years ago, like with, you know, a $55 spot up to maybe $125 or $150 at that point. And today it starts at $110 and goes up to $225. And we do have an intern program that can offer $65 services. But it's self-select. There's no income screening. Look at the website. If they want to work with a highly specialized, like an EMDR provider or eating disorder provider who has a lot of training invested, they are asked to pay the higher fees to work with a specialist, but they really can choose. Pick your fee. And I find that people understand, right, that if people have more, they tend to give a little more. And so it works out that we can have a large number of low-fee clients, which our clinicians love to work with, and it's offset by the people who can afford to pay more and are willing to.
Dan King:
[22:12] There's so much to impact there, too. It strikes me that probably a minority of businesses are truly cash pay, right? 100% cash pay. And so you really need the right buyer who understands the differences, right? Right. And then you need to be even more selective, perhaps, in other practices in terms of. Right.
Danielle Hayes:
[22:32] Because on the system's end. Right. And that has been one of the challenges is that the practice Mindfully Behavioral Health started in Ohio in an insurance market. And but here in Texas, both of the practices they acquired are cash pay. And so, you know, having a they're very supportive of both models. And but it's required on the back end more work for them because it's you can't streamline all of that because it's very different. Right. Thank you.
Dan King:
[22:56] The marketing is so different, right? And you talked about marketing earlier and marketing a cash pay practice.
Danielle Hayes:
[23:03] Right. And they're having to provide infrastructure for insurance and for cash pay. But fortunately, they bought healthy, established practices and retained leaders. So there's not been, you know, there's a level of expertise and education around all of that that we can provide. And they have three clinicians on their executive leadership team who are speaking up and they've retained good clinicians who understand all of these things and they listen and do the best to navigate all of that.
Dan King:
[23:36] Well, let's talk a little bit with our time remaining about leadership retention. I think that's really important. Most buyers, I would say, are still in the 100% buyout, replace leader mode. And it's very different when you retain leadership. So if I'm a practice owner, I'm considering selling, I built a business to the size where it makes sense to sell it. How would you go through that dilemma? First of all, you know, we, I think we need to educate practice founders in general, if this is even an option, because I think more and more practice founders know that I can sell a hundred percent of my business and leave, but there's this other option. So how should I go about it? If I'm a practice selling, how should I think about that dilemma?
Danielle Hayes:
[24:15] Well, here's here. I mean, here's the, let me start with Dan. Like I had the opposite experience that at that time, right. It was different in 22. Nobody was interested in selling if we didn't stay.
Danielle Hayes:
[24:26] So complete opposite experience. I have heard what you just said from other group practice owners, but that is not at all what I experienced. I think, you know, I think so much comes down to the relationship. What are you as a practice owner looking for? Are you looking for an exit? There are, you know, even mindfully, we'll consider that and work with someone retiring, that type of thing. But I think what practices like these are looking for are people who understand, they know they don't know all of that. They don't want to wipe the slate and just start They want to build on what's there. So I think that in general, I'd say if you have a practice that's sellable and you're done, you find a buyer that matches that. And that's what they're looking for. But if you want to maintain your culture and your baby, which most of us have built these babies and grown them, right? And you want to hand your baby off, you know, and launch it in a beautiful way, you're looking for a partner. So it's like a relationship. You're dating, you're sorting out. Who is this person? Does it do their values match?
Danielle Hayes:
[25:24] When would there's conflict? How are we going to resolve it? Are we aligned in expectations? And to have those conversations ahead of time, there's the money side of it. And obviously, today, more than ever, you can get your business evaluated. There's so much more information today about what practices are worth and so many options for what sale looks like. So just talking to other people.
Danielle Hayes:
[25:48] Don't just talk to brokers, right? Talk to other people, get word of mouth, talk to people who have sold, talk to people like you.
Danielle Hayes:
[25:56] Find out, get educated, and then think about what you want in your life. Where are you? Do you have it in you to stay? That's hard. It's really hard. I agreed to stay for at least three years. And the first challenge is all the change and integration. It's culture, right? Shifting culture, integrating culture, believing in what you're doing, getting through the rough spots, right? Right. Getting through that, I think, like a marriage, getting past year two, where everything blows up and then deepening and settling in with a new purpose and just expecting there'll be some of that, but also keeping your eye on the bigger purpose and what you want out of this. And if you're heart centered, I think that's what I come back to over and over again is this is part of a fulfilling of a larger mission, right, of having this thing survive and thrive and grow in a new era.
Dan King:
[26:49] Yes. And that alignment in anything, you know, we're talking about integration, we're talking about buying and selling businesses, that alignment is so crucial, right? It's the case in any, we're going to keep going with the marriage analogy, which I think is a really apt one. It reminds me of a brilliant coach. Years ago, I was looking for my first business partner. And he told me, it's a very simple test. Would you marry this person? Right? Yeah. And it's a very high standard, but you should apply a high standard, right? You're a baby. It's your purpose in the world. If you're not aligned, it's going to be a disaster. The odds that it will be a disaster are very high.
Danielle Hayes:
[27:25] Yep. I agree. I agree. And I think it's worth doing the due diligence. You know, it's not just deciding, oh, I want to sell my practice. And then, you know, it's spending, in hindsight, spending some time. I think, you know, things kind of came together for me in a way that everything's aligned in a certain way. But it's work, you know, it's also... Work out as it needed to, right? And I'm happy with where I am and in the role I get to play now. And with the women who are, you know, people who were with our company for years are now running the organization, which feels really good and aligned, but they don't have the burden of ownership. At their stage of career, that was too much, but they've risen to the occasion and I still get to be, I'm behind the scenes, I'm coaching, I'm supporting them, all of that. So it's been really nice. Yeah, but it's a lot of work. It's a lot of work.
Dan King:
[28:18] That is a lovely note to move us towards the end of our time together. I have just a couple questions left. Well, what insights would you leave group practice owners with? I'm a group practice owner. I see the challenges that you're talking about. The marketplace is getting more complicated. I'm getting tired. I may or may not want to sell my business. I got to find a values aligned partner if I do. Looking back on your experiences, what would be the top sort of one or two insights that you might share with group practice owners thinking through those dilemmas?
Danielle Hayes:
[28:46] I would seek more support and it's more readily available today. So I would reach out like this podcast, the group practice owner conference, get connected with other people who have sold, come to something like the group practice owner networking meeting I'm doing, connect with other people. Everything's changing. The M&A market is also changing all the time. So you need to also have some place to get trusted. I know there's some thought leaders on LinkedIn and stuff. To connect with what's happening and where the market is. Get some coaching and support and it doesn't have to all be paid, right? It's hard when you're busy and you're running your business and you're trying to do all these things, but prepare in advance. Maybe give yourself a year to get your financials together, to understand what buyers are looking for. Do some of the word of mouth introductions. Meet some people, right? Meet a few different buyers. Get a feel for that. We did take a year to do that. It just, I learned a lot in that process that I probably could have short cut a little bit if I had understood more and what's available today, right? There are group practice owners who have been through this and who are happy to share and point towards the pros and cons of various models.
Dan King:
[29:58] Yes. So when you're not doing this important next phase of your career journey with Mindfully, what do you do for fun?
Danielle Hayes:
[30:06] I have a giant goober yellow lab that I love. Like I said, my kids are launched. So that's my baby. And we have play dates. I volunteer in my community. I'm part of like an alignment committee in my neighborhood. I've been here in this neighborhood for 20 plus years. And so helping neighbors meet each other and connect. There's more turnover in our neighborhood today because of, you know, jobs and people coming and going. So connecting with people in the area, providing things that where people can get together. I like building connection.
Dan King:
[30:40] I can see that right away. Danielle, thank you so much for sharing your insights. It's really awesome to get the chance to connect. And you built a really spectacular practice. It's a tremendous achievement to move it on to a buyer who is going to continue that legacy. It's a beautiful thing. And it's so awesome that you're in this mode of wanting to give back. So that is the best. You're the best. And thank you again.
Danielle Hayes:
[31:02] Thank you. It was great to see you.