Episode 126: From Burnout to Breakthrough: Selling A Group Practice Successfully [featuring Gabrielle Juliano-Villani]

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Transcript

PATRICK CASALE: Hey, everyone. You are listening to another episode of the All Things Private Practice podcast. I'm your host, Patrick Casale. I'm joined today by my friend and colleague Gabrielle Juliano-Villani, LCSW. She is a coach, consultant, Medicare expert extraordinaire, retreat hostess, and a lot of other things that I can't remember at this point in time, because neither of us have slept well. And our brains are not working.

But nevertheless, we're going to talk about selling your group practice, because I think this is a topic that's coming up more and more. Gabrielle has done this successfully. She also offers coaching around how to do this. And there's a lot of ins and outs, there's a lot of struggle areas, too. And there's a lot of emotion behind making a decision like this.

So, thanks for coming on again and sharing some of this story.

GABRIELLE JULIANO-VILLANI: Thank you for having me for a second time.

PATRICK CASALE: So, how long has it been since your sale?

GABRIELLE JULIANO-VILLANI: I officially sold on December 31, 2021. So, it's been about almost two years, like a year and a half.

PATRICK CASALE: Any regrets?

GABRIELLE JULIANO-VILLANI: Nope.

PATRICK CASALE: I think at first, yeah. So, this is a topic that, you know, I think we see a lot of in the circles that we both run in and maybe not for people who are just starting out, like, this isn't on your mind as even something that's a possibility, but it is. And a lot of people are moving into that mindset of, I would like to sell the group practice that I've created.

And I own a group practice, I've definitely considered it. And I know for myself, it brings up a lot of guilt, shame, emotion behind something that you've worked really hard to create, the relationships that you've built, the staff that you employ, all the things.

GABRIELLE JULIANO-VILLANI: Mm-hmm (affirmative).

PATRICK CASALE: So, tell us a little bit about what you can tell us in terms of your journey and selling your group practice. And you know, how that kind of came to be.

GABRIELLE JULIANO-VILLANI: So, it started because of burnout, of course, and-

PATRICK CASALE: Your other specialty area.

GABRIELLE JULIANO-VILLANI: My other specialty area. And I was having a conversation with a friend a very close friend of mine. She's also my mentor. And she is an entrepreneur in another field. And it's been really invaluable to have somebody who is also an entrepreneur, who's not a therapist to talk to.

And we were talking and this was in like, I don't know, June, May, something like that, in 2021. She's like, "Why don't you just sell your practice?" I was like, "Well, I never really thought about that. I didn't really think that was a thing. I've heard like some rumblings of that. But, I mean, who would like want to buy it?"

We ran some numbers. And I was like, "I don't think that's really worth it. So, I'll just put that on the back burner and just keep hating my life."

And then, actually, in Hawaii, where Patrick and I both were for a conference, I was on vacation. And that was, actually, close to this time of year. I think it was like the end of July of 2021. And I got a voicemail from somebody and they said, "We represent this company who wants to acquire your practice. Call us back." And I was like, "Well, that seems like spam. Like, you know, like your car warranty is running out. Like, I'm not calling these people back."

But my friend was like, "No, that's how a lot of these deals happen, call them." So, I did. And of course, researched and made sure that it was legit. And we had a Zoom meeting. And they were real people. And they were like, "We want to meet you."

So, we met and we talked. And that process took a little bit longer because of scheduling. But I think that was around September 2021. And decided to move forward. And then I signed on the dotted line on December 31st. So, it happened really quickly.

PATRICK CASALE: That's a real really quick turnaround, because most of the time I'm hearing, well, like 18 months is an average to sell something like that.

GABRIELLE JULIANO-VILLANI: It can be. We were trying to rush because the capital gains taxes were going to change. And they did end up changing, not in our favor. So, I'm glad that we were able to do it that way. 

PATRICK CASALE: Yeah. So, that was a decision that it kind of sounds like it went from, I didn't even know this was a thing to being a very real thing in a matter of months.

GABRIELLE JULIANO-VILLANI: It did. And I appreciate that you already brought this up about the emotions, because that's really the hardest part. I mean, there is a lot of legal stuff, and paperwork, and back and forth. But it's the emotions that go along with all of that.

And even my attorney, when I first called them to tell them, you know, I think I'm doing this, like, you know, I need your help. They were like, "You need to be prepared emotionally and have a support system, because it's going to be a roller coaster. And there's a lot of ups and downs."

He was telling me they have like a $20 million deal that they were working on. And they're like, "It's been dragging on forever." Because the owner, you know, he's like, "Ooh, $20 million is awesome. But I don't really know if I want to do this." So, he drags his feet, and he wouldn't send them documents. And that's pretty common, too.

PATRICK CASALE: I think that makes sense, and maybe, I mean, that's a very large deal. But it makes sense why you would be interested then immediately almost have that like buyer's remorse feeling of like, "Do I really want to go through with this?" Because this is a life-altering decision and it is impactful to a lot of people.

And I know, as group practice owners, and former owners, that we have a lot of restless, sleepless nights thinking about the well-being of our staff, making sure that they feel taken care of, that they feel satisfied in their careers, that they're showing up as their best selves. Like, there is a lot that goes into it.

And I think group practice ownership gets a bad rap a lot of the time from people who are like, "I worked at a group practice and they took advantage of me, took all my money. What the hell was I doing there? And they treated me poorly." I hate hearing that. But I know that there's a lot of owners out there who really care about the quality and the culture.

And when I think about selling, because it's at a point where I'm like, "Do I enjoy being a group practice owner?" And the answer is, and I'll be very transparent, you know, because I know some of my staff listen to this, the answer is no. Like, I don't ever have a day where I'm like, "Oh, this is really lighting me up. This is really energizing. This is really enjoyable."

I think I almost think about selling every day, for the last year, actually, since we migrated EHRs last summer, and it just became a nightmare. And that was the first time where I was really thinking like, again, in Hawaii, really, where I was getting bombarded by messages every single day about things not working, or being disgruntled, or frustrated. And I was like, "What am I doing this for?"

GABRIELLE JULIANO-VILLANI: Yeah, I felt the very same way. And I mean, it was a red flag for me not only that, maybe this was not a good fit, but also for my burnout, because I was like, "I don't really care what happens today." Like, I would have such a hard time responding, because I just felt so overwhelmed and again, burnt out. And I was like, "What am I doing this for? Like, I can't hear it, I don't care."

Like, really, at the end of all of this, I was like somebody could say I will take this practice over for $1 and I would give it to them. It's just hard. And there are definitely things that you can do to prevent that. And that's what I do a lot of coaching and consulting on is like leadership and all of that stuff. But also, it's not a good fit for everybody. And you can do all of those things. But at the end of the day, it's lonely at the top, it's always going to come back to you as the owner. And you have to be okay with that.

PATRICK CASALE: Yeah, absolutely. And there's always going to be situations where you could have handled things differently or kind of with a different perspective. But I think there's this perspective as well that you're the owner, you're just making insane amounts of money off the staff, and I'm like, "No, show me where it is. Like, I'd love to know." But-

GABRIELLE JULIANO-VILLANI: I had therapists, actually, two of them made more than me. Like, I would look at my P&L, and I'd look at my salary, and their salary, and they were making way more than I was. So, that is a misconception. [CROSSTALK 00:09:37]-

PATRICK CASALE: There's a lot of [INDISCERNIBLE 00:09:37] that goes into running a group practice, and a lot of expense that eats into the profit, especially, if you, you know, value people over profit, which a lot of colleagues that I surround myself do. So, it's challenging.

And I also have made the mistake of hiring a lot of my good friends, which makes it way more challenging, because there's more emotion and investment in like, if I was to sell, when do you have that conversation with them? When do you start being really transparent about this? Versus the other side of it of like, do you just keep your mouth shut, because you've signed an NDA and you need this to go through smoothly?

So, I know a lot of people wrestle with, like, how do I navigate this process, because it's going to feel really lonely? And I think you mentioned just having a good support system, having people who are not therapists in your life who you can also process a lot of this stuff with. And I do think that it's a viable option.

And here's the thing, a lot of group practice owners I don't think know that it is an option and just assume, "I'm going to be in this perpetual state of stress, and overwhelm, and burnout until I just can no longer do this. And then I have to just say, like, 'We're closing shop. Like, this is not a thing that I can run anymore.'"

GABRIELLE JULIANO-VILLANI: I think that's an interesting thing for our field, because in other fields people start businesses with the intent to sell them. And people realize that it's an asset, and that you can use that to retire, you can use that to start something else, you can pivot like I did.

And that is something to start thinking about from the very, very, very, very beginning of when you're starting your little private practice, because you really never know.

I mean, I know this is like going to sound really cheesy, but seriously, as a little baby social worker who started in this field making $35,000 a year working in Child Protective Services, I never, ever thought that I would own a business, grow it to seven figures, sell it, and do what I'm doing now, which is pretty much my dream life. And you just got to think big, because really, it is limitless. But you also need to take a line of action and do the back-end work too.

PATRICK CASALE: Yeah, that's such an important point. And I think the reason that people, including myself, you know, at the time starting off as a little baby, Licensed Clinical Mental Health Counselor making about the same amount of money, we don't think about it is because we don't have business training, for the most part. I will guesstimate that, and I'm trying to be conservative in my estimation that 95% of us in the mental health field have zero business training. And we don't talk about it in grad school. And it's almost like a taboo topic to even talk about small business ownership. It's like becoming more and more normalized.

But I still think that it leaves us in positions where we're kind of just flying by the seat of our pants without a plan. We're kind of basing it off, like what other people have told us in Facebook groups, or checklists that you can download, or whatever the case may be. But you never really fully evolve into an entrepreneur and business owner.

And you're just kind of like, "Okay, I have this private practice. And that feels wonderful. But I don't know what else to do with it. And that means that I'm just going to be in this state of like, selling clinical hour for dollar for the rest of my life, which means that I have to spend the majority of time with my ass in the seat, because I don't have the ability to comprehend how this can look differently."

GABRIELLE JULIANO-VILLANI: That is so true. And no offense. Like, this is not every therapist, but a lot of the ones that I work with, or that I see on social media, it's like we're very narrow-minded. We think exactly. We can only do one-on-one sessions for an hour. And that's how we make money.

And I was, actually, literally this morning talking about this with my friend, because we just got back from the Zumba Convention. And she's probably getting sick. And I remembered in, I think it was 2018 or 2019, so it was in solo practice, it was probably 2018. I had also just gotten back from the Zumba Convention. I hadn't worked all week, because I was seeing people in person. I got back and I had bronchitis. And I was like, "Shit. Now, I'm not working another week." And I wasn't really prepared for that.

And now I am like, you know, I have additional streams of income. Like, I woke up this morning, people bought my Etsy template for 10 bucks. Like, it's not huge. But I wake up in the morning and people have bought my courses. And it's just so nice to know that there are other things that you can do that can support you financially and emotionally, where you don't have to always be trading your time for money.

PATRICK CASALE: That's a great point that we talk about on here all the time - how applicable and transferable a lot of our skill sets are. But so often we just don't see the forest for the trees, so to speak.

Like, I left grad school thinking community mental health was the finish line for what I could do. Then it was very obvious that private practice was viable. I didn't know what I was doing, but I knew it was an option. And I thought, "Oh, I could do coaching and consulting." And started group practice, monetized a podcast, host retreats all over the world, rent an entire village in medieval town in Italy, which I never thought I would say in 2015. There's no chance in hell I thought that was going to happen.

Or like you said, that you could have evergreen passive income from courses, and workbooks, and worksheets, and all the things that you can create. Because people are looking for these answers. They're looking for these strategies. You just have to know how to monetize them.

And I think that so many of us keep ourselves in these positions or situations that we are not enjoying, because we don't know anything else. And we don't know that there's another option.

GABRIELLE JULIANO-VILLANI: Yes. Oh, my God, said so perfectly. But really, our skills are transferable. And we don't know that too, because we're surrounded by therapists.

So, I remember, like, my very first TikTok video that I made a long time ago, I was like, "I'm going to make this on the 5, 4, 3, 2, 1 five senses meditation." And of course, if you're listening, you're like, "Duuh, everybody knows that." Everybody does not know that, actually. We all know that, right? But people out there who are not therapists, who've never been to therapy, they have no freaking clue. So, yeah, there's a lot that we can do besides therapy, is the moral of that story.

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PATRICK CASALE: And I think that's such a good perspective, because if you only surround yourself with therapists who, if we are, again, conservatively saying that 95% of them have no business training or experience, all you're going to hear is this is all you can do.

GABRIELLE JULIANO-VILLANI: Yeah.

PATRICK CASALE: Because it's all I know that I can do. But like you said, having a coach, or a friend, or a mentor outside of therapy, who's an entrepreneur, it lends itself to a different perspective in how you can create business and multiple streams of revenue and income.

And I think that's what we all ultimately want. If you're an entrepreneur, especially, I think there's two camps, right? Like, who are probably listening to this podcast, those who are like, "Private practice is it for me. I don't want to be an entrepreneur. I'm not good at it, I don't like it, I don't enjoy it." Great. That's okay.

And for those of you who are listening who are like, "I like doing therapy, but I also have a lot of other interests." Just the acknowledgement that there are lots of ways for you to monetize the skill sets that you have, the training that you have, the experience that you have, the education that you have. And it really is just about starting to pursue those other alternatives and taking action on them. That's a big piece of it too, right? It's like-

GABRIELLE JULIANO-VILLANI: Yes.

PATRICK CASALE: …we have to take action, it can't just live in our heads, it can't just die as an idea. Like, there has to be in the implementation, and strategizing phase, and there is going to be risk and there is going to be self-doubt, and there's going to be fear around all of this stuff.

But I like it. Like, I think for me, those types of things are the energizing types of things. So, like, I pursue the things that make me uncomfortable. It's really easy to stay in your comfort zone and say like, "I could do this thing, I am interested in speaking, I am interested in starting a podcast, but I don't know how. I'm not going to do it, because I don't know how."

And I hear that way too often. And it's really a shame. But I think it's really important to acknowledge that there are a lot of different pathways in this career, in this profession.

GABRIELLE JULIANO-VILLANI: There are. I hear that so often too, same thing. That it's like, I don't really know how, and just like a lot of, I guess, kind of negativity or… and I know that that goes deeper than that, right? Like, the fear of being seen, the self-doubt, and the impostor syndrome, but the only difference between me and whoever is listening is that I'm doing it and you could do it too.

And I also enjoy being uncomfortable and pushing myself, because that's how I've grown. Even like when I applied to be a coach for the SBA, I was like, "They're not going to pick me because I am a therapist, and they just probably, you know, won't want me to be coaching executives." And I kept pushing myself till the deadline. And I was like, "I really need to do this if I'm going to do it."

And I sat down, and I did my whole application, and like within 12 hours they had emailed me and they're like, "We want you to do this for us." And so that's just like another way that I was able to grow and expand, but it was because I had to push myself to do it.

PATRICK CASALE: Yeah, And I think that's such an important lesson for people to hear. And if you're thinking like, "I don't know what else I could do, or I want to start this thing, or pursue this passion." Whether it's a coaching program, or a podcast, or any other sort of alternative stream of revenue, I imagine, if you've created a private practice, you had the same thoughts about creating a private practice, where you sat there and told yourself for months or years, "I don't know how to do it, it's not for me, other people do it better, other people have more training, I'm not experienced enough. I don't have any experience in business." All the things that we tell ourselves, until one day, you hit your breaking point at your community mental health job, and you say, "Fuck this, I'm not doing this anymore. I'm going to take this risk."

And it's unfortunate that so often we need to hit that breaking point to then say, "I will take this risk." When in reality, you can do it very intentionally. And you can pursue these things with strategy and planning. And you can move forward even though it's a bit scary, still feeling like I'm taking action, like I'm taking these steps to do this thing.

GABRIELLE JULIANO-VILLANI: It's the same thing with selling, because that's what happened to me and ended up working out. But the goal, really, is you want to do that before you're burnt out. Just like it will be great to leave your community mental health job before you're sick, because those jobs do make people sick.

And I absolutely believe, I think I talked about this on our last podcast, actually, that like, a lot of my autoimmune stuff came from my previous jobs, and would have been nice to not have that. But here we are.

So, yeah, just a reminder that you can have a strategy, and you can implement it, and work towards it in a different way than working towards things when you are completely burnt out and you hate life. Like, you don't want to get to that point.

PATRICK CASALE: Absolutely. And if you are a group practice owner, and you've considered selling or this conversation is making you, like, consider even looking into it, I would challenge you to just think about what it would be like if you no longer ran your group practice, and what it would feel like to say, "This is no longer a responsibility that I have or something that I have to do."

Because when I think about it, I take a really deep breath in and it feels like really freeing. And I think it's important to acknowledge that if you feel that way, then like Gabrielle was saying, that's a red flag to start paying attention to. Like, you're already, like, starting from a position of feeling like you're making decisions out of frustration, irritability, feeling rundown. I mean, you don't want to make decisions when you're in that mindset, because, ultimately, everything is going to feel negative, and everything is going to feel like an uphill battle.

And I think you really want to start making these types of decisions, whether it's a big one, like selling a group practice or starting a private practice in a frame of mind where you're doing so where the why aligns with your values and it aligns with your goals for your future. Because it's so easy to just do the next thing because you think you're supposed to, or to just go through the motions.

And life is too damn short to do that. And if you're no longer finding joy in the things that you used to love, that's a sign that's an indication that it's really time to start implementing some action steps and strategies.

GABRIELLE JULIANO-VILLANI: I talk about our why and our values constantly. It's like one of my favorite things to talk about. And when I train, I did a training, like, in June on building a group practice, and like I started so much on that. And I think people really get frustrated with me sometimes because they're like, "No, I need to know the logistics and blah, blah, blah." I'm like, "Sure we're going to get there. But you can't do any of this without knowing that. What is your mission? What are your values? And what is your why?"

And those things matter too, when you sell, by the way. When I was coaching for the SBA, we spend a lot of time on that too. And my cohort was like, "Is this really worth it? Like, who cares we're doing all of this deep inner work on our values and our mission statement?" And they're like, "Does anybody even care about that?" I'm like, "Yeah, they do." Especially, when you sell. They do also because the buyer also wants to make sure that those things are in alignment too. And when you have those things in place, you build a culture around that, and you build a reputation around that too.

PATRICK CASALE: Absolutely. Could not say that better myself. And I think that's really important. And I always do that with coaching clients as well. And they do get frustrated when it's like, "I want to refer."

I always ask, "Do you want to refer in instead of out and just make more money? Or do you want to be a leader, and a boss, and a coach?" Because if you don't want to deal with the administrative side, or the operational side, or when things go awry, you're the one to help, you know, kind of jump in and help fix it. I don't think group practice ownership is for you."

And that really leads through this disconnecting culture where it just feels like, we can't retain staff, we can't attract staff, I'm bleeding money, and I'm feeling like this was the worst decision of all time.

And a lot of the times, it's just because you didn't initiate the process and alignment with your values. And I think that's important in any business decision. Whether it's to start a private practice, a group practice, a coaching program, a podcast, anything. I think you have to have that alignment.

Also, just like thinking having this epiphany moment, as you're talking, that this is what you should absolutely do, your speaker sessions in Italy on is that. Because I think it's so important. Like, really aligning your values with your why. And I think that's important. That is just consistent with the theme of that summit. So, hopefully, you will consider that, no pressure. [CROSSTALK 00:26:16]-

GABRIELLE JULIANO-VILLANI: Well, it's already part of the thing that I do. So, we'll do a little activity on that. So, if you're coming to Italy, be prepared.

PATRICK CASALE: Cool.

GABRIELLE JULIANO-VILLANI: I'll have fun colored pencils and paper for you, also, so…

PATRICK CASALE: Love it. The reason I'm thinking that is like, I get so excited to extend invites to speakers that I really didn't even care when they were like, "What do you want me to speak about?" I'm like, "I don't know, I just want you to speak. Like, I just know that our audience will get a lot out of what you have to offer." And then I just leave it at that. So, that's really awesome to hear.

But yeah, I think circling back to the most important piece for me, again, is the emotional side of this, and really acknowledging that this is going to be an emotionally charged process. And there are going to be highs and lows, and you're going to question your decision. And I think that is totally, totally normal as a human experience, and just to acknowledge that that is okay, like, and to ensure that you have a support system in place so that you can process how you're experiencing this and how you can kind of have some support and encouragement around it. Because there are going to be days when you're going to really question if you're making the right decision.

GABRIELLE JULIANO-VILLANI: Oh, for sure. And even in the same five minutes, it's like 30 seconds ago I'm like, "Yeah, let's do this." And then 30 seconds later, I'm like, "Oh, fuck, what am I doing? Like, this isn't right."

And I went through that a lot. And everybody does. And also, it was like this weird thing where it was such a big part of my identity was like, "What am I going to do with my time if I'm not like, in Simple Practice looking at everybody's calendars, and like doing billing, and whatever?" And it's hard.

And I don't know… I think that there's a couple of ways to think about this. But I do think it's okay to, like, distance yourself a little bit from your business. And I know, like, not everybody agrees with that. But I think for me, that was helpful. And it's helpful for me now too, to not feel like this is me, and this is my only identity, and this is my everything.

And what really helped shift my mindset with that, too, was my broker who unintentionally became my therapist. And he said the same thing. He's like, "Everybody struggles with this. And this is what I tell everybody." He's like, "Look at your life, the book of Gabrielle's life, and what's like the end chapter. This is just a stepping stone to get you to the next thing."

And when I reframed it like that, it was like, "Yes, like this, to me is like my way of like, moving into a different timeline, and like leveling up." I guess. But like, this was me thinking like, I'm ready for the next thing, because I did feel a lot of shame selling. And not necessarily like personally from people, but things have shifted a little bit about that, too.

But a couple years ago, when I was thinking about selling, people would talk about it, and the things that I saw were like, "You're a failure. You're a sellout. And that's like not what entrepreneurs do." Which is totally wrong, by the way. And I felt that I was like, "Maybe I am a sellout, maybe I'm like, not good enough. And that's why I don't want to do this anymore. Maybe I should just push myself."

But when I thought about it in that way of like, what do I want my life to look like? Do I want to get up every morning and see all the problems that my stuff was having, and clients stuff, and insurance stuff, and EHR stuff? Like, is that what I want my day to look like? It's not. And I am very happy, but not looking like that anymore.

And I always worry too, that my previous staff thinks that when I say things like that, that I hated them or something and I didn't. Just managing people is not something that I enjoy doing.

And there's just a lot of stuff on the back end, that if you're an employee of a group practice you don't see. And it's just hard to understand all of the things that we do, and all the hats that we wear, and all this stress, and worrying about them too. Like, are they happy? Am I doing enough for them? Constantly waking up in the middle of the night and being like, "Oh, my God, I forgot to do this? Or, "Oh, my God, should I have responded to that a different way?" Somebody had texted me, you know, later in the night, "Should I have responded to them? Should I have called them? Was I nice enough? Was it too cold?" Like, there's just so much that goes on with running any business though, since we're talking about group practice ownership.

PATRICK CASALE: Yeah, I relate to every single thing you just said. And I think a lot of group practice owners that are listening do as well. And it's unfortunate, again, because we live in a capitalist society, the group practice owner is always going to be looked at in some form of negative light from someone in the group practice, whether you're trying to do everything you can for your staff or you're not. And a lot of times, you just don't see the behind-the-scenes stuff, like the stuff I was telling you before we hit record.

GABRIELLE JULIANO-VILLANI: Yes.

PATRICK CASALE: Has kept me in like this sleepless pattern for the last five days. And it's one of those things where you do have to really start examining, like you said, what do I want the next chapter to look like for me?

And the solution is certainly not just saying, I'm just going to hold on to this until it just crumbles and falls apart. And I no longer have to deal with it. If that's how you're feeling, or thinking about how this comes to an end, it's time to put some things in action, because that's not a strategy. And that's not fair to your staff either, or to you, or to your clients.

So, when you're already starting to feel that sort of way of like, I don't have an exit plan, but I need something to happen. Like, I'll sell it for $1, like you said, or, you know, people explore the like, "Could we do employee financing within the group? Can we do like, owner financing from another therapist?"

Those are solutions, but like, really protect yourself, because if that implodes, which it so often does, and you are now stuck in a position where you try to sell, it came crumbling down. And now you really have to make some hard decisions. And it's a really hard existential place to be when you're sitting there and really questioning which direction do I go?

GABRIELLE JULIANO-VILLANI: It is so difficult. And I just kept going back to like, what do I want my life to look like? And that was really the most helpful thing. But you should have I hate [INDISCERNIBLE 00:33:09] but sorry, you should have an exit plan from the very beginning. I talk about that, too, when I do coaching. Like, when you start, you should know how this is going to end? What if shit hits the fan? What are you going to do? What is that going to look like?

Because the other thing about selling that nobody likes to hear either is that you need to sell when you are growing and you're doing well. Nobody wants to buy your business when you haven't paid taxes in five years. And you have a huge outstanding business loan. And all your employees quit and you're just like, "I don't really want to deal with this anymore. I want somebody else to deal with it." They don't want that either. Nobody wants to buy a business that's struggling. So, I know that's hard to hear, also.

PATRICK CASALE: So true. That's such a good point. Because once you get to that, like, fuck it mentality, it's really no longer a viable option. And then if you do sell it, it's going to be to the wrong person or business. You're going to get financially taken advantage of because you're so desperate to get out. And that doesn't feel good either.

And so I really do encourage all of you who are thinking about this, even whether you're in grad school, whether you're in community mental health, in private practice, going into group practice ownership, to have an exit plan for any of your ventures, to really strategically think about this because your health can fail you. You may just lose interest. There are so many factors that are outside of our control.

I never expected to retire as a therapist the way that I did because I have not worked as a therapist since October since the throat surgery that I had. I never expected that to be how things came to a culmination or ahead. And sometimes this stuff is just way outside of our control. So, I think it's really important to have the endpoint in mind when you are starting out, and really starting to think about how do I put things in place so that if I want to sell I have my financial documentation in order, I have my profit and loss statements, I have all of the expense tracking? Like, have that stuff available, instead of having to scramble and figure out where to pull it from or how to organize it, or how to even do it in the first place.

And this is a rabbit trail to go down. And I'm definitely diverging here, but this is a conversation when it comes to like, when do I start outsourcing? If you feel like I'm running a business, and I cannot handle the financial piece of it, outsource the financial piece of it. Have someone doing your budgeting, your P&Ls, your QuickBooks. Like, really make sure that your bookkeeping is in order, because you really cannot sell your business if all you have to offer them is just a collection of emails and spreadsheets and things that don't make any sense.

GABRIELLE JULIANO-VILLANI: Yes. It might make sense to you, right? Like, that might be how you do it. But it does need to be organized. And I am a huge fan of outsourcing. Especially, when I started my private practice, the first thing that I hired somebody to do was bookkeeping. Because I know I'm not good with numbers. And I know that's important to run my business. And that I need that to understand so many other different things. But I'm not good at that. So, why am I going to waste my time, probably, fuck shit up, just give it to somebody who's a professional, pay for it.

PATRICK CASALE: This is another example, though, of having a short-sighted vantage point of business ownership of saying like, this is costing me money in the short term and I don't see how this is going to be favorable to me in the long term, when in reality, it's like by outsourcing some of these things, this ensures that there is a return on investment in the long term. And it's really hard to have that if you're very afraid or gun shy to pay someone 25, $30 an hour to handle responsibilities for you that you don't have time to do, you don't want to do, or you just don't enjoy doing.

And I always think that as therapists, especially, we look at it from that short-sighted vantage point of like, "Oh, money, I don't want to spend it."

GABRIELLE JULIANO-VILLANI: Yeah.

PATRICK CASALE: When in reality, it's like this will actually help you. This will help you relinquish control. It'll help you get your time back. It'll help you make more money in the long run. Because you're able to spend time doing the things that make you money, instead of being bogged down in these administrative tasks that bring you no joy or just frustration.

GABRIELLE JULIANO-VILLANI: That's exactly what leads not only to burnout, but to more problems, especially, if it's something that is so… what's the word that I'm thinking of? Like intense, really. Like bookkeeping, like it seems really easy, but there is, you know, specific things that need to be done. That's why people have degrees in it.

And I'm not going to say that I know how to do that when somebody else could just do it better. And then I don't have to spend more money trying to clean up that mess later.

And I think that's one thing I was thinking about, again, this morning, I was like I'm going to write an email about coaching for the SBA. So, maybe it's just on my mind. But that was one of the things that I learned about from, like, the difference between therapists and other entrepreneurs is all of those people in my cohort, none of them were therapists, unfortunately. I'd love to see more people in that program. But they valued that. They valued spending money on things that they knew would be helpful to them. They valued coaching. They knew that it costs money, but that it was going to change the way that they ran things. They valued marketing, and you know, like financial planning, they all outsourced those things. And even though it costs them money, they knew that there was the long-term impact of it.

PATRICK CASALE: Yeah, that's such a great perspective. And I think that's a really important takeaway from this conversation. And I hope that we move more towards that mindset, just the acknowledgement of like, it does cost money to run a business. The more you invest into your business, the better it's going to treat you in the long run. And I think that's really important in terms of also combating burnout in this profession as well.

GABRIELLE JULIANO-VILLANI: For sure.

PATRICK CASALE: We could probably talk a lot longer on this subject and continue diverging into these other areas. But I think that this is a good place to just put a pin in it because there's a lot of information in this conversation and a lot of good takeaways. And I really appreciate you just sharing your own process and perspective on this, because I think it's a really needed voice in this industry, when we're thinking about these options, and acknowledging that they exist.

GABRIELLE JULIANO-VILLANI: I am happy to share because when I was going through all of this, I didn't have anything like this to listen to or to turn to. And one of the really difficult things about selling is you do sign an NDA, and you can't be posting on Facebook, you can't tell your staff. And so it's very isolating.

And I really was dying for somebody who had been through this before to tell me what it was like. And I couldn't find anyone. I found a couple of people who had sold but they were very kind of more informal sales, like it was to another therapist in their town, nobody who had done it on my scale. I knew there were people out there, but I couldn't find them. So, I hope that this sheds some light on it.

It's a very complex, nuanced thing to go through. But it really has changed my life for the better. And it's something that anybody can do. I know that, you know, we get into our heads about, like, the timing and the economy, and now everybody's trying to sell, but I, just like with anything, I really feel like there's space for everyone.

PATRICK CASALE: Absolutely. Couldn't say it better myself. Well, thank you so much for coming on again and sharing this part of your journey. And I'm really excited for your next chapter. And part of that is hosting your first retreat in Belize, in January. So, please tell everyone where they can find more about that and more about the coaching that you offer.

GABRIELLE JULIANO-VILLANI: Everything is on my website. I am probably the only person with this long ass name. So, I'm kind of easy to find. It's gabriellejulianovillani.com. We'll be Belize January 25 to 30th. Belize has a very special place in my heart, the people there are very warm, and friendly, and welcoming. It's kind of hard for me to put into words, but the energy is just different. And that's why I chose that place.

And it's going to be a true wellness retreat. So, we will be resting, relaxing. There's going to be meditation. I'm also a certified sound healer among everything else that I do. So, lots of sound healing, lots of immersion in nature, and adventure, if that's your thing, too.

And if you want coaching or consulting on how to scale your practice, how to add income streams, how to prepare to sell, Medicare, we were talking about that earlier. That's my other weird niche. Because my group practice was mostly Medicare-based. So, I'm very familiar with that too. And it's actually one of the things that helped me sell. You can find all that info on my website, too.

PATRICK CASALE: Awesome. Thank you so much for sharing all of that. And that will all be in the show notes so that you have easy access to all Gabrielle's information if you want to learn more about the retreat, coaching, Medicare, Etsy templates, whatever. They're all there for easy access and they'll all be in the show description.

Thanks again for coming on. And I am super excited for you and to see you in Italy next year. Which feels like a very long time away now that I realize it's still a year from next month.

GABRIELLE JULIANO-VILLANI: It's still a year but I don't know. I feel like it's already coming fast. Because when you launched it, it was April.

PATRICK CASALE: Was it may? Yeah.

GABRIELLE JULIANO-VILLANI: Yeah. And it it's already August now. So…

PATRICK CASALE: The walls are closing in on Jennifer, I know, where it's like everything solidified. Now you have to do the real logistical behind-the-scenes planning like meals, and activities, and all the things that go into transportation. So, going to be an exciting, stressful year, feels like every day of her life.

GABRIELLE JULIANO-VILLANI: I can't wait to be there, though.

PATRICK CASALE: So, to everyone listening to the All Things Private Practice podcast, new episodes are out every single Saturday on all major platforms and YouTube. Like, download, subscribe, and share. Doubt yourself, do it anyway. I'll see you next week.