Dr. Jeremy Sharp (00:01)
Hey folks, welcome back to the podcast. I have a mega business episode for you today. This is a topic that we have not tackled on the podcast before, which is kind of interesting. You know, it’s been many years of the testing psychologist, many business conversations, but we have never talked about selling a practice. So I went out and found the best possible person to talk about this.
My guest today is Dr. Carrie Sanger. She’s a clinical psychologist and owner of Orchard Mental Health Group, which has 165 clinicians in 10 locations throughout Maryland. She has a particular interest in the intersection of business and technology and mental health. She regularly mentors and speaks about parity and regulatory challenges in the industry, AI threats and opportunities, financial literacy for practice owners and exit planning strategies. So she was
Perfect person to talk about this. She also runs the mental health mergers and acquisitions Facebook group, which we will link in the show notes and talk about during the episode. we try to cover, ⁓ you know, a nice broad base of material for what it might look like to sell or take on a financial partner in your practice. So we talk about like first steps in that process, how you know you might be ready.
both financially and emotionally. We talk about the different options for ⁓ selling. We talk about the documents and processes you might need to have in place. We talk about the people you need on your team. This is a really rich discussion for really anyone out there who might be considering ⁓ selling or taking on a partner in your practice. So you’ll hear Kerry talk about how we really need to be thinking two to three years down the road.
because it can take that long sometimes to get the house in order, so to speak, and be attractive to a buyer. So if you’re in that boat, ⁓ this one’s for you. Without further ado, I’ll give you my conversation with Dr. Kerry Singer.
Dr. Jeremy Sharp (02:06)
Gary, hey, welcome to the podcast.
Carrie Singer (02:08)
Hi Jeremy, nice to meet you. Thanks for having me.
Dr. Jeremy Sharp (02:10)
Yeah, yeah. It’s good to meet you too. Yeah. I, know, you’re in like this somewhat large, but really probably small group of people that I would call like online friends, you know, like where we’re in the consulting world, but you know, share some Facebook group membership. And, I think we’ve messaged back and forth a few times over the years, but yeah, it’s good to meet you in person and have you here to talk about a topic that I think is pretty relevant for many people out there. So yeah, thanks for being here.
Carrie Singer (02:37)
Thank you. I feel like I’ve met most of my professional peers online, which is kind of strange but exciting too to get to hear perspectives from all over the world.
Dr. Jeremy Sharp (02:42)
Mm-hmm.
Yeah, I know it really is kind of a gift, know, online and social media and all that stuff can be weird in a lot of ways, but this is one place that I’m really grateful for it. have a lot of quote unquote online friends that have turned into real friends. Yeah. So nice to connect with you. So.
Carrie Singer (03:02)
went on a group practice or
a retreat and we were all going to get matching t-shirts that said we met online just to make people feel really nervous.
Dr. Jeremy Sharp (03:09)
I
love that. It’s so true though. It’s so true. Yes. So I’m going to totally go off script right off, right from the beginning. And when, what does this group practice owner retreat? There aren’t many of those.
Carrie Singer (03:23)
Yeah, we egotistically call ourselves the group practice pros. So it’s kind of a spinoff. You know, there’s a lot of communities built towards solo practice owners and kind of people who are dipping a toe in developing a group. But then there’s some large group practice owners who don’t really feel like they have other people who they can talk to about like other issues that happen when you’re scaling. So we kind of splintered off and for people who have like around like 50 or so employees, we meet monthly online and then at annual retreat.
Dr. Jeremy Sharp (03:32)
Mm-hmm.
Mm-hmm.
that’s fantastic. Yeah. Yeah. Yeah. I know there are so many stages of practice ownership and people say like large group or medium group and kind of throw those terms around loosely, but yeah, I feel like it’s pretty rare to find y’all, you know, who are like 50 plus or a hundred plus especially. so back on script, suppose, let’s talk about, you know, selling a practice. first of all, why, do you personally care about this? You know, why is this important to
you right now.
Carrie Singer (04:17)
I mean, I wouldn’t say it’s like a passion project, but I feel like it’s an area of kind of knowledge gap. I mean, I think a lot of mental health professionals don’t get business training at all, of course, in school, how to run a practice. But then certainly when it comes to talking to people who might want to invest or buy a practice, when I had, during the pandemic, I started to have these companies like LifeStans and Refresh and others that would start sending me like emails, like.
Dr. Jeremy Sharp (04:23)
Mm-hmm.
Hmm.
Carrie Singer (04:40)
We wanna talk to you, we like what you’re growing. I guess I’m not even sure how they found me. think they poached psychology today in other ways and then they think how many providers are at that address and then they start to target people. And I was like, no, no, no, this sounds like a hoax. I don’t even know who these people are. But then the more that we’re asking, was like, wow, maybe I actually have something valuable. Maybe I should entertain some of these conversations. Maybe I should get knowledgeable about what the process entails. And when I started to look online, there was no information.
not just mental health specific, but even just like healthcare practice sales specific, which you think would kind of be a big thing. Cause I feel like, you know, doctors have been selling the hospital systems and getting rolled up, you know, for like a decade now, at least there really wasn’t a lot of good guidance. And the only guidance that was out there was from people who had a stake. So like brokers or buyers and they’re like, yeah, your business is worth one times your profit, like propaganda to kind of make you think that you didn’t have something important. So just taking it, speaking to different people in the know.
Dr. Jeremy Sharp (05:26)
Hmm.
Carrie Singer (05:34)
having them take a look at my practice and what it might be really worth, asking them a lot of questions, reading what I could, know, taking an auditing MBA courses. I took like a UPenn private equity like online course to try to like figure out the lingo. And ultimately I decided that I didn’t want to sell Foley, but I did. I was interested in having some extra investment in my practice to be able to scale and reach our goals and to look into acquiring other practices for growth because there was some labor shortages at the time.
and even just like marketing, having strength in numbers. So I got interested in the concept and I just felt like there was like a hole that needed to be filled with like this knowledge gap. And so I started this Facebook group called Mergers and Acquisitions for Mental Health Professionals. So basically for group practice owners. was like, well, nobody’s probably gonna really care about this, but now we have like 2000 members and people are really interested. Maybe they’re not looking to sell tomorrow, but you know, I think any business owner should have an exit plan in mind and what that could look like. I mean, cause I think…
you know, historically I thought nobody even would want to buy my practice. Like sometimes I’m like, why would you want to inherit this shit show? But it, you know, run well and profitably. Any business can be sold and it’s worth what someone is willing to pay for it. So how to position it to have the most value, to have the most interest, to kind of create like a five or 10 year plan that would help me get to the exit. And that’s why I help other practice owners do too. They come in and they’re confused.
They don’t really know how to read their profit and loss statements. Sometimes they don’t even have a bookkeeper. They’re not using QuickBooks. They don’t get great reports from their EHR about finance and stuff. it’s very hard for them to comprehend their value or how they might be able to connect with colleagues who might want to partner with them to help them with their business. So there’s so many options out there. doesn’t even have to be a sale. It could be just different strategic partnerships.
I think it’s just interesting to think about because we see so much like consolidation within mental health, all these different rollups happening. And I think private equity has become like a dirty word. If it’s not through buying practices, it’s through like the headways and almost talk space and better helps of the world. Just like a lot of distrust of like, where is the field heading? You know, you don’t want to be like blockbuster in a Netflix world. But there are some options and we have something that people want, know, mental health.
Dr. Jeremy Sharp (07:33)
Mm-hmm.
No
Carrie Singer (07:46)
in good times and bad economies, it’s always needed. So I think investors see that as a very durable asset.
Dr. Jeremy Sharp (07:52)
Hmm. I love there are so many directions that we can go with this conversation just from all of that. mean, first of all, just, I’m glad that you are occupying this space as a consultant. you know, it’s a, it’s funny. We all have our little niches, you know, in the consulting world and this is a really valuable space. So yeah, I was, I was really glad to find that group, even though I’m not certainly considering selling at this point or anything, you know, it’s just like introducing and kind of planting that seed of,
This business is valuable and there are people out there who can help you with the process. ⁓ it’s great to have that resource.
Carrie Singer (08:25)
And people are maybe a little hesitant
to join the group, but I’ll say everybody posts anonymously for the most part. So it’s just people usually asking questions or sharing their experiences. I think people, sometimes they don’t chime in or comment, but I know that they’re reading things and taking it in.
Dr. Jeremy Sharp (08:32)
Yeah.
Absolutely. Yeah, I think that’s what a lot of people do. Yeah, my Facebook group is the same. There are a lot of lurkers, readers, not posters. So yeah, lots of directions we could go. Maybe we start, guess, just with basic info. Let’s talk about the ways that you could, quote unquote, sell a practice. There are different ways to go about this, right? And I’d love to just get an overview of what is out there.
Carrie Singer (09:07)
Sure. mean, the sky’s the limit with different people who might be interested. But typically speaking, sometimes I’ve seen people try to sell to their employees, which sounds good in theory. You’re going to have the people who already love working there, who know how it goes, who hopefully share your values running it. But a lot of times I find that people join group practice because they don’t like the business aspects of it. So if you’re trying to give a share to every single employee, that gets a little bit messy. But there is a company called Project Equity that you can look into that will help you
Dr. Jeremy Sharp (09:29)
Mm-hmm.
Carrie Singer (09:37)
structure
that. Like legally, there’s a way you have to kind of structure it. Of course, they take pretty hefty fee to help you set that up. Sometimes people will just choose like say like the clinical director or one or two trusted people on their team who might be interested and maybe those people go take out like an SBA loan and they buy out the owner either in one chunk or kind of over time from the continued profits of the business. Then there could be selling to a colleague who has a similar group practice model who might benefit from incorporating yours. Maybe
Dr. Jeremy Sharp (09:40)
Mm-hmm.
Carrie Singer (10:03)
they’re having trouble scaling in the area, they could benefit from your client list, the expertise of your staff. Maybe they’re a practice that doesn’t offer testing. Maybe they’re therapy and medication providers. And so this would be a great add on. And then if your practice is profitable enough that it might be considered even by like an institutional investor or kind of the private equity route, most people then would choose to get a broker to have a valuation done. And then there’s kind of a process. develop a marketing prospectus.
and they send out kind of like an anonymous teaser to everybody in their database. If anybody is interested, there’s like a deadline and then they have to sign a non-disclosure. And then they might access like three years of the financials of your business. And they can decide like, is this business the size that we’re looking for? And then from there, you kind of whittle down the list and meet with the people who are the most serious, who are willing to give the best offers. And there’s lots of different chains of like, they need to give you this document and that document. And then they want to review so many things about your business.
insurance audit history, three years of the profit and loss and tax statements, what technologies do you use, who are your referral partnerships, they’re gonna wanna audit your billing and coding, sample some of your notes, make sure that they’re compliant, so it’s a pretty in-depth, time-consuming process, but the payoffs can be more. So it just depends on what route you wanna go. If money is the primary thing that’s gonna drive it, or if it’s just feeling like you…
have it in somebody’s hands who’s like-minded, who you really trust. Hopefully you can find both in the same package.
Dr. Jeremy Sharp (11:26)
Yeah, there’s even a lot to pick apart there. I so just big picture, we can think about, okay, we could sell to a peer essentially, like someone, you know, an employee or maybe a colleague around town. That’s sort of like the homegrown, I don’t know, organic version maybe. And then there’s the like private equity or private funding version that seems a lot more formal and rigorous, but potentially more profitable as well.
And then within, so gosh, I have so many questions, Kerry. Let’s, let’s back up because I’m guessing people are wondering about who can actually sell. So I see this question come up a lot in your Facebook group. Like, Hey, I have, you know, two practitioners who are a part-time contractors and you know, we take insurance and it’s all online. Like, can I sell my practice? And then all the way up to like, you know, I have a hundred clinicians and we have this amount of EBITDA and like, you know, it’s detailed.
Can I sell my practice? So what have you seen on the continuum of like what practice is sellable?
Carrie Singer (12:28)
tell you on the perspective of being a buyer now looking to acquire other practices, like it needs to be something that would be hard for me to go out and build in a period of six months to a year. So if I can put up an ad on Indeed or LinkedIn in higher
Dr. Jeremy Sharp (12:33)
Mm-hmm.
Mmm.
Carrie Singer (12:43)
three new therapists in the next three months. Why am I going to pay you a couple hundred thousand dollars to take your three? Who might quit after the deal anyway? So it needs to be something that’s making sink their teeth into that would be hard to build, but everybody feels like their business is their baby. It’s amazing. It’s wonderful. It’s the best thing I’ve ever done. And somebody else must feel that way. And it’s like, well, you know, I’ve surveyed like hundreds of businesses now and yours is actually not that profitable. Like, and I find that a lot of times practice owners, they’re making their pocketing less than when they were in solo practice because there’s so many additional expenses.
Dr. Jeremy Sharp (12:46)
Mm-hmm.
Mm-hmm.
Carrie Singer (13:13)
of running a business that you have to hit a certain scale before there really is even profit.
Dr. Jeremy Sharp (13:18)
Yeah, yeah. Is there any like rule of thumb or even like ballpark number that we should be like? Where would you say, hey, I can’t build this in six to 12 months? Are we talking like, is it a specialty within the practice? Is it like a number of clinicians? Is it an income target?
Carrie Singer (13:34)
That’s hard because every buyer might be looking for something different. mean, even if they’ve done acquisitions in your area, they might be looking to do what they call like a tuck in. Like here’s a complimentary practice that would add services or scale or staffing that we don’t really currently have. So it might be worth it just for like the services you offer. if you have a niche or a specialty that they don’t have. But I mean, for me personally, I’m not really interested in a business that probably has less than $250,000 a profit a year because that is something that takes a lot of time to grow and develop, you know, on your own.
but other buyers might have different feelings. If it was like a colleague or something they might be more interested in. But like a solo practitioner who’s retiring, that to me really doesn’t have a lot of value because the value is in the provider delivering the services. So if you’re not leaving behind many providers, then there’s really not much value.
Dr. Jeremy Sharp (14:08)
Mm-hmm.
Mm-hmm.
Yeah, that makes sense. Well, very pointed question. Where does testing fit into this landscape? Like, what are you seeing as far as testing practices being attractive to buyers?
Carrie Singer (14:32)
Yeah, any profitable business can be sold. I think there’s some education needed to help people even understand what testing is. I think a lot of people think, like said before, it’s just like, I can’t like a psychiatrist give a Connors. Isn’t that ADHD evaluation? Lots of places do that. Now, like, no, it’s like a objective process. It’s really in-depth. It takes a lot of hours. And some buyers exclusively only want to consider insurance-based practices, which sounds counterintuitive, because in our field, self-pay is usually the pinnacle of
of doing good business, but sometimes they see self-pay practices as a little bit harder to market, sometimes a little bit more attached to kind of the owner’s branding and the insurance pay practices. It can be a little tough though to make the margin to be able to scale the testing practice to have it ready for sale. So it’s kind of hard. It’s like, which approach do you take? So sometimes if you have a blend of other services you’re offering, like if you’re also offering therapy or we have like nurse practitioners that do medication management, like they see that as like kind of,
Dr. Jeremy Sharp (14:59)
Mm-hmm.
Carrie Singer (15:27)
easier to understand. You’re like a one-stop shop kind of clinic, if you will. ⁓ But again, anything’s profitable. I mean, if you say like, we do neuro-psych testing for ADHD and autism, I think most people are like, yeah, that sounds important. Yeah, that’s hot right now. Like, everybody has ADHD and autism. We need get on that bandwagon. They do go through cycles of like different diagnoses that they’re really interested in backing. Like substance abuse treatment centers were really hot for like five to 10 years. And then eating disorder clinics.
Dr. Jeremy Sharp (15:30)
Mm-hmm.
Yeah.
Carrie Singer (15:53)
And then in the last five years, was like ABA clinics. And so now there has been like a little bit of a shift to outpatient mental health. But I think if you have a niche, usually speaks to them if they understand the terms you’re throwing around.
Dr. Jeremy Sharp (15:57)
Yes.
Okay. Yeah, I appreciate that insight. I do see these trends, I think in Facebook groups and so forth, you know, what’s getting bought and what’s not getting bought. You know, I keep hearing though about the state of the market, so to speak, and whether mental health practices are still attractive to, let’s just stick with private equity for now. What are you seeing as far as trends in terms of, you know, increased acquisitions, decreased acquisitions? What’s that look like?
Carrie Singer (16:31)
Yeah, I think the biggest years for acquisitions in our field for outpatient mental health were like 2021, 2022, 2023. That was like the boom of COVID and the lab investor interest flooded the space.
And then it seemed like a lot of the larger practices had already been acquired. And so then like, did investors want to have to go like pull together a lot of smaller practices? Like that’s a lot more management and kind of overhead and resources. Cause typically private equity, have like a mandate. They’re only looking at businesses that have more than a million dollars in profit or $2 million in profit, five, 10, like they have different benchmarks and a lot of mental health practices, lot of businesses in general never hit a million dollars in revenue, nevermind a million dollars in profit.
Dr. Jeremy Sharp (16:53)
Mm-hmm.
Carrie Singer (17:10)
So, you know, finding the right people, which sometimes means people who are jumping to the field for the first time, that maybe they’ve built businesses in other industries before and they want to work with maybe a leader who wants to stay on and just takes them with a financial risk off of them. I have a colleague who sold self-pay practice and the buyer took out a $5 million SBA loan that’s like the max you can take out. And they were willing to help them with technology and business structure or employee management. And they’re like, oh, this is great. I can take some chips off the table. Do you risk my future?
Dr. Jeremy Sharp (17:11)
Mm-hmm.
Carrie Singer (17:40)
have like a partner to help me with things. So it can work.
Dr. Jeremy Sharp (17:44)
Okay, good to hear. Good to hear. I really want to tackle this question of when is the right time to sell. So I’m trying to work through this in like a logical sort of chronological way. I know it’s not always that clear and distinct, but you know, for me, one of the first steps might be like, when is the right time? And again, I see this question come up a lot, like, should I sell now or should I wait for two years or so? How do you think about the right time?
Carrie Singer (18:12)
I mean, people perform a lot of mental labor over that because I don’t think that they’re maybe ready to sell yet. So sometimes it’s like motivational interviewing, like, well, nobody’s forcing you to, but like, what are your goals? Like, what’s your timeline? Maybe sometimes they sell because there’s other businesses or other family things that they just want to have more time to pursue. Shoot, now I lost my train of thought. Yeah, thank you.
Dr. Jeremy Sharp (18:16)
Yeah.
You want me to ask a question again?
Yeah, we can just go back.
So one of the things I definitely want to dive into is this question of the right time. So I see, again, this question comes up a lot in the Facebook groups. So I’m curious how you think about what is the right time. I mean, I’m guessing it is some combination of being emotionally ready, but also practically and financially ready to be attractive. But I’m interested to hear how you think through and help people, like, when is the right time?
Carrie Singer (19:05)
And I think that’s a very individualized answer, like making any decision. There’s so many different inflection points. I think some people though, they get in this feeling of burnout and desperation and they just want somebody to take it. Like, I don’t want to deal with this. Like, if I could pass it over tomorrow, I would. Maybe it hasn’t been profitable. They feel like it’s not a rewarding employee experience. They’re working more hours than they ever did before, having less time with their family. They put having a practice would be like passive income and it hasn’t materialized to be that.
Dr. Jeremy Sharp (19:21)
Yeah.
Carrie Singer (19:34)
like that, I would say it’s not good to sell from a place of desperation. Try to get some business coaching. Maybe you’re not, maybe my, worked with an executive coach for a long time. He was like, you know, do you have any SOPs or KPIs? And I was like, what’s that word salad? Figuring out like that is standardized operating procedures. Everybody knows what they’re doing and knows how to do it. So they can do it even if I need to take a vacation and KPIs, key performance indicators.
Like what are the expectations for each role? How will we know if each person is successful or not and be able to give them feedback, which sounds scary corporate and all that. But if you are going to scale and have a lot of staff, a lot of clients, you need to have some, standardization in place. So don’t sell from place of desperation. But sometimes I’ve seen people they’re ready to retire. They maybe have had like a health issue in the family. They really need to take a step back. Or if it’s like financially motivated, you know, looking at the interest rate environment and.
you know, sell when you have an offer in hand. That’s, that’s my best advice. Like, if somebody comes to you and is willing to give you a fair amount for your business, like to say, Oh, I don’t know, will I have regrets? Like, I don’t really meet many people who have regrets, because on the other side, when there’s less stress, or if you still want to stay involved, and you don’t want to, you know, fade off into the sunset, and you’re rocking chair quite yet, most buyers want you to stick around and be involved, because most time they don’t know how to run your business as well as you do. So
Dr. Jeremy Sharp (20:32)
Mm.
Thank
Carrie Singer (20:58)
Usually I would say to people, start thinking about selling two to three years before you’re even really ready to, because you might have to stay around for three to five years.
Dr. Jeremy Sharp (21:06)
Such a good point. Yeah, I want to pin that and talk about that more in just a second, but I’m going to ask a question from something you said previously around people being burnt out and the practice not being profitable and they just want to offload it. So again, this question comes up a lot. feel like I’m just like parroting your Facebook group, but bringing it to the public. So the question is like, is a non-profitable or barely profitable practice sellable?
Carrie Singer (21:31)
No, sorry.
Dr. Jeremy Sharp (21:32)
Okay, thanks. Moving on. No, tell me about it.
Carrie Singer (21:33)
Yes.
If you couldn’t
make it work with all of your blood, sweat, and tears, it’s going to be really hard for somebody else to make it work. And usually, what they call your evaluation, so what your business is worth, is a multiple of the profitability of your company. So let’s say 3 to 5x for practices under $500,000 of profit. If your profit is $20,000, I guess you could find somebody willing to buy your practice for maybe $60,000 to $100,000.
But after you pay taxes on that, it’s really not leaving a lot behind. Again, it’s probably not a lot for a buyer to sink their teeth into. So it’s not to put down what you’ve built. It’s just for buyers, it’s not really getting them excited.
Dr. Jeremy Sharp (22:17)
Yeah, that’s good to know. That’s good to know. so I’m going to highlight one of the things you said, which is just like, if you’re in that place of feeling burnt out and like you just want to unload it, it’s a great time for business coaching and try to get things tightened up and, you know, work toward a different scenario where you are.
Carrie Singer (22:33)
And I will
say this sounds like backwards, but some people like, they’re like, you know what, group practice ownership is not for me. I took a chance. We had so many clients that needed care. I hired these people, but I really don’t enjoy being manager. I stay up at night worrying about, I have enough money for payroll. Like it’s, it’s, it’s impacting my mental health and it’s okay to close down your practice. Like I’ve seen a lot of people do that this year. Like, you know,
Dr. Jeremy Sharp (22:55)
Mm. Mm.
Carrie Singer (22:57)
Reimbursements are sometimes going down. There’s threats to like Medicare and Medicaid eligibility. It’s harder to hire people. Like inflation has cost of everything going up. Rent, utilities, like it is harder to make a margin. And it’s okay to say, tried. Okay, staff, you take your clients. You know, can rent space for me if you want, but we’re gonna be wrapping this up. So I do wanna put that out there. I don’t see it as a failure. I think it’s just listening to what you personally need.
Dr. Jeremy Sharp (23:02)
Right.
Mm-hmm. I appreciate you saying that. Yeah, I think, you know, we went through a big, uh, right sizing as they call it. So I don’t know. I don’t think we’ve talked about this by any means, but you know, we scaled down from probably 45 people to 15 or 18, um, purposefully. And it’s been a huge, it was a great decision, but it was also like a lot of wrestling with that. Am I a failure? Why couldn’t I make this work? You know, why couldn’t I take it to the next level? Um, so it’s just validating to hear you.
say that and to even take it further and say like, Hey, you can shut down your practice. That’s just the decision you’re making. And hopefully it’s the best decision for you and for your people. There’s no shame in that. I’m guessing some people out there need to hear it.
Carrie Singer (24:01)
I think some people, even the best of us, get competitive. Whatever we do, we want to do it well.
Dr. Jeremy Sharp (24:07)
yeah, of course, of course. Yeah, it’s either it’s all or nothing. It’s either like wild success or total failure, you know, but there’s something in middle. Yeah. So, okay. So maybe somebody’s thinking about this. We’ve got our options. There’s like the homegrown, you know, peer thing. There’s like private equity. What would you say are some of the first like, just first steps in going down this path for someone?
Carrie Singer (24:13)
Yeah.
you don’t have a bookkeeper and you’re not using QuickBooks or something similar, you should start. Because when somebody asks you for your financials and you give a two-page printout from the EHR, they’re not going to think you have a very solid, stable business model. ⁓ And having somebody explain what that means to you, like…
Dr. Jeremy Sharp (24:42)
Yeah. Yeah.
Carrie Singer (24:48)
Like, what are overhead costs? What goes into that category? Staff costs. Like, what about payroll taxes? Like, take-home pay. Like, looking back, like, sometimes there’s, like, what they call, like, adjustments to EBITDA. EBITDA is basically a fancy word for EB, I forget, before taxes and depreciation and amortization, whatever the heck that is. So, like, before you pay income taxes and what’s left over, like, how much is there in the account that would be able to be assumed by a new owner?
Dr. Jeremy Sharp (25:04)
Mm-hmm.
Carrie Singer (25:14)
So say your practice this year did $100,000 in profit. They want to make sure that next year there’s going to be at least that amount of money available to them. So if you bought a car for the business, or you had your kids on payroll, or a lot of the profit was from your personal clinical work, whatever it might be, or you bought $50,000 of office furniture, something that’s not going to be an ongoing repetitive expense, so you’re going to add those things back to the bottom line and try to create a future forecast. Maybe you have five new staff that you’re hiring that are in the pipeline.
Dr. Jeremy Sharp (25:35)
Mm-hmm.
Carrie Singer (25:41)
you know are going to add revenue, but they’re just not up to their caseload yet. They’re waiting on credentialing, whatever it is. So you’re to put together, you know, the narrative, I guess, that you’re going to be presenting to buyers. You’re going to be trying to maximize your value. So getting all your ducks in a row. And then from there, if you think that you might have a business that could be attractive to private equity, and you need more guidance, a lot of brokers will give you a free valuation. So you take those documents you pulled together to them, and they’ll look at it honestly. They’ll say,
in your region, given the current buyer climate and interest rates, this is the multiple of profit that we think that you might be able to fetch. And if you want to work with us, sign this agreement where you’re going to pay us probably 5 to 10 % of the sales price. So you have to be selling for an amount that makes it worth it to be able to pay the 5 to 10%. So those are usually the initial steps. If you’re looking for a peer to buy your practice, it’s hard because you don’t want to just say,
Hey, county, anybody interested in buying my practice? Because people say, they’re going to tell your staff, they’re thinking about selling. You should jump ship and come work for us. So it’s a little bit of a sticky situation. So I’ve seen people list their practice themselves on a website called bizbuysell.com, which is like, you’ll see a lot of frozen yogurt franchises and stuff on there. But hey, you can list any business there. And I look there. So other people sometimes do, too, for smaller businesses for sale. Or you can even have your.
Dr. Jeremy Sharp (26:40)
Mm-hmm.
Hmm?
Carrie Singer (26:59)
your lawyer put on their letterhead and send out to your competitors, say I have a client in your area that’s type of practice about this size revenue looking to potentially sell, reach out to me if you might be interested to have a neutral party who kind of does that. And of course, get them to sign the non-disclosure.
Dr. Jeremy Sharp (27:14)
Of course, and just to make it super clear, why are we doing a non-disclosure?
Carrie Singer (27:18)
because you don’t want them to go tell people what you make and never give them your insurance fee schedules. I learned that one the hard way because those are very protected and sometimes people will only want to take a look at your practice to see what your fee schedules are because then they’ll go back to insurance and say, you’re so and so 15 % more. So people have all different motives for wanting to get to know you. So just be careful.
Dr. Jeremy Sharp (27:41)
Mm-hmm. Mm-hmm. So what if we are, and this has happened for me over the years. I can’t even count the number of folks who have reached out and asked to sell, right? So how would one vet these outreaches?
Carrie Singer (27:55)
So if you want to buy.
Dr. Jeremy Sharp (27:57)
Well, I’m thinking if you are wanting to sell. if someone’s out to you and says, like the typical email is like, hey, I saw your practice profile and it looks like you’d be a great fit for our agency. We’re acquiring mental health practices and done all these deals and we could really help you. Say someone is getting those emails, then how do you comb through those or even know which ones are legit?
Carrie Singer (28:19)
Yeah, can be hard. I look them up. I look at their LinkedIn profiles, try to read whatever I can, if they have any kind of online reviews or Glassdoor, just to see if they’re serious. mean, that’s where a broker can be helpful, because they have the knowledge, they have the database and the connections to say like, this is a place that cold calls like hundreds of different types of businesses, versus like, if it’s a buyer whose name you might have heard of, who’s done similar deals in the space, then you know that they’re at least legit.
that they have money, that’s important because sometimes people get offers and they don’t know until the end of the process when they pay all this in legal fees, actually that person can’t deliver at the closing because their funding didn’t come through. So you need to verify them, not just their reputation, but their funding. So if you’re not going to work with a broker, your lawyer, that can help. It helps to have a lawyer who’s well versed in mergers and acquisitions, and they can help you with all those different aspects. And they’ll probably put you in touch if you don’t have a CPA who’s skilled and that there are ones that also can help with that.
Dr. Jeremy Sharp (29:09)
Mm-hmm.
Carrie Singer (29:13)
process.
Dr. Jeremy Sharp (29:14)
Yeah, let’s spend a little bit of time just to take a quick detour around the team or the folks who are going to help you through this process. You’ve mentioned a broker, you’ve mentioned an attorney. Talk to me about both of those positions and what they do and why we would need them and then any other folks, professionals that might help in the selling process.
Carrie Singer (29:32)
A broker helps you find and vet a buyer. They’ll help you with your evaluation and they’ll help you with contract negotiations. The lawyer is going to be the one that reviews all the documents to make sure that they’re compliant because you might be signing up for things like
We can talk about this later, like rolling your equity or some type of phased earn out or these different concepts that could come back to bite you if they’re not structured the right way. Or if you’re staying on, you want an employment agreement. Or there might be some non-compete provisions. You can’t open another group practice for.
five years within a 50 mile radius. Like you want to make sure that what you’re signing on to is really what reflects your kind of longer term goals. The CPA and your bookkeeper, they’re going to be working to help produce a lot of those financial documents that validate that yes, you are worth what you’re asking for. And then you’re going to need probably likely somebody on your team who can also help you. Like our company had a COO and I would have been lost without her because I don’t even know how to pull financial documents anymore. Like she’s the one who has like all of the…
insurance records and malpractice policies like in a binder like you know so having somebody on your staff if it’s not you you know you don’t want to tell everybody that you’re considering this but it helps to loop one person in also because you want somebody to talk to it can be kind of an isolating process because you’re trying to keep it anonymous.
Dr. Jeremy Sharp (30:45)
That’s such a good point. Yeah, the isolation I could see being very heavy and just the emotional burden, right? That’s a lot.
Carrie Singer (30:53)
That’s also why I’m here to
consult and help people talk things through and understand what’s being put in front of them.
Dr. Jeremy Sharp (30:58)
Right, right. Yeah, yeah, that’s good to know. Okay, so we’ve got our bookkeeper slash accountant, a broker, an attorney, maybe a COO or a financial person slash emotional support person. ⁓ I’m curious about the broker. This is kind of a black box to me. who is the broker? Is this person like another attorney or like what is a broker? Is that just their whole job? They’re just a broker, like a business person, like an MBA. And how do you find a broker?
Carrie Singer (31:10)
you
I don’t know if they all have MBAs, but I Googled behavioral health business broker and I narrowed it down to like, there weren’t really a lot of people, like three main companies. And so I met with each of them. I just felt like I could tell right away the one who’s working style I felt the best with. I’ll put it in a plug for them. They’re called Merck’s Taggart. We send a lot of people there because they’ll give you a free valuation whether or not you work with them, which is nice because not everybody will do that.
Dr. Jeremy Sharp (31:35)
Hmm. Okay.
Hmm.
Carrie Singer (31:52)
And so they took time, they explained the sales process, who was involved along the way, what to expect. So that did help a lot, just somebody who’d been there before. And they don’t get paid unless you sell, so they’re motivated to help you.
Dr. Jeremy Sharp (32:05)
Got to, got to. Speaking of getting paid, all these people on your team will presumably want to be paid for the work that they do. So I think this is super important just to talk explicitly about like how much money you might owe in this whole selling process. So can we tackle, yeah, like what each of these people cost and taxes, assume you pay taxes when you sell a business and ultimately
I think the question in people’s minds is like, what am I actually going to walk away with? Like if I sell for a million, how much of that goes to my bank account? So let’s get into that.
Carrie Singer (32:38)
Sure.
Well, just like a specialist in our field would command more than a generalist, same thing in the legal field. So an &A attorney is going to charge probably around $600 an hour. And so you want to be careful how many hours they’re billing. So don’t ask them a million questions that could be answered by someone else or by chat GPT, or ask them to put a junior associate on the lower level tasks themselves. The CPA, that really varies, I’d say maybe $300 an hour. And then the broker, like I said, usually gets like a 5 10 %
Dr. Jeremy Sharp (32:56)
You
Carrie Singer (33:07)
commission,
but sometimes it’s like a $200,000 minimum. So you really want to make sure that the sales price dictates that. And then in terms of taxes, you’re going to have a federal capital gains tax and then also your state capital gains tax. So some states don’t have capital gains tax. I think there’s like five of those states. So people are like, I’m just going to move there right before my sale. You have to be like an established resident there for a number of years before you sell and your business like has to be headquartered there. So nice try, but that’s pretty tough to do.
And then I think the capital gains tax at the federal level right now is 20%. So all in you may be looking somewhere between 20 to 30 % with the state capital gains tax factored in. So it’s considerable, but if you don’t sell, you have to think about future profits and then income tax rate might even end up being higher than the capital gains tax rate.
Dr. Jeremy Sharp (33:34)
Mm-hmm.
Mm-hmm.
So all in, there a way to estimate 20%, 30 % for capital gains taxes and then the hourly rate for these folks? I know that’s going to probably significantly from case to case, but I mean, it sounds like, don’t know, it might not be unusual to say 35 to 40 % of the selling price is going to come off the top for fees and leave you with the rest. Is that fair?
Carrie Singer (34:21)
I mean, if you have 20 to 30 % taxes, and then the legal fees, I’d say I’d budget at least probably $50,000. I mean, there’s a standard kind of number of hours that it takes to close each deal, whether it’s large or small. And the rest of it is just how much do you feel comfortable researching on your own versus asking a professional every time you have a question, which will be multiple times a day, every single day. So just trying to be cautious that they are always on the clock. There are no freebies. But yeah, it depends. If you use the broker, like I said, they take five to 10%.
So you could do it without.
you save that money. So it really depends on your sale price. So it needs to be something that is going to meet your financial needs. And it helped for me to talk to a financial planner who was specialized in exit planning. And they helped me look at what is your freedom threshold. And they did a lifetime capital needs planning assessment, which involves some Monte Carlo simulation of interest rate projections over the next 50 years, what the cost of college for my kids might be when they’re ready to be college bound. And I came up with a number.
and they said, you need this after taxes. So like, if you never wanna have to work again, if you wanna keep working, then you need less. So that helps. Like what numbers should I be striving for that makes sense for me?
Dr. Jeremy Sharp (35:31)
I love that you just threw out a lot of terms that I’m sure people are like, what in the world just happened? But yeah, mean, yeah, who does? Who does, right? But people can rewind and listen to that whole thing again. But essentially, sounds like you just talk to a financial planner who will run a bunch of scenarios and figure out exactly how much money you need and use that as your goal.
Carrie Singer (35:36)
Why the morphing?
But a lot of people
are not hoping to be able to sell for a place that they never have to work again. Maybe they just want to pivot and go back to solo practice and have something in their pocket that reflects the years of work and risk that they took on, which is fine too.
Dr. Jeremy Sharp (35:59)
Mm-hmm.
Yeah, yeah, for sure. So that leads to, guess, another set of questions just around what happens after the sale for folks. So there’s, maybe we talk about staying on or not staying on. I see this question come up a lot as well. Like, I just want to sell this practice and walk away. How common is that versus times when, you know, buyers want the owner to stay on for
Carrie Singer (36:28)
Well, if you’re selling to private equity, I’d say it’s not common because they don’t usually have somebody waiting in the wings to come in and take over, somebody who has clinician and business knowledge, and even like to avoid corporate practice of medicine law, they have to structure it in a way that some clinician is still in charge of the clinical practice because it’s not allowed for a corporation to own a healthcare business. So if it’s not new, needs to be somebody who can run a healthcare practice.
Dr. Jeremy Sharp (36:48)
Mm-hmm.
Carrie Singer (36:52)
which could really be any clinician. So it helps if you have a clinical director or somebody that you’re grooming eventually to kind of move into that role that you can trust.
Dr. Jeremy Sharp (37:01)
Cool.
Carrie Singer (37:02)
But if you’re selling to a colleague or to your employees, you might assume that they have some base level knowledge of how to run a health care services practice, maybe not as much your employees. So in that case, I would suggest starting to train someone over time to shadow you gradually giving them more and more of the tasks that you would have done to see do they like it? Can they do it? So to have kind of a transition plan in place. Well, I think a lot of people do sign like a three to five year employment agreement, or they have equity that they’ve left on the tables.
rolled equity, so a certain percentage of the sales in cash and a certain part was in equity or rather shares. So the goal is as they hopefully acquire other businesses and eventually resell all those bundled businesses that they’ll sell for a higher amount than you did and so that your equity shares might end up even being more than what your initial chunk of cash was. But that is,
That could be a multi-year process that might involve a lot of variables that you can’t really influence. So I always advise people to try to get as much upfront as you can because you really don’t know what the future will hold. And a lot of people who want to leave the practice are because they do worry about financial uncertainties in the future for mental health care practice owners.
Dr. Jeremy Sharp (38:07)
Right, right. So let me, I want to make sure I’m understanding. It sounds like whatever happened, whether you do the rolled equity or not, most buyers will want you to stay on for two, three, four, maybe five years for, a transition. Is that fair?
Carrie Singer (38:21)
Yeah, although they
can’t really force you for the most part. But sometimes it’s like if you quit before your time is up, you won’t get your equity cashed out or whatever it is. And they’ll put you on a salary. Like you can negotiate all of that.
Dr. Jeremy Sharp (38:31)
Mm-hmm.
Yeah, I was just going to ask, does you staying on, does that influence the sell price?
Carrie Singer (38:40)
think it can, because if they don’t have somebody who can replace you, they need to budget what would it cost to hire the CEO for this company. And it’s probably more than you’ve even been paying yourself.
Dr. Jeremy Sharp (38:46)
and train.
Yeah, yeah, that’s a good point. then tell me again, maybe I’ll just summarize the rolled equity concept and see if I’m on the right track with it. So it’s essentially like, let’s say, you know, theoretically you could sell your practice for a million dollars. I’ll just stick with that nice round number. but rolling equity is essentially you say, I’m going to actually sell it for 500,000 and put 500 grand back into this new entity. You know, this new business that my practice now is.
Carrie Singer (39:16)
Sort of. Yeah, you should never roll 50 % equity. That’s not good. You shouldn’t roll more. You should never roll probably more than 30 % equity. So say at the time of closing that end with a million dollar business, you get $700,000 in cash and you get $300,000 in shares.
Dr. Jeremy Sharp (39:16)
in hopes.
Okay. Thanks for clarifying that. Yeah.
Gotcha. And then the hope is that the new owners then buy more practices and the whole thing gets more valuable. And then eventually you cash out a higher value based on that. Yeah.
Carrie Singer (39:42)
Maybe today
if your practice is the only one in their portfolio, the share is worth $10, but then they add five other practices and now it’s worth $50 a share.
Dr. Jeremy Sharp (39:48)
Mm-hmm.
Yeah, yeah. Let me, and if you can’t answer this question, that’s okay. But I feel like I’ve seen, you know, dentist friends of mine, eye doctor friends of mine, you know, other professions, not mental health, but other professions do a rolled equity model and it has not gone well. I’m curious just from what you’ve seen in the mental health landscape, is that typically a good choice?
Carrie Singer (40:16)
I haven’t seen anybody who’s stuck with it throughout the thing and cashed out and said like, yeah, that was so much better. I’m sure it exists, but yeah, money today is better than promised money tomorrow, especially if it’s a partner you don’t know super well.
Dr. Jeremy Sharp (40:24)
Hmm.
Carrie Singer (40:31)
You don’t know how they run businesses. Like, I think, you know, not to trash any particular one, because they’ll probably accuse me of slander or something, but like life stance. They grew really fast. They took on all these businesses, but they didn’t really do anything to like improve the insurance reimbursements or the clinician experience. They made people see more clients and they cut their wages. They took away a lot of their support staff and then people quit.
And then, lo and behold, their equity, their shares, they went down. They had been on Wall Street. They had gotten so big that they were like over a billion dollar company. And now they’re at risk of being taken off the stock exchange because they’re not that size anymore. So you have to be careful who you partner with.
Dr. Jeremy Sharp (41:09)
Mmm.
Yes. That I think leads to some questions just around the gosh, emotional component of selling, right? And, private equity for most of us does not have like a warm and fuzzy sort of vibe. So I don’t know. How do you talk people through that process? of just like, I’m selling to private equity. Like that just sounds gross.
Carrie Singer (41:33)
Yeah, and I think the term sounds gross, but if you meet different people, like they’re not all bad people.
Like just like your employees, they think you’re bad because you want to have a profitable business. Like, yeah, there are businesses to make money, but they’re not like only focused on that or else they would go to some other industry like software tech companies that have much bigger margins. Like if they’re interested in mental health, it’s usually because they do care about the cause. It’s, know, not entirely divorced from their mission. So I get to get to know some people, you know, find somebody who is aligned with your values, at least surface level.
Dr. Jeremy Sharp (41:40)
Mm-hmm.
Yeah.
Carrie Singer (42:06)
the company that we ultimately decided to invest in. They’re not technically private equity, they’re called a family office. It’s a guy who’s worth $8 billion and he told his kids go out in the world and invest in good causes. So we felt a little bit more mission aligned and they didn’t expect kind of any year over year growth targets for us to hit like some of other companies we talked to were expecting.
Dr. Jeremy Sharp (42:07)
Mm-hmm.
Hmm.
Gotcha. Gotcha. And is this, well, presumably this is someone that your broker connected you with.
Carrie Singer (42:31)
Yeah,
there are so many people out there that you would never find on your own.
Dr. Jeremy Sharp (42:35)
That’s a good point. Okay. Yeah. I wanted to go back to that actually. And I ask at some point you could sort of threw out the possibility or the, the reality that some folks do this without a broker. Is that legit and would you recommend it?
Carrie Singer (42:47)
Only, I mean, because the broker fees and their minimum that they take, and they might not even choose to represent you if they think you’re going to sell for less than a certain amount of money. So for most small practice owners, when I say small, I mean, probably 10 staff or less. It’s not that the broker is not going to be interested. Private equity is not going to be interested. Like peer to peer is kind of your best bet. And you’re going to have to chase down some of those leads on your own. You’re going have to find online directories or have your lawyer scout people for you, or even in the Facebook group.
Dr. Jeremy Sharp (43:13)
Hmm.
Carrie Singer (43:15)
People post anonymously, I have a practice for sale in this region. Leave your email address here if you’re interested and I’ll reach out to you. I had somebody do that a week or two ago and they already got like five offers from colleagues and they were really surprised.
Dr. Jeremy Sharp (43:28)
Sure, sure. OK, so it’s doable. It is doable. Just complicated as it sounds.
here it’s doable. Let’s see. I always hear, you know, again, from friends and other fields, culture is a big thing and we’ve kind of touched on this a bit, but just from your experience and, you know, selling yourself and talking with other people, what has that looked like post sale? I feel like there are a lot of horror stories out there, but you know, how do we navigate, you know, culture staying what we want it to be? And if it doesn’t,
What do we do? You know, there’s lots of feelings around that.
Carrie Singer (44:03)
Well, when we took on a financial partner in the beginning, nothing really changed for our staff, you know, because we were still running things the way that we had been. But as we started to acquire businesses, that’s been tough because we don’t, you know, we’re clinicians even, but like maybe this other practice has been doing things a certain way that works better for their staff, but makes it really hard to grow the team. You’re always battling, I guess, like efficiency versus like keeping clinicians happy. So like
Dr. Jeremy Sharp (44:31)
Mm-hmm.
Carrie Singer (44:32)
Like right now the practice we’ve acquired, like we have different cancellation policies. We have different PTO policies. Sometimes they’re going to have different EHRs, payroll platforms. And if you’re all trying to get on the same one, that can be tough because it’s a lot of change in a short amount of time. And to help staff understand, well, how does this benefit me? And to actually help it benefit them to be able to give better benefit packages. Now we’ve been able to hire HR, marketing, finance, IT, things that we couldn’t afford before. So now we have like a
more sophisticated business, which is hopefully going to generate more referrals and ultimately trickle down into a better clinician experience. But that doesn’t happen on day one. The first six months are really hard.
Dr. Jeremy Sharp (45:09)
Yeah, it seems like that’s a given. Change is hard no matter what. And this is a huge change for a lot of practices. So I would imagine it’s extra hard.
Carrie Singer (45:16)
But I do tell practice owners
sometimes that are hesitant about selling to maybe an investor type person who’s not a clinician themselves. They’re like, well, I’m going to sell to my employees because I’ll preserve the company. I’m like, and what if they turn around and sell to private equity? Like you can’t always control the future.
Dr. Jeremy Sharp (45:33)
huh. Yeah, that’s a good point. Do you have any thoughts around when owners and how owners present a sale to their employees? Like when in the process and then what do you say?
Carrie Singer (45:45)
They always say never make any announcements until the ink is dry on the deal and you have the money in your account because anything can change even sometimes up until the last minute. And when you do, usually you’re going to work with the buyer to have a make something mapped out. You’re going to have like a town hall meeting. You’re going to have them come out to meet people or just you personally are going to tell them what’s happened. You’re going to try to address their concerns. But really ultimately, it’s just time will tell. Like we think this is a good partnership. You stick around and see if you feel the same.
But if you can make nothing change for them in terms of, you know, their pay’s not gonna go down, their caseload’s not gonna go up, nobody’s gonna be, they’re still gonna report to the same people they used to, like that their day-to-day is not going to change as much as possible.
Dr. Jeremy Sharp (46:26)
Yeah. I appreciate you making that really clear. could see a temptation, just speaking personally, if I was in this situation of talking with people way ahead of time to try to prepare them and be kind and all those things.
Carrie Singer (46:40)
Just gotta rip the bandaid.
I think every practice owner feels bad about it. They feel some kind of guilt. I don’t know if that would be the same. Like if like you owned a bank and you were selling a bank, would you feel guilt? I think it’s just specific to being mental health providers. know, like we’re empaths. You know, we want to make sure that we’re not impacting anyone negatively. And, but ultimately like if your staff member had the opportunity to have like a life altering financial event, do you think they would think twice about you?
Dr. Jeremy Sharp (46:46)
Hmm.
Hmm.
Sure. It’s a good way to put it. It’s a good way to put it. It feels different, but I know where you’re headed with that. Yeah. Yeah. There’s a lot to this whole process. So we’ve talked about a lot of different things. mean, we could get in the weeds with any number of these questions. Hope was just to provide a big picture overview for folks and a little bit of a roadmap. Maybe we start to close with your thoughts on, I mean, anything
you know, the people don’t anticipate like hidden experiences, things people might want to be aware of, but not know about. Yeah, just that you’ve run into over the years.
Carrie Singer (47:47)
think, you know, don’t put all your eggs in one basket. Like, people get really excited to have an offer. They put a lot of time into getting all the documents ready. And then for one reason or another, it doesn’t pan out the way they want and it doesn’t work out. But sometimes it’s like, you know, you gotta kiss a couple frogs to find your prints. Like, if you just keep going, like, you can find it. I think most people, just like when, like, freshmen go off to college and like, wait a minute, this is not good. Like, it just takes time to find the right match.
Dr. Jeremy Sharp (48:14)
Mm-hmm. Mm-hmm. The whole time we’ve been talking, I keep having this parallel of buying a house. It feels a lot like buying a house. Like you can get different offers. You put in different offers. Maybe they don’t go through. You get all excited. You can do it on your own, but maybe you shouldn’t. You kind of need a realtor. So there’s just a lot of similarities, it seems like, to that process.
Carrie Singer (48:34)
I mean a home and a business is
probably the biggest assets most people are going to have. So it does help, think, to have a professional who’s walked the path before because a lot of people have experienced buying and selling houses. Not many people in our field have experienced buying and selling businesses.
Dr. Jeremy Sharp (48:50)
Right, right, such a good point. So let’s see, you are post deal, whatever that looks like. Yes, I’m curious what that actually does look like for you these days, just from someone who has done it.
Carrie Singer (49:03)
Yeah, well, I negotiated to stay on like a part-time remote, primarily capacity. So, which is honestly what I was doing before anyway. We hired a really excellent COO who I was getting 300 emails a day and staying up till 2 a.m. running payroll and like wearing all the hats. And now she does that and now she’s getting overwhelmed that we need to find more support staff. But so I’d already kind of taken a step back from the business. Like, so as much as you can, I think it does help because if…
you’re so in the business that every single part, you’re at every single one of your staff members, kids, birthday parties, and all that kind of stuff. Like it’s gonna be really hard to wrap your mind around doing things a different way. So to kind of gradually take things off your plate, take small steps back, not that you’re not caring and involved, but just make yourself less indispensable.
Dr. Jeremy Sharp (49:45)
That’s good advice. Is there anything you wish you had done differently, you know, having the perspective of hindsight?
Carrie Singer (49:51)
Well, I’ll say the financial partner that we took on, well, they’ve been easy to work with and they haven’t really rushed to change very much. They also didn’t have a ton of mental health experience. So I really thought they were going to be bringing resources to us and that hasn’t really been the case because we were the first one to kind of partner with them. So if you were looking to really have team members who can share the workload, don’t be the first person to partner with someone new. Be an add on to something they’ve already built.
Dr. Jeremy Sharp (50:07)
Mm-hmm.
That’s fair, that’s fair. This is great. I feel like there’s so much just concrete advice and perspective that you’ve shared. So thanks for being here. If people do want to reach out, yeah, and work with you or just find your Facebook group, get some resources. What’s the best way to do that?
Carrie Singer (50:24)
Thank you.
Yeah, on Facebook, the name of the group is Mergers and Acquisitions for Mental Health Professionals. And then I created a website for consulting services called SellYourPractice.com. If you go on there, you can find links to the groups and ways to contact me.
Dr. Jeremy Sharp (50:46)
Nice, nice. That’s a great URL. don’t know how you.
Carrie Singer (50:49)
all of the URLs related
to healthcare practices for sale are open. So I just bought like 60 of them.
Dr. Jeremy Sharp (50:54)
Good for you. Good for you. That’s incredible.
Carrie Singer (50:55)
I think that just
points to the lack of information though that is available online.
Dr. Jeremy Sharp (51:00)
Yeah, exactly. Exactly. Well, I’ve really enjoyed this. Yeah, it was great to meet you and talk with you after, you know, crossing paths online so many times, but,
Carrie Singer (51:08)
Thank you, you too.
And good luck to your listeners. I know it’s gonna be tough making those decisions, but I think it is exciting to feel like there’s a light at the tunnel and there’s rewards for all the hard work.
Dr. Jeremy Sharp (51:19)
Absolutely. Yeah. I think if nothing else, we’ve instilled some hope. You have instilled some hope primarily, and it’s just good to know that there are resources and folks like yourself who can guide us through that process when the time comes. yeah. Thanks again, Kerry.
Carrie Singer (51:30)
Thank you, take care.
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