Starting a new practice is exciting. It’s a creative process. You’re inventing something new! You determine what it’s going to look like and feel like. How it’s going to be different from other practices. You choose what services your practice will and won’t offer. You write down a core mission and company values. You decide on a name, and a logo, and furniture style, and wall color, and so much more. And then, after not too long, you realize that your creation is complete. Now, instead of inventing it, you need to run it. And this, for many entrepreneurs, is where the fun stops.

This is the part of the story where many entrepreneurs decide, “I’ll hire an office manager” or “director” or even better, that they will somehow automate the running of their practice. I’m here today with bad news: These approaches rarely work. It’s extremely difficult to find a person, or even a team of people, who can execute your vision, or even run your business day-to-day without significant oversight from the owner/founder. There are two reasons for this.

Reason One: Money. If you’re like most of us, you probably can’t afford to fish in waters that might, possibly, provide CEO or COO-caliber professionals who can truly do the job.

Reason Two: Obsessive Caring. Even if you had an unlimited budget and could snap up a Harvard MBA or two, you’d probably still find yourself stepping in and running your practice to keep it on track. It is almost impossible to find someone who will run your practice—meaning tackle the day-in and day-out challenges you will face—with as much dedication, persistence, and caring as they will need. Blood, sweat, and tears are reserved for founders.

Consider this. Right now, Elon Musk, after a string of production problems on the Model 3, is literally living in Tesla’s factory, trying to solve production problems. He has basically unlimited resources and still there’s no one to whom he can delegate the fixing of these production problems. This isn’t uncommon. Similarly, to turnaround their flailing companies,

  • Jack Dorsey returned to Twitter
  • Alexis Ohanian returned to Reddit
  • Howard Schultz returned to Starbucks
  • Steve Jobs, famously, returned to Apple.
  • And there are tons more.

Lorne Michaels has been producing Saturday Night Live since the show began in 1975. When asked why he’s still at the helm, he explains, “People always say, ‘there’s so many talented people you can hire. People who can run things’ and you go, ‘you know how many people there are in the world [who can do the job]? There are like nine, so you’re one, so that leaves the other eight. Do you think any of them are going to come work for you?’ So, it’s like, you have to roll up your sleeves…”

As you contemplate starting your counseling practice—as you weigh the costs and benefits—take a long view. Ask yourself, “After I create it, will I want to run it?” If the answer is “no,” you might want to rethink your creation. Maybe starting a practice isn’t the right route, or maybe your creation just needs to be simpler or smaller than you first envisioned.

***If you’ve started a practice, was running it easier or more difficult than you first thought it would be? Let me know @AnthonyCentore or @Thriveworks.

Anthony Centore

Anthony Centore

Anthony Centore Ph.D. is Founder and CEO at Thriveworks--a counseling practice, focused on premium client care, with 80+ locations across the USA. He is Private Practice Consultant for the American Counseling Association, columnist for Counseling Today magazine, and Author of How to Thrive in Counseling Private Practice. Anthony is a multistate Licensed Professional Counselor and has been quoted in national media sources including The Boston Globe, Chicago Tribune, and CBS Sunday Morning.

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