Selling the Practice You Built: Lessons from a Behavioral Health Owner Who Has Been There
- Jul 16
- 8 min read
Updated: 2 days ago
At a Glance A behavioral health owner who grew a solo practice into a much larger New York City business shares ten lessons from selling it. Among them: get clear on why you are selling, interview several advisors and compare them side by side, choose a behavioral health specialist you trust, protect confidentiality from the first conversation, and organize your financials long before going to market. |
For many behavioral health practice owners, the decision to sell does not begin with a neatly defined exit plan.
It may start with growth. It may start with fatigue. It may start with an unexpected inquiry from a buyer. Or it may start with a quiet realization that the business has become bigger, more complex, and more stressful than the owner wants to manage alone.
That was the case for one clinical psychologist in New York City who recently shared their experience selling a behavioral health practice with Mertz Taggart.
The owner had practiced for about 15 years and started as a solo practitioner. Over time the practice grew, and COVID accelerated that growth, since the organization was already comfortable working remotely and in the home. What had once been a manageable practice became a much larger business, with more pressure around cash flow, hiring, firing, and day-to-day management. When the owner grew to over 325 employees, it was time to do something different.
"I couldn't see myself continuing to build the business on my own, ” the owner recalled thinking. “I would love to have a partner who was an expert in all the things I was not."
That thinking led to a sale process that ultimately closed about a year later. Looking back, the owner described the outcome as financially rewarding, but also more emotional and complex than expected.
For other behavioral health owners thinking about a future sale, this experience offers several practical lessons.
1. Know Why You Are Considering a Sale
Before interviewing advisors or responding to buyer interest, get honest about your motivations.
Are you trying to reduce the day-to-day management load, create financial security, avoid taking on a partner, set the business up for its next stage, or simply learn what the practice might be worth?
The answer matters, because selling a behavioral health practice is not only a financial decision. It affects the owner, the employees and clinicians, the patients, the referral relationships, and the future identity of the organization.
The owner we spoke with was not chasing a transaction for its own sake. The practice had grown, the responsibilities had become heavier, and selling became a way to create relief, reduce risk, and set up for the future. That clarity helped guide everything that followed.
2. Interview Multiple Advisors, but Compare Them Thoughtfully
The owner interviewed five or six M&A advisors before choosing Kevin Taggart and Sandra Zervoudakis with Mertz Taggart. A few factors stood out during those conversations:
• Cost structure
• Process and communication style
• Trust
• Expected value
• References
• Behavioral health experience
The owner was especially focused on whether the fee structure was simple and understandable. Some advisors quoted upfront costs or layered percentages that felt complicated, and simplicity mattered because the owner did not want to guess what the process would cost.
Trust mattered just as much.
New to M&A and selling a company for the first time, the owner wanted someone who could explain the process clearly, set realistic expectations, and feel like the right person to rely on through a high-stakes decision.
Their advice to other owners: build a structured way to interview advisors so you can compare them fairly. Ask each of them similar questions, take notes, and understand the differences in process, fees, buyer approach, experience, and communication style. And do not be afraid to ask for references.
3. Behavioral Health Specialization Matters
Selling a behavioral health practice is different from selling a general business. The owner felt strongly that industry experience was essential, because behavioral health is a specialized market with its own buyer universe, terminology, risks, and operating dynamics.
“I wouldn’t hire a gastroenterologist to examine my heart,” the owner said. In their view, few advisors truly specialize in behavioral health, which made the choice more important. The right advisor needed to understand the field, the buyers, and how to position the business so it made sense to the market.
That expertise also matters when comparing buyers.
The highest bid is not always the deciding factor. Fit, expectations, structure, and certainty to close all influence whether a buyer is the right choice.
4. Confidentiality Is One of the First Fears Owners Face
At the beginning of the process, the owner was most worried about people finding out.
No one inside the company knew a sale was being considered, and there was real concern about competitors hearing the news, especially in New York City, where the market can feel smaller than it looks.
Those fears are common. Owners worry about staff morale, rumors, referral relationships, and whether early information could create instability. It is one reason the process has to be handled carefully, and why owners should be thoughtful about who they involve, when they involve them, and how they eventually communicate a completed transaction internally.
The owner noted that strong internal relationships make the announcement easier when the time comes. Weak or purely transactional ones create risk, and losing key people can do more than sting; it can put the deal itself in jeopardy.
5. The Process Is More Stressful Than Most Owners Expect
The owner had been told the process would be stressful, and still found it hard to grasp until they were in it. The stakes were high, the experience was unfamiliar, and the owner had to trust an advisor, an attorney, and a buyer while continuing to run the practice.
“It’s like giving your child over to strangers and having to trust them,” the owner said.
For founder-led businesses, that feeling makes sense. Owners are used to being in control. They built the company, made the decisions, and carried the risk. A sale asks them to share information, wait for feedback, weigh unfamiliar options, and accept that parts of the process sit outside their direct control. The stage after the letter of intent is often the most stressful of all, when negotiations, legal questions, deal structure, and buyer requests arrive at once. This is where strong legal and M&A support matters most.
6. Calm, Honest Guidance Matters
One reason the owner chose Kevin Taggart was his demeanor. Compared with other advisors, Kevin did not come across as overly negative or overly optimistic. He was matter of fact, realistic, and steady, and that made a difference.
The owner described him as a “calm, stabilizing force” during a process that often felt uncertain. He offered guidance without pressure and made clear that the decisions ultimately belonged to the owner.
The owner also valued that Kevin was willing to share his perspective early, before asking for any formal commitment.
7. Get Your Financials and Operations in Order Early
One of the owner’s biggest lessons was the value of preparation. They wished they had organized their financials better before starting. Smaller practices often lack large finance or HR teams, which means data requests can fall heavily on the owner or a small internal group, and that becomes time-consuming fast.
Preparation is not only about financials.
It also means building the business for the future rather than only for today. Hiring, software, processes, and documentation all affect how smoothly a sale runs. Repeatable processes matter, whether it is onboarding, clinical documentation, or another part of the operation, because consistency helps you respond to buyer requests without unnecessary friction. That kind of preparation cannot be done 30 days before going to market. It takes time.
8. Be Involved in How Your Story Is Told
For a distinctive behavioral health business, the owner believes it is important to stay involved in how the company is presented to buyers. An advisor leads the process, but the owner knows the business best: what makes it different, how it grew, and which parts of the story should not be oversimplified.
That does not mean managing the process alone.
It means the advisor and owner work together, so the business is positioned accurately and thoughtfully. When a buyer does not understand something, they tend to move past it rather than dig in, so clarity is worth the effort.
9. Understand What You Are Giving Up
Selling often means giving up some level of control, and for owners who built a practice from the ground up, that can be hard. The owner advised future sellers to think carefully about whether they are ready for that shift. It’s not enough to ask what the business can fetch. Owners also need to ask:
• What do I want my role to look like after a sale?
• How much control am I comfortable giving up?
• What kind of buyer would I trust with the business?
• What financial outcome would make the decision worthwhile?
• What would make me walk away?
The answers may change over time, but it helps to work through them before you are deep in a process.
10. Build a Network of People You Trust
The owner also recommended talking to people beyond a single M&A advisor: other owners who have sold, attorneys, financial advisors, and people with private equity experience. Each conversation helps you understand the process from a different angle.
The goal is not to crowd the decision with too many opinions. It’s to become more informed so the process feels less opaque. Deal structure, buyer differences, legal terms, rollover, and expectations can all be confusing the first time through, and having people around you who can explain the moving parts in plain language makes a real difference.
A Sale Process Is Not Just a Transaction
For this owner, the sale created a financial outcome they never imagined when they first opened the practice. “The deal of a lifetime,” as they described it.
The broader lesson is simple. Selling a behavioral health practice is a major professional and personal decision, and it rewards preparation, clarity, trust, and the right advisory team. For owners who are not ready to sell today, the best first step may not be going to market at all. It may be getting educated, organizing your financials, thinking through your goals, and understanding what buyers would care about if the time comes.
Mertz Taggart has advised behavioral health owners through the sale of their businesses for over twenty years. If you are starting to think about what’s next, a confidential conversation and an honest look at where your business stands is a good place to begin.
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