Do You Think You're Behind? A Group Practice Owner's Guide to Changing Course at Any Stage
I was listening to a podcast about investing recently. The host said if you haven't started investing by 20 or 30 years old, you're so far behind by 50 that there's no point in starting at all.
It sounded so confident and yet can’t really be applied to every situation.
It also reminded me of a conversation I've had, in some version, with almost every group practice owner I've worked with.
"I see other therapists who graduated the same year I did, and they have a thirty-person practice now. Am I too late?"
"I started my practice on a whim, and now it's running me. Am I too late to put real systems in place?"
"I offered an 80-20 split when I started, and now I can't afford it. Am I too late to change it?"
The short answer is no. You're not too late.
The longer answer is what this post is about, because "you can still do this" isn't actually that helpful on its own. What's helpful is knowing what doing it looks like.
The conversation I keep having
The "am I too late" question rarely arrives on its own. It usually comes attached to a comparison.
A peer who graduated the same year, in a different city, who somehow has a team of 30. A colleague whose Instagram makes her practice look effortless. A program graduate who launched her group practice 6 months ago and is already at full capacity. The voice in your head that says everyone else got the memo, and you missed it.
Comparison is rarely accurate, and almost never useful. The owners whose practices look like they got there overnight didn't actually get there overnight. You're seeing the visible part. You're not seeing the years of small, intentional decisions underneath. There’s a part of you that knows this. You're not seeing the months they spent terrified, the conversations they avoided for too long, the splits they had to restructure once they understood the math, the team members who didn't work out, or the hard pivots they made that weren't documented anywhere.
You're seeing the after. And yet you're comparing it to your during.
Why the short answer isn't enough
When I tell an owner she's not too late, the relief usually lasts about 30 seconds before another wave of doubt rolls in. Because "not too late" still leaves her sitting with the gap between where she is and where she wants to be, and that gap doesn't close on its own.
The reason most owners stay stuck isn't that the work is impossible. It's that they're hoping for a single decision that will fix it. A new template. A new systems platform. A new contract. A new associate. Something they can buy or implement that will close the gap without them having to change.
That isn't how any of this works.
The owners who actually move from "running on fumes" to "running a practice that works for them" do it the same way. Not through one heroic decision, but through a series of small ones, made over time, each one informed by the one before.
What doing the work actually looks like
Here are the moves I see, again and again, in the owners who change their trajectory.
You tell the truth about where you are
You start with honesty. You write down where you are now and where you want to go, and not the version you'd post on Instagram. The real version that quite possibly hasn’t actually been articulated yet.
This is the one that includes the parts that aren't working. The resentment that's been building. The thing you've been avoiding because addressing it feels too big. It includes the numbers you don't want to look at. The conversation you keep meaning to have with your associate.
You can't plan your way out of where you are if you haven't told the truth about where you are.
This step happens in writing, not in your head. The thoughts in your head loop. The sentences on the page sit still long enough for you to look at them. That changes everything. Grab a journal or create a new document on your laptop and get it “on paper”.
You talk to someone about how
The shift you're trying to make is rarely something you can think your way through alone, because the same thinking that got you here is the thinking you'd be relying on to get you out. You need a different angle.
That's what a coach, a peer, or a mentor provides. Someone who can ask the question you haven't been asking yourself. Someone whose feedback you trust to push you to think things through rather than just reassure or soothe you. Someone who has seen this pattern before and can name what they're seeing.
This isn’t the same thing as venting to your spouse, your colleagues, or your therapist. Those relationships matter, but they're not built to give you the kind of feedback that moves you forward. You need someone whose role is specifically to help you see what you can't see from inside the situation.
You make a plan, small enough to start this week
Not a transformation plan but an achievable action plan.
The owners who change their associate splits don't restructure their entire compensation system in a single conversation. They start with one decision. They map out which associates are on which terms. They get clarity on what the new structure needs to look like financially. They identify which conversations need to happen first. They draft the language and then they schedule the meetings to communicate the why and how this is going to change.
A plan that requires 6 months of preparation before you can take any action isn't a plan. It's a delay strategy in disguise.
The first action should be small enough that you could do it this week. If it isn't, the plan needs another revision.
You talk to your team about why something is changing
This is the step most owners skip, and it's the one that costs them the most.
Changes that happen without explanation breed resentment, even when the change itself is right. Changes that come with context, with the why behind the decision, build trust.
If you're restructuring splits, your associates need to understand the financial reality that drove the decision, the values that shaped how you're handling the transition, and what they can count on from you going forward. If you're implementing systems, your team needs to know why this matters, what it makes possible, and what's expected of them.
Your team doesn't need to love every decision you make. But they need to understand it and where it’s coming from. The difference between those two things is the difference between a team that grows with you and a team that quietly disengages.
You write it down again
What you wrote at the start of the conversation is rarely what you land on by the end. The act of articulating something to a coach, to your team, to yourself in your journal, sharpens it.
The first draft of your plan is almost never the final version. That's not a problem to solve, it’s the process of change and articulation.
The owners who never revise their original plan are usually the ones who never execute it. The ones who let it evolve as they learn are the ones who actually get somewhere and are practicing effective leadership.
You hold yourself accountable, and you keep going
You reference your plan. In conversations with colleagues. In your work with your coach. In your journal. You check whether you're still aligned with what you said you wanted, you adjust what needs adjusting, and you keep going.
This is the unglamorous part. It's the part nobody posts about. But it's the part that separates the owners who change their practice from the ones who keep telling themselves they will, someday, when things settle down.
Things don't settle down. You decide. You move. You adjust. You keep going.
Three owners who weren't too late
The owner who built the 30-person practice didn't have a head start on you. She had 10 years of small, intentional decisions. You can have 10 years of those too. They start now.
The owner who finally put systems into a practice that was running her instead of the other way around didn't do it in one heroic month. She did it the way you do anything sustainable. By deciding, and re-deciding, and refining as she went.
The owner who restructured her splits didn't avoid the hard conversations. She had them. With clarity, with care, and with the underlying reasons clear enough that her associates could understand even when they didn't love the answer.
None of them were too late. None of them got there by accident either.
What's the thing you've been telling yourself you're too late to change?
Sit with that for a minute.
The associate split you set when you didn't know better. The systems you've been meaning to implement for two years. The conversation with the contractor you've been avoiding. The financial review you've been postponing. The marketing you've never quite figured out. The role you're playing in the practice that you don't actually want to play anymore.
You're not too late. But you're also not going to fix it by reading one more blog post or buying one more course.
You're going to fix it by doing the work I just described, one small move at a time.
If you're ready to stop telling yourself it's too late and start mapping out what doing the work looks like for you specifically, a Strategy Session is the place I'd point you. It's a single 90-minute session designed for exactly this kind of inflection point. We look at where you are, where you want to go, and what the next three to five moves actually need to be.
Or, if you want to keep reading and thinking before you make any decisions, the Group Practice Network newsletter goes out every week, and I'd love to have you on the list.
You're not too late. You just need to start.
Lisa Catallo is a Canadian Registered Clinical Counsellor and the founder of Group Practice Network, where she coaches Canadian group practice and multidisciplinary clinic owners through the leadership work of building a sustainable business. She is the host of the Empowered to Lead podcast.
