A Letter About What Lets You Stay

After naming what group practice ownership costs, there is a quieter, necessary question that lingers.

Why stay?

Not in a romantic sense. Not out of obligation. But in the practical, embodied reality of holding a system together day after day.

Because people do stay.
They keep choosing this work.
And they are not doing it by accident.

This is not about hustle.
It is about what makes leadership survivable.

The First Sustainer: Peer Leadership Circles

You Cannot Hold a System Alone

One of the most persistent myths of practice ownership is that independence equals strength.

In reality, isolation erodes discernment.

Group practice owners need other owners. Not mentors performing expertise from a stage, but peers who speak the language of payroll stress, insurance ceilings, team dynamics, and responsibility that cannot be delegated.

Peer leadership circles do three essential things.

They normalize the weight without minimizing it.
They interrupt shame before it calcifies.
They provide reality checks when anxiety distorts perception.

These spaces are not for venting. They are for co-regulation at the leadership level.

Without them, owners do not become stronger. They become more alone with their authority.

The Second Sustainer: Financial Transparency Without Shame

Numbers as Information, Not Moral Judgment

Money is one of the fastest ways shame sneaks into leadership.

When the bank balance dips, owners often turn inward. When revenue spikes, they feel pressure to immediately redistribute without regard for seasonality, reserves, or long-term stability.

Neither reaction is sustainable.

What sustains owners is learning to relate to finances as data, not as proof of worth.

This includes understanding cash flow cycles without panic. Naming financial constraints honestly instead of absorbing them silently. Letting go of the fantasy that ethical care requires personal depletion.

Financial transparency does not mean telling everyone everything.
It means telling yourself the truth without punishment.

Transparency is not disclosure without boundaries.
It is honesty without self-erasure.

The Third Sustainer: Nervous System Care for the Ones Who Hold

Leadership Is a Somatic Role

Group practice ownership lives in the body long before it shows up in spreadsheets.

The jaw tightens.
Sleep lightens.
The chest holds just a little too much.

Sustainable owners treat nervous system care as infrastructure, not self-indulgence.

This looks like building rhythm instead of reacting to urgency. Tracking stress responses instead of moralizing them. Having practices that discharge responsibility from the body, not just the mind.

A dysregulated leader unintentionally spreads dysregulation.
A regulated leader creates room for repair.

The nervous system of the owner quietly sets the tone for the entire practice.

This is not about perfection.
It is about capacity.

The Fourth Sustainer: Releasing the Fantasy of Being Fully Understood

Letting Leadership Be Partially Lonely

One of the quieter turning points for many owners is this realization.

Not everyone will understand your decisions.
And you cannot make choices primarily to be liked.

Sustainability comes when you stop trying to be fully seen by everyone and instead focus on being coherent.

Coherence matters more than consensus.
Integrity matters more than approval.

When owners release the need to be perfectly understood, they conserve enormous amounts of energy.

The Fifth Sustainer: Meaning That Outlasts Metrics

Remembering Why This Was Chosen

What ultimately sustains group practice owners is not resilience in the abstract.

It is meaning.

Seeing clinicians grow into their work.
Watching communities form where isolation once lived.
Knowing that even when someone leaves, something good continues forward.

Meaning does not erase stress.
It contextualizes it.

And context changes everything.

The Truth at the Center

Group practice ownership is not sustained by grit.

It is sustained by being held while you hold others. By letting systems support you instead of replacing you. By naming reality without collapsing into it.

This work is not meant to be survived alone.

It is meant to be held together.

A Note on the Foundation This Builds From

This article focuses on what allows group practice owners to stay. The supports, relationships, and internal shifts that make ethical leadership sustainable over time.

It builds on a companion piece, What No One Tells You Before You Open a Group Practice, which names the realities and costs that often live beneath the surface of ownership. Visibility fragility. Financial strain. Structural limits. The grief of mentoring and letting go.

Together, these articles offer a fuller picture of group practice leadership. Not just what it costs, but what helps people keep choosing it with clarity and care.

Written by Jen Hyatt, a licensed psychotherapist at Storm Haven Counseling & Wellness in Temecula, California.

Disclaimer:
This article reflects lived experience and professional perspective as a group practice owner. It is offered for reflection and context, not as legal, financial, clinical, or business advice. Group practices vary widely in structure, size, payer mix, and regulatory environment, and what supports sustainability in one setting may not translate directly to another. Readers are encouraged to seek appropriate legal, financial, and professional consultation when making decisions related to practice ownership or leadership.