Two Years of Profit First for Therapists: Why It Still Matters More Than Ever

When I sat down to write Profit First for Therapists nearly four years ago, I had no idea what was coming. I certainly didn’t have a crystal ball. I just knew one thing for sure: therapists needed a system. A system that put their financial well-being at the center. A system that was simple enough to start with, strong enough to sustain growth, and wise enough to weather the storms of private practice.

Now, here we are—14,000+ copies sold and two years into publication—and I’ve never been more convinced of the need for this work.

Since the book launched, I’ve watched practice owners implement the system and:

• Survive total cash flow disruption during the Change Healthcare crisis of 2024

• Navigate mass resignations and staff shortages with clarity and calm

• Say yes to expansion opportunities with confidence instead of fear

• Launch brand-new practices with financial structure already in place

• Sleep better at night knowing exactly what’s in each bank account—and what every dollar is for

  
  

You don’t need a magic wand. You need a plan, and Profit First delivers.

One Simple Change That Makes a Massive Impact

Let’s talk about one of my favorite (and most underused!) components of the Profit First method: the Owner’s Pay account.

Too many practice owners either:

1. Forget to pay themselves consistently, or

2. Pull money from the business randomly based on what “looks available.”

Neither of those builds a sustainable practice—or a financially stable life.

Here’s what the Owner’s Pay account does:

• Creates a predictable income for you as the owner.

• Separates your personal financial life from the business.

• Helps you plan responsibly without draining the business dry.

• And (maybe most importantly), it reminds you that you deserve to be paid—not just as a clinician, but as a business owner.

  
  

When tough times hit, this account often saves the day. When good times roll, it makes sure you don’t fall into lifestyle creep (like upgrading everything before the business is truly ready).

That one shift—automating your owner’s pay—can completely change how you feel about your business.

Why Profit First Still Matters—Maybe Even More Than Before

Let’s talk about the world therapists are navigating today:

• Insurance payments are unpredictable.

• The phone doesn’t ring quite as much as it used to.

• Costs are climbing, from clinicians, to rent to software.

• Clinicians are harder to retain, and turnover is expensive.

• And many of you are being pulled between survival and scaling.

In this climate, clarity around your money is non-negotiable. And yet, too many practice owners are still crossing their fingers at the end of each month, hoping the numbers will work out. That’s why this work is still critical.

Profit First doesn’t fix every problem. But it gives you a map when you're in the thick of it.

Let’s revisit just one crisis: the Change Healthcare outage in 2024.

Suddenly, providers across the country weren’t getting paid for weeks—or even months. I got call after call from practice owners who were panicking.

And while it was incredibly hard for everyone, I noticed something important:

🟢 Those who had implemented Profit First had options.

🔴 Those who hadn’t were making emergency decisions under financial duress.

Profit First isn’t just about maximizing profits. It’s about making sure your business can keep going, even when everything else stops.

Celebrate Profit, Celebrate Progress

The last two years have been an incredible ride. I’ve heard from thousands of practice owners who are making more money, feeling more empowered, and building businesses that truly support their lives. And while Profit First doesn’t prevent hard things from happening, it does give you the tools to handle them.

If you’ve been meaning to start—or restart—your Profit First journey, there’s no better time than now.

To celebrate the second anniversary of the book, I’m offering the first month of Profit First Academy for just $2 through the month of May. That’s my membership group where we go deeper into the system, answer your questions live, and help you implement the method with support and community.

Start small. Keep going. Celebrate the profit along the way.

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This article is designed to provide information only and should not be considered legal or tax advice. Because of the complexity of the law and the variables in your own personal tax situation, you can’t rely on our advice specifically related to your unique circumstances. In order to get the best tax savings and legal advice available to you, you should consult with your own accountant, attorney, or advisor regarding your particular facts and circumstances.

GreenOak Accounting specializes in working with counselors and therapists in private practice. For more information on our services, visit our website.

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