The How of Business - How to start, run, grow and exit a small business.

How psychiatrist Dr. Duncan Gill transitioned from employee to entrepreneur and built a thriving behavioral health practice serving children, teens, and families.
Show Notes Page: https://www.thehowofbusiness.com/611-duncan-gill-practice-owner/
How psychiatrist Dr. Duncan Gill transitioned from employee to entrepreneur and built a thriving behavioral health practice serving children, teens, and families.
Many highly trained professionals discover that technical expertise alone is not enough to build a successful business.
In this episode, Henry Lopez speaks with Dr. Duncan Gill, founder of Direction Behavioral Health, about his journey from practicing psychiatrist to entrepreneur and business owner. Duncan shares how frustration with bureaucracy and a desire to serve patients differently led him to launch his own behavioral health practice.
They discuss the challenges of transitioning from clinician to business leader, including hiring and managing employees, navigating partnerships, delegating responsibility, monitoring key performance indicators, and building systems that allow the business to grow beyond the founder.
Duncan also shares why creativity, adaptability, and a willingness to take calculated risks have been critical to his success. He reflects on the lessons he learned from building a team, expanding facilities, and creating a practice that serves children, teens, and families while providing him with the freedom to pursue other interests, including music.
This conversation offers valuable insights not only for healthcare professionals but for any entrepreneur seeking to build a business that can grow beyond their direct involvement.
Healthcare professionals should not underestimate their ability to become successful entrepreneurs.
Dr. Duncan Gill is a board-certified Child and Adolescent Psychiatrist and the founder of Direction Behavioral Health. He earned his Bachelor of Arts in Physical Sciences from Harvard University and his Doctor of Medicine degree from Saba University School of Medicine. He completed his General Psychiatry residency and Child & Adolescent Psychiatry fellowship at the University of Connecticut.
Before founding Direction Behavioral Health, Duncan served as a staff psychiatrist with the Community Council of Nashua's Child and Adolescent Program. He has also worked with Southern New Hampshire Medical Center and performed psychiatric evaluations for New Hampshire's court system.
Today, he leads Direction Behavioral Health, a specialized behavioral health practice serving children, teens, young adults, and families through intensive outpatient programs and other structured mental health services.
This episode is hosted by Henry Lopez. The How of Business podcast focuses on helping you start, run, grow and exit your small business. The How of Business is a top-rated podcast for small business owners and entrepreneurs. Find the best podcast, small business coaching, resources and trusted service partners for small business owners and entrepreneurs at our website https://TheHowOfBusiness.com

What is a Professional Employer Organization (PEO)? Learn how Professional Employer Organizations help small businesses with HR, payroll, employee benefits, compliance, and retention.
Show Notes Page: https://www.thehowofbusiness.com/610-casey-clark-peos/
Managing employees is one of the biggest challenges facing small businesses, but what if you could offload much of the HR burden while improving employee retention and compliance? That's where a PEO, a Professional Employer Organization may be the right fit for your small business.
Most entrepreneurs start a business to serve customers, solve problems, and create value not to become experts in payroll administration, employee benefits, HR compliance, and workforce regulations.
In this episode, Henry Lopez speaks with Casey Clark, President and CEO of NAPEO, about how Professional Employer Organizations (PEOs) help small businesses offload many of these administrative responsibilities while maintaining full control over their employees and business operations.
Casey explains how the PEO model works, the concept of co-employment, and how PEOs help business owners manage payroll, benefits administration, compliance, onboarding, offboarding, and employee support. He also shares why businesses that use PEOs often experience higher employee retention rates and improved long-term business success.
One of the most compelling advantages discussed is access to larger-group employee benefits. By pooling many small businesses together, PEOs can often provide benefits packages that would otherwise be unavailable or unaffordable for smaller employers.
Whether you have five employees or fifty, this conversation will help you determine if a PEO could be a valuable partner as your business grows.
"We're small business enablers. We help small businesses grow faster, retain employees longer, and focus on why they got into business in the first place." - Casey Clark
Casey Clark is President and CEO of NAPEO, the National Association of Professional Employer Organizations. NAPEO represents the PEO industry, helping small and mid-sized businesses manage HR, payroll, employee benefits, and workforce compliance. Casey brings more than 25 years of experience advising businesses, trade associations, and organizations on strategy, communications, and regulatory issues.
This episode is hosted by Henry Lopez. The How of Business podcast focuses on helping you start, run, grow and exit your small business. The How of Business is a top-rated podcast for small business owners and entrepreneurs. Find the best podcast, small business coaching, resources and trusted service partners for small business owners and entrepreneurs at our website https://TheHowOfBusiness.com

How small business owners can build mission-driven companies that earn trust, create long-term value, and avoid the traps that cause good businesses to lose their way.
Show Notes Page: https://www.thehowofbusiness.com/609-eric-ries-incorruptible/
What causes good companies to go bad?
According to Eric Ries, author of The Lean Startup and his new book Incorruptible, it often begins when organizations lose sight of their true mission and start making decisions based solely on short-term financial results.
In this episode, Henry Lopez speaks with Eric Ries about how entrepreneurs can build businesses that stay true to their purpose as they grow. Eric shares why mission is much more than a statement on a wall, how trust becomes a powerful competitive advantage, and why governance structures matter even for small businesses.
They discuss real-world examples from companies like Cloudflare, Patagonia, Costco, and Taylor Guitars, exploring how organizations can make principled decisions that strengthen trust and create long-term value. Eric also explains why profit is often misunderstood and how business owners can think differently about profitability, purpose, and organizational longevity.
The conversation concludes with Eric's thoughts on how AI is accelerating entrepreneurship and why founders who move quickly, learn rapidly, and remain grounded in their mission will be best positioned for the future.
Whether you're launching a startup, leading a growing company, or planning for succession, this episode offers valuable insights on building a business that endures.
Eric Ries is an entrepreneur, author, and creator of the Lean Startup methodology. His work on innovation, entrepreneurship, governance, and long-term company building has influenced founders and business leaders around the world. He is the bestselling author of The Lean Startup, The Startup Way, and Incorruptible.
This episode is hosted by Henry Lopez. The How of Business podcast focuses on helping you start, run, grow and exit your small business. The How of Business is a top-rated podcast for small business owners and entrepreneurs. Find the best podcast, small business coaching, resources and trusted service partners for small business owners and entrepreneurs at our website https://TheHowOfBusiness.com

Selling a business is far more complicated than most entrepreneurs realize and many business owners wait too long to prepare for it.
Show Notes Page: https://www.thehowofbusiness.com/608-selling-a-business-roundtable/
In this final episode of the three-part entrepreneurial roundtable series, Henry Lopez is joined again by Giuseppe Grammatico, Rocky Lalvani, and David Barnett to discuss what actually makes a business sellable and how business owners should think about exit planning from the very beginning.
The conversation explores one of the biggest misconceptions in entrepreneurship: the belief that a small business will automatically sell for a high multiple. The panel explains why buyers care about much more than just financials, including owner dependency, systems and processes, operational documentation, and whether the business can realistically continue without the founder heavily involved.
David Barnett shares insights into business valuation, buyer psychology, and deal structures, including why many sellers are surprised to learn that buyers often want seller financing, earnouts, or transition support to reduce risk. The group also discusses why most businesses listed for sale never actually sell and what separates a transferable business from a job disguised as a business.
The episode also covers:
• How systems and SOPs increase valuation
• Why franchises often have an advantage in resale value
• The hidden tax implications of selling a business
• The emotional challenges of exiting a business
• Why some owners should focus on maximizing income instead of pursuing a sale
Whether you're years away from an exit or just starting your entrepreneurial journey, this conversation will help you think differently about building a business with long-term value.
This episode is hosted by Henry Lopez. The How of Business podcast focuses on helping you start, run, grow and exit your small business. The How of Business is a top-rated podcast for small business owners and entrepreneurs. Find the best podcast, small business coaching, resources and trusted service partners for small business owners and entrepreneurs at our website https://TheHowOfBusiness.com

Identify what to fix next in your small business and build consistent profitability using the Profit First methodology.
Show Notes Page: https://www.thehowofbusiness.com/r322-mike-michalowicz/
Many small business owners stay trapped in survival mode because they don't know what to fix next in their business. They work long hours, constantly fight fires, grow revenue, and still struggle to achieve predictable profitability.
In this episode, Henry Lopez talks with entrepreneur and bestselling author Mike Michalowicz about how business owners can identify the right priorities, stop spinning their wheels, and build a more profitable and sustainable business.
Mike shares insights from his book Fix This Next, including his Business Hierarchy of Needs framework that helps entrepreneurs determine what their business actually needs next instead of reacting to daily crises. He also explains why many businesses mistakenly believe more sales will solve every problem when, in reality, increased sales often create more stress, obligation, and operational chaos.
Henry and Mike also dive into the core principles behind Profit First, the cash management system that challenges the traditional accounting formula of Sales – Expenses = Profit. Instead, Mike explains why business owners should prioritize profit first by allocating profit before expenses, forcing smarter operational decisions and healthier financial discipline.
During the conversation, Mike shares:
Why entrepreneurs often struggle to identify their biggest business problem.
The "A to B" exercise for determining what your business needs next.
The Business Hierarchy of Needs framework.
Why growing revenue alone often increases stress.
How Profit First changes the way owners manage cash flow.
Why most small businesses operate check-to-check.
How to begin implementing Profit First starting with just 1%.
Why profitability forces better business decisions and innovation.
The importance of validating your business model early.
Mike also shares the personal story behind creating Profit First after losing nearly everything financially following the sale of his businesses.
This episode is packed with practical insights for entrepreneurs who want to stop chasing revenue and start building a healthier, more profitable business.
Mike Michalowicz is an entrepreneur, speaker, and author. He is the bestselling author of several influential business books including Profit First, Fix This Next, The Pumpkin Plan, and Surge. Mike is also the founder of Profit First Professionals, an organization that helps accountants, bookkeepers, and financial professionals guide business owners toward greater profitability.
This episode is hosted by Henry Lopez. The How of Business podcast focuses on helping you start, run, grow and exit your small business. The How of Business is a top-rated podcast for small business owners and entrepreneurs. Find the best podcast, small business coaching, resources and trusted service partners for small business owners and entrepreneurs at our website https://TheHowOfBusiness.com