Therapy Without Compromise: A Founder’s Fight for Quality Care w/ Doug Polster of Thriving Center of Psychology

Summary

Doug’s path to entrepreneurship started in an unexpected place: a risk-averse family and a PhD in psychology. After fellowship work in neuropsych at UCLA and a small private practice in Los Angeles, he dabbled in an exercise-meets-cognition program that evolved into an app—an early experiment that tempered any illusions about quick wins. When COVID disrupted referral patterns, a timely call from a grad-school friend became the catalyst for something bigger: partnering to expand a New York practice into California and Florida, which ultimately grew into Thriving Center.

Thriving Center operates like a modern, scaled version of a community psychotherapy clinic—virtual in 14 states with several brick-and-mortar locations—emphasizing evidence-based care and human matching over purely automated funnels. The founders differentiate by keeping clinicians and clinical outcomes at the center: real humans review intake forms to place clients with the right therapist; brand growth has leaned more on quality, reviews, and relationships than splashy ad spend. Along the way, they tackled gnarly growth challenges: multi-state legal structures, moving into insurance, and the hardest one—technology. A year-plus EHR build was launched, then deliberately killed within 24 hours when it became clear it would sink the business—a painful, correct call that informed “version 2.0.”

Culturally, the team was born remote and scaled from a handful of people to ~25 staff plus a nationwide therapist network. That created new leadership imperatives: define co-founder roles for the org (not just between the founders), listen deeply to front-line operators, and tie every hire to explicit KPIs. Financially, the service model enabled profitability from day one without outside capital; the company has explored funding but hasn’t needed it. Doug’s therapist lens shows up in his founder playbook: exposure therapy for entrepreneurship—take graduated, uncomfortable actions so confidence can follow action, not precede it.

Takeaways

1. Let action lead confidence: take small, uncomfortable steps (“graduated exposure”) to build momentum rather than waiting to “feel ready.”
2. Differentiate with outcomes and experience: highlight evidence-based care and real human matching instead of over-automating intake.
3. Tie roles to metrics: define the company-level KPIs first, then craft job duties, then hire for proven skill where it matters.
4. Listen to operators: include the people who touch a tool daily in vendor demos and selection—they’ll surface reality fast.
5. Kill the wrong project quickly: a decisive shutdown of a misfit product can save the company and clarify the right next build.
6. Sequence tech thoughtfully: you don’t need to build everything—assemble a stack of buy + build that serves clients and clinicians.
7. Scale brand through quality: consistent, good care produces reviews and referrals that compound into brand equity.
8. Define founder lanes early: make org-wide clarity on who owns what to avoid confusion and competing directives.
9. Hire for trust or expertise—intentionally: promote trusted generalists where stakes allow, recruit specialists where errors are costly (e.g., billing/coding).
10. Bootstrap services, fund products: services can often be profitable from day one; product builds usually demand upfront capital or capability.
11. Balance accessibility with rigor: embrace tech for convenience but anchor offerings in proven, evidence-based modalities.
12. Treat clinicians as customers too: design processes and tools that make providers’ work easier; great clinician experience improves client outcomes.
13. Market when timing’s right: relationships and BD can precede formal marketing—then layer in brand content when operations are ready.
14. Ask “dumb” questions early: poll experts for the 5% insight you’re missing; it compounds across finance, ops, and tech.

Chapters

• [00:01] Origin Story & Risk-Averse Roots
  • Doug’s upbringing, academic path into neuropsychology, and the early itch for entrepreneurship.
• [01:33] Private Practice to First Venture
  • Launching a small LA practice and building a cognitive-plus-physical training program that became an app.
• [02:51] COVID Pivot & Forming the Partnership
  • Referrals dry up, a grad-school friend calls, and the duo expands into CA and FL—seed of Thriving Center.
• [05:44] From Clinician to Operator
  • Doug steps back from taking new clients to focus 99% of his time on operations and complementary co-founder roles.
• [08:28] What Thriving Center Is (and Isn’t)
  • A scaled “mom-and-pop” psychotherapy practice—virtual in 14 states, with select in-person locations.
• [09:25] Tech Growing Pains
  • HIPAA constraints, fragmented EMRs, and the push to assemble a pragmatic, provider-friendly tech stack.
• [10:46] Two Sided Customers: Clients & Clinicians
  • Owning patient acquisition and matching while delivering a great experience for providers.
• [12:40] Differentiation: Evidence & Human Matchmaking
  • Competing with venture-backed incumbents by prioritizing care quality, reviews, and therapist-run leadership.
• [16:25] Marketing Late, By Design
  • Organic growth and BD first; only later investing in brand content and a first marketing hire.
• [17:34] Big Structural Bets
  • Centralizing multi-state entities, moving into insurance, and the high-stakes EHR build decision.
• [19:03] Pulling the Plug to Save the Ship
  • Soft launch → hard stop on the EHR; why the swift cancellation was the best decision.
• [19:57] Bootstrapped & Profitable
  • Why a services model enabled profitability from day one without outside funding.
• [23:32] Building Culture While Remote
  • Scaling internal staff and an all-virtual therapist network while maintaining community and accountability.
• [25:55] The Leadership Maxim: Listen to Your People
  • Let front-line feedback shape priorities and solutions to build trust and execution speed.
• [27:30] Hiring Playbook: KPIs → Duties → Talent
  • Avoid fuzzy roles; define metrics first, then craft the job, then select generalist vs. specialist intentionally.
• [32:27] Lessons from Failures
  • The cost of undefined founder roles and how tech missteps reinforced better decision hygiene.
• [34:38] Better Tech Decisions, Second Time Around
  • Bringing operators into demos, demanding tailored proofs, and pushing vendors for specificity.
• [43:03] Exposure Therapy for Founders
  • Practical mindset: consistent, small discomforts compound into confidence and capability.
• [45:47] Actions First, Confidence Follows
  • A book recommendation (“The Confidence Gap”) and the central quote that guides Doug’s execution.