The barrier you can't quite see
Most people outside the field assume mental healthcare is limited by clinical knowledge: that we simply haven't figured out how to treat people well. That hasn't been our experience. The limiting factor is rarely the clinical work. It's everything built around it: the incentive structures, the ownership layers, and the quiet pressure to run a practice like a portfolio company rather than a place where people get better.
We call this the glass barrier. It's rarely visible from the outside: the website still looks warm, the intake process still runs, the sessions still happen. But underneath, a clinician's autonomy gets thinner every year: caseloads climb, documentation multiplies, and the room to actually practice the way they were trained shrinks. Clients feel the same barrier from the other side, in the form of rising costs, shorter sessions, and care that increasingly optimizes for billing over healing.
The barrier is glass because it's structural, not personal. No one villain built it. It's the predictable output of an ownership model that answers to something other than clinicians and clients.
Private equity and venture capital are the clearest version of this force in behavioral health right now, and we don't think that's controversial to say plainly: capital raised on a return timeline needs a return, and the fastest paths to one (larger caseloads, thinner staffing, standardized and often lower-cost care) are frequently the paths that erode what made a practice worth investing in to begin with. Profit-driven insurance administration adds a second layer of the same pressure from a different direction. Even well-intentioned independent practices, without outside capital pushing them, often can't out-negotiate these forces alone.
Our role in the solution, not the whole solution
Midsommer Health is our attempt to be part of the answer to that barrier, not a claim that we've solved it outright. We don't think one company reshapes an entire industry's incentive structure. What we can do is build a working alternative, prove it inside our own firms, and make it easy for other clinician-led practices to adopt the same structure.
That only works under one condition, and it's the one we hold ourselves to above everything else: Midsommer only succeeds if our clinical directors and partner firms are genuinely, structurally better off for having partnered with us. Not "better off on average," and not "better off net of our fee." Better off in the day-to-day experience of running and practicing in their firm. If that stops being true for a partner, the model has failed regardless of what our own financials say.
The Midsommer Method
The organizational framework we use to hold up that condition is what we call the Midsommer Method: small, self-managing pods of roughly 10–12 clinicians, organized by geography or specialization, given the infrastructure of a much larger organization without the bureaucracy that usually comes attached to one.
- Pod structure. Clinicians organize into small teams designed to govern themselves once established, not permanently managed from the center.
- Collaborative decision-making. Pods make their own calls on client care, resourcing, and practice management, informed by organizational psychology rather than top-down directive.
- Shared knowledge across pods. What one pod learns doesn't stay siloed. Clinical and operational insight moves across the network deliberately.
- Supportive infrastructure. Billing, compliance, technology, and continuing education are handled centrally so pods can stay focused on care.
This isn't a philosophy we describe after the fact. It's applied organizational design theory, built the same way we'd build it for an outside consulting client, and then held to the same standard inside our own firms first.
The flywheel: why serving partners is the growth strategy
We think of growth less as a sales function and more as a byproduct of a structure working as intended. When a pod or partner firm succeeds under this model, two things happen at once: the clinicians and clients inside that firm are better served, and Midsommer's own capability (capital, infrastructure, expertise, track record) grows a little more. That added capability is what lets us take on the next partner, and support them better than we could have supported the first one.
Success compounds outward, not just upward. Every partner we genuinely serve well increases our capacity to serve the next one. That's the entire growth model.
Our intent is to keep populating this ecosystem deliberately: bringing in new pods and new partner firms not to maximize our own footprint, but because each well-supported addition feeds the capacity of the whole network to help the next practice, and the clients behind it. Organic growth and strategic partnerships are simply the two channels through which we do that; the underlying mechanism is the same either way.
What we won't do
Midsommer is self-funded and structured to never accept venture capital or private equity investment. We think that's the only credible way to hold the line described above: an outside capital structure with its own return timeline would eventually put us in the exact position we're trying to build an alternative to. Growth here is organic and partnership-based, on a timeline that answers to clinicians and clients rather than investors.
An invitation
We don't think Midsommer is the only path to a more humane model of mental healthcare, and we'd genuinely like to see this structure, or something like it, replicated well beyond our own portfolio. If you're a clinician, practice owner, or organization who sees the same glass barrier we do and wants to build against it rather than around it, we'd welcome the conversation.
Spencer R. Potesta & Taylor Newendorp
Founders, Midsommer Health
