Kindly give our readers an introduction to your business. Please include what your business is all about, in which city you are located and if you have offices in multiple locations/ cities.
Adelpha Psychiatric Group is our physician-owned group psychiatry practice in California. We opened our first office in Encino, CA in 2016 and expanded to Pasadena in 2019 with our newest location in Oakland in 2025. We see adults, teens, and children, and we offer comprehensive care by providing psychotherapy, medication management and TMS all under the same roof. Our guiding principle when opening Adelpha in 2016 was to bring personal, evidenced-based, comprehensive psychiatric care to our own communities. To achieve this, we’ve worked hard to build the systems that allow us to take some commercial insurance, and we actively work to expand our partnerships every year to increase access to care.
Kindly give us a brief description about yourself (it should include your brief educational or entrepreneurial background and list some of your major achievements).
We’re Dr. Victoria Huang and Dr. Elizabeth Casalegno, and we’ve known each other since our psychiatry residency training at UCLA. Before either of us even contemplated starting a business together, we laid the foundations of our psychiatric and leadership skills with Elizabeth serving as the Program Chief Resident at UCLA and Victoria serving as the unit Chief Resident at the West LA VA Schizophrenia Unit and Chief Resident of the UCLA Interpersonal Psychotherapy Clinic. Both of us are board-certified adult psychiatrists. After residency, we spent three years working in another private practice group. During this time, we honed our psychiatric skills and learned a lot about the barriers to care our patients face and the frustrations physicians need to navigate in order to provide the care they spent years learning. This experience sparked our desire to see if we could do things better. We worked hard to learn the business side of medicine and created Adelpha, where patient care and physician autonomy are the pillars of our foundation. We started Adelpha in 2016 with a goal to create the job we had wanted when we first left UCLA. We hoped to create a place that provides psychiatric care that we would want our own families to receive–comprehensive, evidenced-based and personal; as well as a place that could provide excellent jobs for our physician colleagues. We believe that our practice has accomplished both of these goals, as well as encouraging and fostering ongoing growth, collaboration and mentorship for our clinicians.
What inspired you to (start a new business venture) or (to make significant changes in an existing business)? How did the idea for your business come about?
Honestly, this wasn’t the plan for either of us. Dr. Huang had envisioned working in a high acuity inpatient team, while Dr. Casalegno was on track to become faculty at UCLA. What changed was the mentorship of Dr. Carol Edelstein. Dr. Edelstein showed us what it looks like to really know your patients over time, helping them achieve life-defining change using psychotherapy and medication management. Then we landed at a private practice that took commercial insurance, and it clicked. We could build something comprehensive and still make it accessible to people with regular jobs and regular insurance, not just helping those who had the means to pay cash. Three years in, we realized we could take that idea further, optimizing on the model to which we were introduced in our first group practice.
What three pieces of advice would you give to budding entrepreneurs?
Trust your gut once you’ve actually done the work. We’re careful, we do our homework, but at some point more deliberating just becomes fear dressed up as caution. Once you know enough, move.
Don’t be afraid to be the odd one out, and don’t be afraid to get it wrong. When we said we wanted to build a practice on commercial insurance instead of cash pay, people we really respected told us it was a mistake. We did it anyway. Some parts of it we got wrong along the way, and that was fine — we just fixed what needed fixing and kept going.
Know what you’re worth before you need someone else to tell you. We see this constantly with the residents we mentor — genuinely talented people who’ve trained at great institutions but still don’t quite believe they could build something of their own.
What would you say are the top three skills needed to be a successful entrepreneur?
Being able to adapt fast. When the pandemic hit, we moved our entire in-person practice to telehealth in a matter of weeks — no committee, no six-month rollout plan, just the two of us deciding it needed to happen and doing it.
Knowing when you’ve thought about something enough. We’re both naturally thorough, but thoroughness can tip into stalling if you let it. Part of effective leadership is recognizing the moment you actually have what you need and making a decision.
Knowing how to balance altruistic desires with business realities. This is a challenge we regularly encounter and something that impacts our ability to remain solvent as an organization.
How many hours do you work a day on average?
This is difficult to answer.
Naturally as an entrepreneur and small business owner, it is hard to turn it off.
Clinically, we both still see our own patients and have full patient panels. This means that we both work full time as psychiatrists. On average, this is a 6-8 hour day for patient care. Depending on our efficiency, we may work a little more to complete clinical administrative duties (e.g. notes, prior authorizations, collaboration with other doctors/therapists, etc).
But as entrepreneurs and small business owners, it’s hard to quantify the time spent on this aspect of our work. As our husbands often likes to tell others, “She’s never not working, even when she’s not working.”
To what do you most attribute your success?
Honestly to each other. We fostered a trusting relationship long before Adelpha existed. It came from years of being in the trenches together through training and supporting one another as we dreamed about our futures. Past that, we’ve tried to always let what’s good for our patients guide things, even when the more common business decision would’ve pointed somewhere else. It’s paid off in ways that are hard to measure but easy to feel — patients stay with us for years and refer their friends and family to us, other doctors send us their toughest cases, and our physicians choose to grow their careers at Adelpha.
How do you go about marketing your business? What has been your most successful form of marketing?
Historically, we haven’t really done traditional marketing. We’ve always focused on providing the highest quality of clinical care for our patients and having active, close collaboration with other doctors and therapists. This has worked for us for many years, but we recognize this can make it difficult for people to find us. This is now our next big project, learning how to genuinely and effectively increase our reach so those in need can more easily find us as a resource.
Where did your organization’s funding/capital come from and how did you go about getting it? How did you obtain investors for your venture?
We have always been 100% self funded. We worked and saved hard for a few years before opening Adelpha. And aside from our commercial building mortgage, we carry no debt.
What is the best way to achieve long-term success?
Keep coming back to your values when you make decisions, not just the clinical ones, the structural ones too. Every time we’ve grown, it has been in service to our guiding principles–what is best for our patients and how can we support our employees?
Where do you see yourself and your business in 5 – 10 years?
We want Adelpha to keep being a place where doctors build careers, not just clock in. Most physicians were drawn to the field to help people. We want to be the place that helps doctors achieve that goal without being bogged down by all the complexities of administrative duties. If a doctor here has an idea for a new service, we want to be the kind of partners who help make room for it. This extends to our non-physician employees as well. We hope to continue to support and inspire our administrative team to grow in their own ways – whether it is a career in health administration, therapists, doctors, etc. Ultimately, we’d love for Adelpha to be known as a place that grows its own leaders.
Excluding yours, what company or business do you admire the most?
Victoria: I am inspired by Patagonia, Concept2 and Goulet Pen company. I know these are somewhat random, but what has really inspired me about these companies is they have all stayed true to their stated passion. In many ways each has also found ways to protect and support their employees despite external, financial pressures.
Elizabeth: I am inspired by TOMS Shoes (one for one giving model), Netflix (the freedom and responsibility culture), and Spanx (women-owned business producing products for women).
How important have good employees been to your success?
Hugely important, and it matters to us more every year, honestly. Our very first hire was Amber Leitz, our business manager. She had the courage to take a chance on us as a small start up, and it has been exciting growing together. Each of our employees brings their talents and creativity to the group, and we have been very fortunate to work with good people. We view it as our responsibility to care for those who work with us, as we know that well supported employees (whether physician, therapist or administrative staff) will be better able to deliver compassionate and effective support for our patients.
How long do you stick with an idea before giving up?
We don’t really work off a clock for that. Once we’ve decided something’s worth doing, we give it real effort, and if something goes sideways along the way, we treat it as information, not a reason to quit.
What motivates you?
Getting to help people grow and achieve their goals–whether it be our patients or our employees. It is an incredible honor to watch and support someone move through different chapters of their life, overcome adversity, and work towards their goals.
What are your ideals?
That good, thorough psychiatric care shouldn’t be a luxury. If you have a regular job with health insurance, you should still be able to get comprehensive care, not a rushed medication check every few months. That’s the belief the whole practice is built on.
How do you generate new ideas?
We ask our own team, honestly, more than we sit around brainstorming ourselves. If one of our doctors or employees is excited about something we’re not yet offering, we’d rather help them build it than come up with it top-down.
How do you define success?
A patient who has chosen to continue their psychiatric care with us for years because of the trust and rapport that has been built with their physician. A doctor on our team who got to build the kind of practice they always pictured. An employee who is taking the next step in their dream career. Those are the numbers that matter most to us, even if they’re not the kind you can put in a spreadsheet.
How do you build a successful customer base?
By being consistent and a little bit picky. We only work with insurers or partners who allow us to spend the time with our patients that they require. We handle billing directly for out-of-network patients so they’re not stuck fighting with paperwork. That consistency, plus our reputation with other doctors, has built a patient base that trusts us enough to send us their family and friends.
What is your favorite aspect of being an entrepreneur?
For Victoria, my favorite aspect is the creative aspect. I tend to love the nitty-gritty details, and entrepreneurship allows me to channel that work and interest into bigger picture projects that can create more impactful change. This is where my partnership with Elizabeth has been so meaningful and valuable to me. I am incredibly grateful for our friendship and partnership, as Elizabeth often serves as a grounding influence that focuses my energies to be able to be more creative and effective.
For Elizabeth, my favorite aspect of being an entrepreneur is solving complex problems and maintaining an eye on the big picture. I enjoy being presented with challenges and having to find a solution that works for the needs of our doctors, patients, and staff. Vickie’s attention to detail allows me to zoom out and ensures that nothing important slips through the cracks.
What has been your most satisfying moment in business?
Watching people we mentored believe in themselves and create their own dreams–whether this is within Adelpha or outside of it. When we started in 2016, very few solid, insurance-based psychiatry groups existed in LA. It’s incredibly satisfying seeing this number grow as residents we helped train and taught start their own practices. Learning that we could be an inspiration that it is possible, whether through the Private Practice Lecture series we give at UCLA and USC, or the various other points of contact we have with early career psychiatrists, there’s something genuinely satisfying about knowing good care reaches further than just our own practice.
What do you feel is the major difference between entrepreneurs and those who work for someone else?
When you’re employed inside a big institution, it’s easy to start feeling like a replaceable piece of a machine. Running our own practice forced us to unlearn that. We had to trust that our judgment mattered, that we could move fast when the situation required (e.g. rebuilding our entire practice around telehealth during the global COVID pandemic to prevent lapses in clinical care), and that we didn’t need anyone’s permission to fix a problem we could see clearly in front of us.
What kind of culture exists in your organization? How did you establish this tone and why did you institute this particular type of culture?
Warmth, trust, safety and hard work. Our company culture is built on actually trusting each other, not just being cordial. This is no accident. We started this practice as friends who’d been through years of difficult training together and experienced work environments where these values were not prioritized. We work hard to lead by example and ensure everyone who joins us, whether physician, therapist or administrative team member, feels that same sense of respect, trust and gratitude.
In one word, characterize your life as an entrepreneur.
Intentional.
