Podcast Summary: Becker’s Healthcare Podcast

Guest: J.R. Greene, Founder and Chairman of Psychiatric Medical Care
Host: Laura Dardo, Becker’s Healthcare
Date: February 7, 2026

Episode Overview

In this episode, Laura Dardo interviews J.R. Greene, founder and chairman of Psychiatric Medical Care (PMC), about the current and future state of behavioral health services in the U.S., with a particular focus on challenges and innovations in hospital and community-based care, especially in rural settings. The conversation explores organizational culture, sustainability, workforce issues, and strategies for developing impactful, resilient behavioral health programs.

Key Discussion Points and Insights

1. Introduction to Psychiatric Medical Care

[00:12–03:12]

• JR Greene introduces PMC as an organization with four divisions operating in around 300 locations across 34 states:
  • Intensive outpatient psychiatry, mainly in rural hospitals
  • Child Intensive Outpatient Programs (IOP) and Partial Hospitalization Programs (PHP) in urban markets for ages 9–18
  • Inpatient psychiatry in partnership with large hospitals
  • Telehealth services, including care for jails and emergency departments
• Notable moment:
  • J.R. enjoys the literalness of the company name, noting,

    "I do love the fact that our name represents exactly what we do, because so many organizations out there have flamboyantly beautiful different names, but it doesn't necessarily align to what their service is."
    (J.R. Greene, 00:59)

2. Successful Recent Initiative: Embrace You Program

[03:28–05:22]

• Origins: Sparked by community needs observed through coaching youth baseball in Nashville—five out of 12 players had ADHD.
• Program Features: Medical-director-focused IOP with in-person options to better serve children (vs. fully virtual alternatives).
• Impact:
  • The program filled quickly and expanded to six sites within Tennessee.
• Notable quote:
  • "Once we opened the program, we were full within several months. And now we've opened up already, I believe, six locations in the state of Tennessee."
    (J.R. Greene, 04:47)

3. Building a Beneficial Behavioral Health Culture

[05:53–10:56]

• Personal background: J.R.’s father was a psychiatrist, providing him with unique, lifelong exposure.
• The “Right People, Right Seats” analogy:
  • Emphasizes importance of matching peoples’ personalities, skills, and passions to the org’s stage and work style.
• Three Organizational Phases:
  1. Improv:
     • Early-stage, entrepreneurial, few rules—suited to go-getters who thrive on ambiguity.
     • "You've got to fake it till you make it." (J.R. Greene, 06:43)
  2. Musical:
     • Some structure, but still dynamic—like a stage show with understudies and general guidelines.
  3. Syndication:
     • Highly systematized, repeatable operations—like a successful TV show; ideal for large-scale, stable programs.
• Key takeaway:
  • Success and satisfaction depend on aligning personnel with these phases:

    “It's all about aligning people that want to be into one of those three phases... then guess what? You're gonna love what you do because you're now in the... division that you love.”
    (J.R. Greene, 10:31)

• Organizational growth: PMC evolved from three to 300+ sites, moving through these phases as new programs/divisions launched.

4. Healthcare Headwinds and Funding Challenges

[12:35–16:38]

• Cultural headwinds: Navigating bureaucracy and evolving government priorities.
• Funding complexity:
  • Upcoming $50B for rural healthcare, but “a lot of ambiguity” about allocation and qualification.
  • Grants are commonly used to start programs, but reliance on ongoing grant funding is unsustainable:

    “Because what ends up happening... is you get a beautiful program established for 1, 2, 3 years while the grant's alive... but then once that grant stops, boom, the financials stop.”
    (J.R. Greene, 14:31)

• Ideal funding approach: Use grants for startups, but ensure programs are self-sustaining long-term.
  • “If there are grants and funds that can help get a program started that then can be sustainable long term, that is magnificent.” (J.R. Greene, 15:38)

5. Workforce & Staffing: Persistent Challenges Post-COVID

[17:07–21:03]

• Biggest issue: Staffing and retention, especially after COVID’s disruption (e.g. reliance on expensive temporary staff).
• Telehealth as a partial solution for bridging workforce gaps, though some services still require in-person care.
• Avoiding poor-fit hires:
  • Hurrying to “fill a slot” (heartbeat hires) often results in rapid turnover and high costs:

    “Every time we've done a heartbeat hire, maybe one out of 10 we get lucky. But nine out of 10 times, that individual is not a fit to be on the bus either with our hospital or with us.”
    (J.R. Greene, 20:13)

• Strategic hiring:
  • Prioritize the right talent match, even if it slows down program starts, for long-term success and reduced churn.

Notable Quotes & Memorable Moments

• On company naming:

  "Our name represents exactly what we do... psychiatric medical care. Because I do love the fact that our name represents exactly what we do, because so many organizations out there have flamboyantly beautiful different names, but it doesn't necessarily align to what their service is."
  (J.R. Greene, 00:59)

• On org culture phases:

  "You've got to fake it till you make it... you're just trying to literally make it. And you're trying to find ways of growth, obviously being frugal as you're building out any department within the hospital or any type of organization."
  (J.R. Greene, 06:43)

• On funding sustainability:

  “I'd love to help find, you know, areas... that don't require grant funding... because when you get grants... they stop at some point. And I think that that concerns a lot of individuals because you get a beautiful program... but then the financials stop.”
  (J.R. Greene, 14:31)

• On telehealth and COVID-era staffing:

  "Thank goodness that telehealth has expanded as successfully as it has because that allows us to provide that level of care and not be put into those really difficult situations. But we still have locations that require in person care."
  (J.R. Greene, 18:56)

Key Timestamps

• 00:12–03:12: Introduction to PMC and its divisions
• 03:28–05:22: Launch and success of the “Embrace You” adolescent mental health initiative
• 05:53–10:56: Building behavioral health culture and the “improv, musical, syndication” growth model
• 12:35–16:38: Major industry headwinds, funding ambiguity, and need for sustainable financing
• 17:07–21:03: Persistent workforce challenges & strategies for recruitment/retention

Conclusion

This episode spotlights the real-world complexities and rewards of growing behavioral health services, particularly in underserved settings. Greene provides both strategic frameworks—like the “improv, musical, syndication” analogy—and practical insights on launching community-responsive programs, achieving funding sustainability, navigating federal/state ambiguity, and retaining top talent. The conversation is rich with memorable analogies and actionable advice for healthcare leaders grappling with how to evolve behavioral health programs for the future.