Grad school taught me how to sit with a client’s pain. It never taught me how to bill for it. No one taught us to run a business, which may be why private equity now sees therapy as an industry ripe for optimization. Private equity is offering therapists capital, efficiency, and scale, and I keep asking: at what cost? Motherhood, the work at the heart of my practice, shows how badly efficiency fails as a measure of care. Here’s why we’ve made inefficiency our feature, not our flaw.