Theory Doesn’t Scale Business, Reality Does

Many founders fall in love with theory. They map out total addressable markets, adoption curves and perfect product visions. My guest on The Scaling CEO, Matt Cohen, knows why that doesn’t work in practice.

Matt is the CEO of PlaySpace, a virtual therapy platform designed to help therapists engage children, teens and neurodivergent adults. His background spans psychology, management consulting and digital health strategy at MindBeacon. For him, building PlaySpace isn’t just a business. It’s a mission to fix what he calls the “fundamentally unjust” lack of access to mental health care. His story is a masterclass in how CEOs must bridge the gap between theoretical opportunity and messy reality.

Don’t Let Small Markets Trap You

Matt learned early that healthcare scales differently across geographies.

“In healthcare… each market… has different opportunities that actually lend at different points in time. The scale of the U.S. market is something I wish I invested into more at the beginning.”

His lesson for CEOs: don’t get stuck proving yourself in smaller or slower markets if bigger opportunities exist. Parallel validation in larger markets creates more traction and more proof points.

Purpose as Guardrails

At MindBeacon, Matt described lack of access to therapy as “fundamentally unjust.” That personal conviction still shapes PlaySpace.

“The number one rule… is that we cannot interrupt or hurt a session. If we’re trying to enable therapists, we can’t shoot ourselves in the foot and not deliver on that promise.”

Purpose becomes operational guardrails. It attracts employees, inspires therapists and keeps decisions aligned with ethics.

Why Theory Breaks Down in Healthcare

Matt quoted his former boss:

“Theory is right in theory but not in reality.”

Healthcare is full of massive problems, which means every theoretical solution sounds right. But CEOs who ignore the context, gatekeepers, regulations, and provider behavior will fail. Reality is where theory gets tested.

Meet Customers Where They Are

Therapists are not early adopters. Selling them on “more accessible therapy” misses the point.

“If we went out there to say we’re making therapy more accessible and effective, that would not resonate… It’s about meeting them where they are today and speaking to how we can make their life easier.”

For CEOs, the lesson is universal: stop pitching from your perspective. Use your customer’s words. Solve their actual problems.

Change Is Harder Than It Looks

Healthcare incumbents are protective. Regulation raises friction. And products that look like shortcuts often collapse. Matt pointed to digital therapeutics firms that built FDA-style moats, only to see them become barriers to adoption, forcing fire-sale exits.

The warning for CEOs: don’t confuse barriers with defensibility. If your moat slows you down more than your competitors, you’ll lose.

Using AI as an Equalizer

Matt sees AI as a tool that levels the playing field for resource-strapped startups.

“AI can do anything, but it’s not perfect at much yet… The opportunity for AI can become a distraction because sometimes getting it 80% of the way there is easy, but getting it to 98% takes a lot of work.”

For CEOs, the rule is simple: find repeatable, high-value use cases. Test rigorously. Don’t over-invest in automation that may break as your business evolves.

Framing AI for Adoption

PlaySpace uses AI internally and in products, but never sells it as “AI.”

“We don’t call it an AI storybook builder. We call it a story generator… It’s not hiding AI, but applying it to a use case where therapists can benefit.”

The insight for CEOs: frame AI in ways your customers understand and trust. Don’t let buzzwords scare them away.

Final Takeaway

Matt Cohen proves that scaling isn’t about theory. It’s about context, purpose and persistence. CEOs who succeed don’t just identify problems. They translate solutions into reality, one market, one customer, one proof point at a time.

I’m Glenn Gow. I coach CEOs who want to scale boldly and decisively. On my podcast, I reveal the exact playbooks top leaders use to expand faster and lead with clarity.

Listen to the full episode of The Scaling CEO with Matt Cohen to learn how to scale a purpose-driven company in one of the toughest industries in the world.

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Glenn Gow
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