6 Questions to Consider Before Starting a Group Practice

As therapists, we are trained clinically, but probably have not had much, if any, business classes or training on how to run a private practice.  When you add in the additional layer of hiring and managing staff, marketing multiple clinicians, payroll taxes, and worker’s comp — all things that come with a group practice — running a business might seem like even more of an intimidating task!

If you’re considering starting a group practice, there are numerous things to consider. Use these questions below as you start to explore this idea further.

1. Should I start a group practice?

You might start to contemplate this initial question for a few reasons. Perhaps you are business savvy and have always wanted freedom in your career. Or, maybe your private solo practice is full, and you think hiring would be an easy way to solve that problem. 

Before you expand into a group practice, there are a few things you need to think through. 

The solution is not necessarily to hire additional clinicians! If you hired someone to schedule clients, verify benefits, or file claims, you would have more time to see clients. If you have decided that hiring administrative help will not solve the problem you face, then perhaps expanding is a better idea. 

2. Do I have a system in place?

What is your system for answering initial phone calls, completing paperwork, and billing?

Are you organized and up to date with your progress notes and claims submissions?

Expanding into a group requires whatever process you have to be multiplied. If you do not have a system set up, if your practice is not streamlined, or if your procedures are not easily replicated, then you set yourself up for problems. Do yourself a favor and put thought into this first (and maybe record action steps to get things rolling smoothly!) before expanding. 

For consistency, an EHR or practice management platform like SimplePractice would help to make your administrative tasks more understandable and less time-consuming.

3. Should I write a business plan?

YES! Any business, including a group practice, should have a business plan. It is especially necessary if you seek outside funding (whether from a bank or private investors), but it is also a good exercise to go through regardless. 

Writing a business plan forces you to think through all aspects of the business, including: 

  • What is the market share in my area? 
  • How will I market? 
  • What are my estimated revenue and expenses?  

Answering questions like these will be how you fine-tune the procedures and systems you have in place to make sure they will replicate well after you hire. 

4. Should the group specialize?

Now you’ve decided expanding into a group practice is the right step for you, this is the next question to consider. One of the first things you will need to think about is: will your group practice be multidisciplinary, or more of a specialty group? Additionally, will all of your therapists have the same training and all offer the same type of counseling (e.g., all LMFTs offering couples counseling, or a play therapy group practice)? Or, will some specialize in addiction and some in EMDR, so that you have a variety of clinicians available? 

There are pros and cons for each answer, and you will need to figure out which makes the most sense for you and your location.

5. Do I want to accept insurance?

If you have experience in a community agency or hospital, insurance might seem like something you need to accept to be successful. However, there are plenty of self-pay practices that are cash-only and do not participate in any insurance panels. You can decide to accept insurance or not, or to only be credentialed with certain insurance panels. 

Think carefully if you want to have to comply with insurance requirements. If you want your practice to be self-pay and not have to not worry about submitting claims, you might have to work harder to market yourself to your prospective client base.

6. Should I hire IC vs W2?

This question can be quite a debate! Are you more hands-off, or do you want to be able to control more aspects of the work of your hirees? 

Generally speaking, independent contractors are their own business who you hire to see clients. You are very limited in what you can tell them to do and what you can require of them. In many cases, you have to be careful to not require certain paperwork be completed, have a dress code, or even have their name on your website or business cards. With employees, you have much more freedom to dictate how they do their jobs.

Be mindful that each state has their own requirements of what constitutes an independent contractor versus an employee, so reach out to an employment attorney to clarify this. 

The system you use to setup your group practice may impact this, as with SimplePractice, each IC will need their own account.

Know your answers and your next steps

Whether you are ready to go forward with expanding into a group practice, or are just tossing the idea around, these questions will start moving you in the right direction! 


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This blog was prepared by its author in their personal capacity. The views and opinions expressed in this blog are those of the author and do not necessarily reflect the official policy or position of any other agency, organization, employer, or company. The primary purpose of this blog is to educate and inform. This blog does not constitute medical, legal, or other professional advice or services. The author and the blog are not to be held responsible for misuse, reuse, recycled and cited and/or uncited copies of content within this blog by others.


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