7 Reasons Not to Start a Therapy Group Practice

When you think of running your own therapy group practice, what comes to mind? Do you think about the luxury of sitting back while others do the work? Do you imagine having a team of talented therapists within your office that support your local community? Or do you think of mountains of paperwork, never-ending chores to keep the lights on, and stressful evenings spent figuring out what’s going wrong with your charting system?

If you automatically think of the latter, then starting a therapy group practice may not be for you – and that's okay! Not everyone gets excited about the prospect of running a business with employees or contractors. While group practices are often glamorized as the pinnacle of private practice, keeping one going can be very difficult and it's important to be realistic about what will work best for you.

Whether you’re considering starting a therapy group practice or just curious how much work it would be, here are seven reasons why this may not be the right move for you (and ten reasons why it may be!).

1. You don’t like the business aspect of private practice and don’t want to learn to love it

Even though group practices are in the mental health field, they’re still businesses! As with any business, group practices require large amounts of time spent completing administrative tasks such as billing, invoicing, ensuring HIPAA security, and marketing. If you don’t like these aspects of keeping your private practice running, chances are you won’t like them when you add in other therapists.

You may find a way to develop efficient processes that don’t require too much extra time per therapist; however you will never get rid of these administrative duties altogether. As the owner of a group practice, these tasks will likely fall on you, at least at first, making it vital to understand and feel comfortable completing them. You may never love this part of running a group practice – but it will certainly make it easier if you at least don’t mind them.

2. You don’t want to manage people

Inherent to the job of running a group practice is managing your team. This means supervising therapists, teaching them the practice policies and procedures, and redirecting them if they veer off track. Managing people is often hard to get right; being in an industry that’s all about support, well-being, and compassion, this role becomes extremely challenging.

While some people enjoy working with others in a managerial capacity, it can be a lonely position to be in and could potentially tap into unconscious insecurities. Often, people who become managers find themselves facing unexpected negative emotions from their past (think conflicts with authority figures growing up or feeling powerless after trauma). Consider what your emotional wellbeing will look like taking on the responsibility of managing a team of therapists and decide if it’s right for you.

3. Hiring and onboarding staff isn’t your thing

To begin your group practice, you’ll need to find a team of therapists – which means interviewing, hiring, and training. Interviewing dozens of candidates for one spot may become draining – asking the same questions over and over again while representing the business as an attractive place to work. If you know that you don’t enjoy the interview process, this part of running a group practice might not appeal to you.

It doesn’t stop after the interview process, either. Once you find the perfect therapist for your team, you’ll likely need to negotiate their salary, benefits, and job expectations. You may need to adjust the role based on that person’s qualifications or demands, too.

Lastly, after agreeing on all of the job details, you will need to onboard your new hire (or hires!) into the group practice. This includes setting up their benefits, getting them onto your electronic health record system, and creating an email address for them. It also includes communicating your policies and expectations while teaching procedures and facilitating bonding with the rest of the team. Adding new people to your team may sound like a great idea to grow your practice, but know that it takes a lot of effort and time to actualize!

4. You have a hard time with the pressure of being responsible for the wellbeing of others

Alongside managing and hiring your staff, you will be responsible for the wellbeing of your team. As the leader of the group practice, your job is to make sure that the business keeps running and that you take care of your staff – including paying them each pay period, no matter the financial state of the business. By hiring others, you’re promising them a job and stable income. This is a lot of responsibility, especially if you have a large team! It gives the goal of running a sustainable business a greater sense of urgency.

You may also find yourself responsible for maintaining morale amongst your team. When issues arise or when major decisions need to be made, your team will look to you – which is added pressure! If you don’t enjoy being in charge of others or the responsibility of taking care of a team, starting a group practice may not be for you.

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5. You don’t enjoy building processes

When setting up your group practice, you will need to define various processes in order to establish routine and work towards the desired outcomes. Some people really enjoy this part of starting a business; others many find it tedious, anxiety-inducing, or boring. Think of all of the processes that your group practice will need to put in place before you start seeing clients: intakes, terminations, transfers, referrals, and onboarding, just to name a few!

If you have a pragmatic mind, this part may come easily. However, if you aren’t sure what makes your business efficient, it may take trial-and-error to figure out the best ways to complete each process. Once you’ve established what your processes look like, communicating these processes in a way that your team will understand and adopt is another task. You may even need to come up with a process for handling when a therapist does not follow the processes, whether that’s retraining or providing ongoing feedback.

6. The last thing you want to think about is practice finances

Running a group practice is running a business – and that means that money is involved. Because your paycheck (and your team’s paychecks!) are on the line, you need to make sure that your group practice is profitable and sustainable. This means being intentional about therapy rates, which insurances you take, your expenses, sliding scales, how much you pay your therapists, and your rental space. It also means that you will need to either hire an accountant to support your business or take on the bookkeeping and taxpaying yourself – which can be quite confusing if you don’t like thinking about practice finances!

Money is stressful, no matter the position you’re in. Being the owner of a business makes it your job to keep the lights on and if this sounds uncomfortable, starting a group practice might not be a good fit for you.

7. You’re perfectly content with your current practice set up

The last reason that starting a group practice may not be for you is if you’re perfectly content with the way that your current practice runs. If you enjoy working in your private practice, like the way that it feels to go through your weekly routine, and don’t mind the administrative tasks, then why change? If you’re making the right amount of money for the work that you do, it can be risky to move onto a group practice – and especially risky for your own mental health!

With these seven reasons in mind, think through the idea of starting a group practice. It’s not for everyone and if it’s not for you, there’s nothing wrong with that! Because of the amount of work that it takes to set up a group practice, it's not worth it if it won't bring you a sense of fulfillment and better your personal life.

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