So has your counseling practice grown to the point to where you are thinking about adding other clinicians? Or maybe you are just starting out and thinking ahead about starting a group private practice. Maybe too, you now have a waiting list and want to have people to refer to. Starting a group private practice as a counselor or therapist is a great option for a lot of practitioners.
Moving from a solo practice to a group practice is one of the best ways to take your practice to the next level. It is a way to create additional streams of income and helps your leverage your time to serve more clients. A group practice can be something as simple as two clinicians working together to having multiple clinicians under the same name.
When thinking about starting a group practice, there are several things to consider:
- How you will decide on the practice name?
- What will be your business model or structure of the practice?
- What are the office processes and automation you will need?
- How will you monitoring and lead the group?
- Finding the right people to join the group?
Practice Names
One of the first things most people begin to think about is what they will name the practice. In many ways, this is about creating a “brand” that will be recognized and also represent what you do. So put some thought into this. You can certainly use your own name, but that might take away from others in your group.
A good place to start is to simply do some Google research of other practice names in your area. Most importantly though, you do want to have a name that easily identifies what you do. Also look into domain names that you can use. This will go a long way in helping you market your practice as your grow.
So for example, when I started my group practice, I chose Kingsport Counseling Associates since it was 1.) Not already in use 2.) The domain name kingsportcounseling.com was available 3.) It name tells where and what we do. The location in the name is not as important as having the what you do (ex.“counseling”, “therapy” or “mental health”, etc.)
Finding the right people
When starting a group practice, the most important thing to take into consideration is making sure that the people you bring on are going to be a good fit. It is a good idea to spend a lot of time on this. I think it is wise to put the time into really getting to know the people you want to join your group. Make sure their goals for having a private practice are in line with your own. Make sure you share some common values and have similar work ideas.
A question to ask is will they compliment and add to what you are already doing? Will they be someone you can confidently refer to and live into the your own goals and aspirations for your private practice? Will they be willing to put in the work needed to generate their own referral sources and base?
Business Models
First of all, it is highly recommended that as you begin to form a group that you consult with an accounting and/or legal professional about your business model/structure. It will make a big difference for you at tax time and also from a liability standpoint. You will need to have things in place to protect yourself. In general, it is probably a good idea to form a business entity such as an LLC (Limited Liability Corporation) to give you that protection. The laws around this vary from state to state, so definitely seek the advice of the appropriate professional
Sublet or share office space– this is really the simplest way to have a group practice. With this model, the people in the group just simple share the cost of running the office. It might be a set monthly fee or a sharing of the actual expenses. Each person then runs their practice independently under a shared name.
Contracted Providers – This is probably the most common model you hear about. These are also known as “1099 Contract Employees”. (1099 refers to the IRS tax form like a W-2 that you have to give the person at the end of the year; consult your accountant on this) With this model the members of the group are “contractors”. In other words, they provide their services for a set rate or contracted price with the group and they are not an employee of the practice.
The financial arrangement can be done in any number of ways. A very common practice though is to have split fee. In other words, the group practice keeps a certain percentage of the fees collected. A 60/40 split is very common (the practitioner get 60% and the group 40%). But it can vary from a 50/50 split to a 80/20 split. Another way is for practitioner to simply pay a set fee to be part of the group.
The key with contracted providers is that you set up a contract with them that spells out expectations and how they will provide their services within the group. Also they can not be treated as an employee might be treated. They set their own hours and provide their own materials to work with (business cards, forms, etc.)
Again, it is very important that you seek the advice of a tax and/or legal professional about this in your state to have a clear understanding of how you can and can not use contracted practitioners.
Employee Providers – With this model, clinicians are hired as employees of the group. In general this is the more complicated and costly of the models from a business standpoint. On the upside, it does give you more control of what people do or don’t do in the practice. You can dictate more on when and how people work in the practice.
Basically though, you have to follow the state and federal laws for being an employer. In most cases you would have to provide disability and workmans compensation benefits. Also there are minimum wage requirements and other benefits that you may or may not have to provide depending on your state; health insurance for example. You will also be required to do the income tax withholding and pay the FICA.
Office Processes and Automation
An important part of having a successful group private practice is having the office processes in place to make things run smoothly. For example, having an intake process and someone in charge of that will go a long way in making things go well. It might be that it will make sense to get a virtual assistant or intake coordinator handle this piece for your group practice; especially if you have several people using the same office spaces.
Record keeping and paperwork flow is an important piece to keep in mind. With contracted providers, each provider provides and handles this on their own processes, but you can put in your contract how you prefer them to handle this. Having a common practice management system (applications and software) usually make sense. Particularly around scheduling and being able to have some consistency with how the paperwork flows. Some practice management systems are better suited for group practices than others.
Leadership
Finally, knowing how you can best lead your group private practice is something to put some thought into. The more you can outsource or hand-off the tasks you are less enthusiastic about the better use of your own time you will have. Also, having the people in your group do what they do best. For example, if you have someone that is good at networking or social media, let them handle that for the group.
Having an atmosphere in which people feel they are contributing and that they belong is the number one way in which businesses grow and thrive. Having a thriving and successful group practice is absolutely doable. By taking the right steps it can be a reality for you and your practice!
By L. Gordon Brewer, Jr., MEd. LMFT – Gordon is the President and Founder of Kingsport Counseling Associates, PLLC. He is also a consultant and business mentor at The Practice of Therapy. Follow us on Twitter @therapistlearn. Join the Facebook Group.
