Transitioning From Solo to Group Practice Ownership:

Practical Considerations

Are you considering taking the leap from solo practitioner to starting a group practice but don’t know where to start? Congrats, you are in the place EVERY current group practice owner has been in; remember the normalcy of it all. Take a step back and congratulate yourself for being at a place in your private practice that is leading you in the direction.

With the internet and social media, there are so many ways to get information on what to do and how to do it when it comes to growing your practice. It can be overwhelming. What I tell people is that EVERY piece of advice is just that, advice based off of what worked for someone else. There are so many ways to start and grow a group practice, and finding what fits your needs and vision for your business is the first step in figuring out how to get there.

This blog post is meant to serve as a means to introduce concepts of group practice ownership that should be considered as you begin the journey of starting and growing your practice.

 Before you hire your first clinician:

• Check with your state (you can ask other practice owners in your state as well) on any laws regarding how you can pay your clinicians. There are various pay structures,  from paying a flat rate to clinicians, paying a percentage, or salary.
• Set up a business plan. You can check this out for more information on writing a business plan.
• Talk to an attorney about setting up your IRS structure. There are various business structures, from LLC, PLLC, and S Corp. Each comes with its own benefits and I see group practices set up under all of these structures.
• Make sure you have malpractice insurance for your business. AND renters insurance. If you have employees you may want to have them listed individually as well on your business malpractice insurance. If you have employees you will also need workers compensation.
• Decide if you are taking insurance, self pay, or a combination of the two. If you are considering taking insurance (or already do in your solo practice), there are steps to take to set your business up as a group under the insurances so the clinicians you hire can bill under your business (and it is best to set this up before you start hiring clinicians). Check this out for more information on all things insurance and billing for mental health practitioners.
• Decide if you are going to hire independent contractors or employees. You can check the IRS page here and check more out here. It is important to think this one through, as you can get into trouble with the IRS for treating independent contractors as employees. What do you expect your role and their role to be in your group. What is your vision for your group, and do employees or independent contractors fit into that vision? The more expectations you have for your staff, the more likely they are being treated as employees.
• Have an accountant talk to you about your business taxes so you understand them. He or she can also discuss the difference in taxes paid between having independent contractors versus employees.
• Have an attorney look at your documents or draw them up. Important documents to have before hiring staff is intake paperwork (including HIPAA form, consent for treatment, *consent for telehealth therapy, ROI, demographics page, and *credit card on file form), contract for IC/employees.          *not required
• Set yourself up for doing payroll. You can do your own payroll or hire someone else to do it. I use Intuit myself and love it.
• Make sure you have an EHR system you trust and like, and that you understand how to use it when it comes to groups (there are sometimes things to learn when it comes to groups and EHR systems).
• Who is doing the intake calls? Is is an intake person or the clinicians themselves? There are benefits to both and it depends on your business goals. Having the clinicians do it frees up finances since you don’t have to pay someone to do it. Having a dedicated person doing intakes helps you know who is calling, how many calls are coming in, and where they are coming from.
• BONUS (for employees only): Make an employee handbook that lays out the steps they need to take when first being hired (from handing you their license, credentialing with insurances, giving you w4) as well as expectations (marketing, time off, caseload…) and processes (how to use your EHR system, opening/closing the office, taking days off, how/when they get paid, who does intake calls…) *This is the most creative part of the process, figuring out what systems you want in place. A lot of this can change as you grow and see what fits your practice.

As you hire your clinicians:

• Decide on what you need with regards to who you hire before interviewing your first person. This way you know what you are looking for.  Do they need to see a certain population or have a specific background? Is there a gap to be filled? Check out more here and here.
• Market yourself and have your clinicians market themselves. Learn more about how to do it well here and here.
• Figure out how you will pay yourself and how you budget your finances. A financial planner is good for this, as they can help you organize your money and hold you accountable. One of the things practice owners find difficult is knowing how much to pay themselves, how much to keep in the business, and whether they are investing in the right areas of their business. Learn more here and here and here.
• Make sure you are taking care of yourself-you cannot see as many clients when you own a group practice as you can when you are solo. Cut down if you need to so that you can focus on growing your business and take care of your staff.
• Are you HIPAA compliant? Emails, phones, EHR systems, online therapy tools, credit card processors all need to be confidential, safe, and compliant. Learn more here.

If you have decided on and/or done the things listed above, you will be well on your way to having a group practice that has the necessities for being successful.

Looking for consultation as you grow your group practice? Contact me at [email protected].

Download my Barebones Startup Checklist here: Barebones Startup Checklist

and sign up for my group practice startup course here: https://members.thegrouppracticeexchange.com/sign-up-to-the-group-practice-startup-course/

Maureen Werrbach is a psychotherapist, group practice owner and group practice coach. Learn more about her coaching services here: LEARN MORE HERE