A former student recently contacted me for professional “advice” with the following question:
Should I join an established group practice or start my own solo practice?
Your Former Student
As with many things, my answer was “It depends”.. It depends on your personality and your individual goals.
Group Practice Vs. Solo Practice
It is hard enough to make the decision to go into private practice. I mean, quitting a salaried job and transitioning to one where the pay is not guaranteed is a huge leap for most people. The freedom and flexibility are a huge pay off, but the choices that are involved in private practice can be overwhelming.
I have had the great pleasure of being part of a very successful group practice and then starting my own (in my view, successful) solo private practice. Here’s what I can tell you from my own experience:
Pros and Cons of Group Practice
PRO: Someone else has already done the legwork for the business foundation. They have given the business a name, created a letterhead, set up accounting, charting, scheduling, and pretty much everything else that needs to be done. You just focus on building your client list and providing services. You might enjoy having a little protection from the big decisions!
CON: Someone else has already done the legwork for the business foundation. If you are a control freak or just want to be creative then you might not appreciate the work that was involved in setting up a practice. You might get frustrated that the group uses outdated scheduling software or might feel disconnected from the group because you don’t have enough control. You might prefer the feeling of ownership.
PRO: You have an easy source of referrals. You will automatically get referrals from the group overflow. My old group was made up of psychiatrists as well as clinicians. So that meant that I was automatically getting referrals from the psychiatrists in my office because it was a) good for the practice and b) convenient for the clients. WIN WIN!
CON: You might have less say about the types of clients that you see. This really depends on the practice. In my old group, I had the ability to limit my caseload to children and essentially turn away clients based on my own criteria. However, your group might not give you that flexibility. Make sure you ask and read your contract! Not to mention that in a solo private practice, it might take double or triple the length of time to find the same number of clients.
PRO: You have co-workers. There are people in the building to talk to, consult with, network with and get support from. This can be one of the biggest benefits of a group practice. Communication with other professionals is so helpful!
CON: Your co-workers are actually busy most of the time. The truth is that in private practice, most people are busy seeing clients for the entire day and there is not as much “water cooler” talk as you will find in a traditional work environment. Most people go home if they do not have clients to see or if they have free time due to a no-show, you are busy seeing your own clients. Now, many group practices still have staff meetings, professional development, and holiday parties. So, it’s still more than solo practice, but it takes work to get it.
PRO: You make more money. Again, this varies by group practice situation. In theory, you will make more money because you are splitting overhead expenses and sharing common costs. However…
CON: You might make less money. You might be paying for services and luxuries that you don’t actually need or paying a higher percentage than you should. In my old group practice, they were billing people that handled all of the insurance claims. In my solo practice, I do all of that myself. The group had beautiful office space in a historic building. That was expensive. My current office space is not as architectural, but it suits my needs just fine and is a fraction of the cost.
PRO: It’s a lot less work. In my experience, being part of a group practice was a lot less work. Sure, it was the SAME work (clinically), but that was it. In a solo practice, you are the janitor, the plumber, the accountant, the marketing specialist, etc. So, it can be hard to fit in the same number of clients and do all of those other tasks. In my group practice, I literally showed up, saw my clients and did my notes and went home.
CON: It can get repetitive. Doing nothing but see clients day in and day out can get very repetitive and boring. Those odd jobs that I have in my solo practice actually help break up my day and prevent me from getting burned out. Now, you may find that your group allows you to take on some special projects, but all in all, you are basically just seeing clients.
What Is Your Work Personality?
You might lean towards an established group practice if you are:
- Newly licensed.
- An extroverted people person that likes to socialize.
- A person that doesn’t like to be in charge of decisions.
You might lean towards a solo private practice if you are:
- A control freak.
- Highly creative and get bored easily.
- Have an established service niche.
- Prefer working alone/independently.
And then of course, there is the third option – owning and operating a group practice. That is something that I have decided not to do (for now). But, that is a whole different conversation!
Final Thoughts On Group Practice
The bottom line is that I enjoyed my work with the group practice and learned so much from my colleagues there. It gave me some preparation for my private practice, but there were still a zillion things that I had to learn when I opened my solo practice. I get more personal satisfaction from having MY OWN business. But the work is the same. And that is really what drives me.
Always, always, always read every single line in your group practice contract. You might get stuck in a group and be unable to leave! Most group practice contracts have a non-compete clause that says that you cannot open another practice within a specific number of miles from their practice. And you cannot (actively) take your clients with you. And you cannot take any of the group’s employees either. That’s the business part of it. Make sure you know your options before you sign on the dotted line.
Jennifer Taylor, LCSW, RPT is an experienced child and family therapist and public speaker who specializes in trauma, ADHD, and conduct problems. Discover more about her diverse clinical background and family. Reach out to Jennifer with questions or comments by emailing at firstname.lastname@example.org.