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Why Therapists Choose you over Solo Practice

Writer's picture: Julie HerresJulie Herres

The barriers to starting a solo practice have never been lower. With a few clicks, a therapist can set up a website, join a telehealth platform, and start taking clients. But while it’s easier than ever to start a private practice, that doesn’t mean it’s a road paved with rainbows.


Running a practice is hard work. Many solo practitioners find themselves working long hours for less pay than expected, barely breaking even in their first year. And let’s not forget that a practice is a small business. There’s a huge mental load to managing all the operational aspects of a business.


Not all clinicians have the desire to be business owners, they don’t want the stress, the overhead or the responsibilities that come with it. This is where your group practice becomes a game-changer. By providing a supportive environment, you offer therapists the opportunity to focus on what they do best—helping clients—while sidestepping the overwhelming responsibilities of business ownership. But to attract and retain great clinicians, you need to create a practice that meets their needs and sets them up for success.


 

Understanding the Realities of Solo Practice 

While solo practice has its appeal, the realities often paint a different picture. Based on our data, 50% of solo practice owners see 15 or fewer clients per week. For some, this is a deliberate choice to maintain a part-time schedule, but for others, it’s due to challenges in client acquisition. 


More than half of solo practitioners earn less than $50,000 annually after expenses, and 31% make less than $25,000. Achieving a six-figure income is rare, with fewer than 10% taking home over $100,000 annually.


Additionally, while many therapists aspire to run cash-pay practices, 77% end up accepting at least one type of insurance to boost referrals. Though cash-pay rates might exceed $150 per session, the average session rate for most solo practitioners hovers around $130 due to insurance and sliding-scale fees.


For clinicians who find these challenges daunting, the stability and support offered by a group practice can be a game-changer.


Note: These numbers are based on data from GreenOak Accounting’s client base and may not reflect the entire industry. They are intended to provide general insights and context for understanding the financial realities of solo practice.


Your Responsibilities as a Group Practice Owner

To make your practice appealing to potential hires, you need to address their biggest challenges. Here are two critical areas to focus on:


1. A Reliable Client Pipeline

Therapists shouldn’t have to market themselves to fill their schedules—especially not without compensation. If they’re responsible for finding their own clients, they may quickly feel they’re doing the work of a solo practitioner, even if marketing is only a sliver of the administrative work a practice entails.


Your responsibility as a group practice owner is to establish systems that deliver a steady stream of well-matched clients for your team. This means having effective marketing, referral networks, and administrative processes in place to ensure clinicians have full schedules without taking on additional responsibilities.


2. Sustainable Compensation Models

Every session provided by your clinicians must be profitable for your practice. Session revenue will need to cover the clinician’s paycheck, but also costs like software, rent, intake and much more. Without a sustainable compensation structure, you as the business owner risk working harder than ever just to keep the business afloat.


 

The Benefits of Working for Your Group Practice

While starting a solo practice might seem appealing, many therapists don’t want the stress and risks of being a business owner. Here’s why your practice offers a better alternative:


1. They Don’t Have to Find Clients

For many therapists, the idea of building a caseload from scratch is overwhelming. Networking, marketing, and managing client inquiries require time and energy that many clinicians simply don’t have—or don’t want to spend.


Even if they join a platform like Headway or Alma, clinicians will still need to go out and find their own clients. 


When they work for your practice, you (or your team) handle the client pipeline. This allows therapists to focus solely on their clinical work without the pressure of filling their own schedules.


2. No Administrative Headaches

Billing, credentialing, paying expenses, marketing, answering phones—these tasks can easily take 20+ hours a week for a solo practitioner. By working in your group practice, therapists avoid these time-consuming responsibilities and can focus purely on providing excellent care.


3. Access to Established Systems

Setting up systems for a private practice takes time and effort. Remember the countless hours you spent choosing an EHR, designing a website, and creating intake forms? Your clinicians don’t have to.


When they join your team, they benefit from efficient systems that are already in place.


4. Lower Financial Risk

Starting a solo practice comes with significant financial responsibilities. For example:


  • Rent: A private office can cost $1,000–$3,000 per month, often locked into a five-year lease. That’s a $60,000–$180,000 commitment.

  • Startup Costs: While it isn’t particularly expensive to start a therapy practice, it still requires some initial investment. The expenses like state registration, building a website, consultations with attorneys, accountants or consultants, and all the software subscriptions will usually require an initial investment of a few hundred to a few thousand dollars. Not everyone is going to have that kind of cash just laying around. 

  • Reduced Income: In the early stages of private practice, a clinician’s income will dip. Even if their clients follow them from a group practice, not every client will follow. Without strong marketing and referral systems in place yet, there will be a time when sessions are lower than expected. If a clinician just can’t afford to take a pay cut, even temporarily, then private practice likely won’t be a good fit for them. 

  • Self-Employment Taxes: Solo practitioners are responsible for both the employer and employee portions of Social Security and Medicare.


Group practice alleviates the financial pressure and client scarcity that many solo practitioners face. By joining your team, therapists bypass the challenges of building a client pipeline from scratch or managing unpredictable income. This stability allows them to focus on providing excellent care without worrying about financial strain or administrative burdens.


5. Better Work-Life Balance

Owning a solo practice often means working long hours and wearing many hats. Therapists must juggle clinical work, billing, marketing, and client management. Evenings and weekends are often spent catching up on administrative tasks.

In contrast, working for a group practice allows clinicians to truly “clock out” at the end of the day. With fewer administrative responsibilities, they can enjoy more personal time and maintain a healthier work-life balance.


 

Breaking Down the Numbers

Here’s a side-by-side comparison of what solo practitioners and group practice clinicians can expect:



Solo Practice Owner

Group Practice Employee

Practice Income

Insurance payments: 25 x $124 x 4 weeks = $12,400 monthly income

Insurance payments: 25 x $124 x 4 weeks = $12,400 monthly income

Compensation


$65/session x 25 sessions x 4 weeks = $6,500

Overhead Expenses*

$3,100 (25%)

None

Taxes (Social Security & Medicare)

Self-employment taxes (FICA): $1,423

Employee portion of FICA: $504

Take-Home Pay

$7,877

$6,095

Hours Worked



Clinical

25

25

Administrative

20+ (billing, intake, marketing, etc.)

4 (notes, meetings)

Hourly Rate

$43.76

$52.54

*Our solo clients spend on average between 10-50% on overhead expenses. 10% is most common for practices that are full and extremely efficient. 50% is more common for newer practices that are just getting started. 


Unsurprisingly, the chart shows the solo practice owner will have a higher take home pay if their caseload is full. What’s a little less obvious though, is that they are working significantly more administrative hours. As the chart shows, clinicians working for a group practice often enjoy a higher hourly rate and significantly fewer administrative hours than solo practitioners. 


 

But What If Things Don’t Go Well?

While starting a solo practice might seem like a dream, the reality can be much harsher if things don’t go as planned. High overhead costs, an insufficient number of clients, and unexpected expenses can quickly turn that dream into a financial nightmare.


Let’s paint the picture:

  1. Overhead Keeps Adding Up:

    • Office rent, software subscriptions, liability insurance, and professional memberships don’t stop, even if your client load is low.

    • If you’ve signed a multi-year lease for a pricey office space, you’re locked into that commitment—whether or not you have the income to cover it.

  2. Not Enough Clients:

    • Without a steady stream of clients, revenue can fluctuate wildly. A few cancellations or no-shows can derail your monthly income, especially if you’re relying on a small caseload to meet expenses.


    • Building a marketing pipeline takes time, and many solo practitioners underestimate how much effort is required to attract and retain clients.

  3. No Profit, No Pay:

    • If your revenue barely covers your overhead, there’s little to no profit left to pay yourself. This can lead to burnout and financial stress as you work harder without seeing the rewards.

    • Don’t forget about taxes. If you’re not setting aside money for quarterly tax payments, a large bill at year-end can push you further into financial trouble.


 

The Risk in Numbers

To put this into perspective, consider this table comparing a thriving solo practice to one struggling with high overhead and low client volume:



Thriving Solo Practice

Struggling Solo Practice

Practice Income

Insurance payments: 25 x $124 x 4 weeks = $12,400 monthly income

Insurance payments: 5 x $124 x 4 weeks = $2,480 monthly income

Overhead Expenses*

$3,100 (25%)

$3,100 (165%)

Taxes (Social Security & Medicare)

Self-employment taxes (FICA): $1,423

Self-employment taxes (FICA): $0

Take-Home Pay

$7,877

-$620

Hours Worked



Clinical

25

5

Administrative

20+ (billing, intake, marketing, etc.)

40+ (billing, intake, marketing, etc.)

Hourly Rate

$43.76

-$2.44


Part-Time Clinicians

In group practice, the breakeven point for a clinician typically hovers around 10 sessions per week, where revenue merely covers the operational expenses of those sessions. Seeing fewer than this often results in net losses for the practice. For a group practice, clinicians who can't consistently maintain a caseload above this threshold may not generate enough profit to justify the costs. For clinicians wanting to work part-time, a solo private practice with minimal costs is often the best course of action. 


 

Why Group Practice Can Be A Win


For Clinicians:

  • Fewer Risks: No need to take on financial commitments like long-term leases, startup costs, or software subscriptions.

  • More Time for Clients: With administrative tasks handled by the practice, clinicians can dedicate more time to client care.

  • Better Balance: They can go home at the end of the day without worrying about business responsibilities.


For Practice Owners:

  • Attract Top Talent: A supportive environment with fair pay and fewer responsibilities is a major draw for skilled clinicians.

  • Build Sustainability: A well-designed compensation model ensures your practice remains profitable while supporting your team.



 

Building a Practice Where Therapists Want to Work

To make your group practice the best place for clinicians to grow and thrive, consider these key elements:


  1. Offer Stability Therapists join a group practice for predictability. Ensure they have full caseloads, fair pay, and the resources they need to succeed.

  2. Foster Growth Many therapists are drawn to group practices for the opportunity to learn and grow. By providing mentorship and support, you can help them advance in their careers while benefiting your practice.Creating future leadership positions for seasoned clinicians can also be a great recruiting tool.

  3. Create a Collaborative Environment Building a positive team culture can make your practice stand out. Therapists who feel supported and valued are more likely to stay and contribute to the success of your business.


 

Final Thoughts

Starting a solo practice may seem appealing, but the reality is that it’s often more stressful and less profitable than expected—especially in the early years. By providing a steady client pipeline, efficient systems, and sustainable compensation, your group practice becomes an attractive and supportive option for clinicians who want to focus on their clients without the burdens of business ownership.


If you’re ready to optimize your group practice’s financial model or streamline your systems, GreenOak Accounting is here to help. Let’s work together to create a practice that thrives—for you and your team.


 

This article is designed to provide information only and should not be considered legal or tax advice. Because of the complexity of the law and the variables in your own personal tax situation, you can’t rely on our advice specifically related to your unique circumstances. In order to get the best tax savings and legal advice available to you, you should consult with your own accountant, attorney, or advisor regarding your particular facts and circumstances.


GreenOak Accounting specializes in working with counselors and therapists in private practice. For more information on our services, visit our website.


 


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