Solo or Group Practice: Which Is Right for You?

Have you ever dreamed of working for yourself, being your own boss, or running your own group practice?

Are you conflicted about leaving a secure, salaried agency position because you depend upon health care benefits and predictable streams of income? Do you doubt your ability to lead a group?

You’re not alone.

Switching from an agency to a solo or group practice is a significant personal, professional, and financial decision. It’s not the right decision for everyone. There are many opportunities to continue growing and evolving as a mental health practitioner that don’t involve owning a group practice.

If you’re considering establishing or managing a group practice, take some time to reflect on your motivations for owning a group practice as well as what you naturally enjoy doing.

It’s a challenging decision that many therapists face — whether or not to go into private practice.

Leaving a secure, salaried job with traditional benefits and transitioning to one where pay isn’t guaranteed is a valid source of anxiety, even for seasoned practitioners.

From my own experience over the many years I’ve been a private practice therapist, the freedom and flexibility that accompany private practice are well worth it. Yet deciding to take the initial leap can feel overwhelming.

To put things in perspective, the average annual salary of a private practice therapist in the United States is $91,966 per year. However, this number can range anywhere from $24,500 to $180,000+.

That’s a lot of variability in earning potential for private practice therapists, which is influenced by multiple factors, including the number of sessions you conduct each week, your rates, specialty areas, compensation, practice location, and years of experience in the field, to name a few.

Evaluate Your Why

Many times, solo practitioners go into group practice ownership because it feels like the natural next step in their career. The problem with this approach is that it isn’t intentional. People often go into group practice ownership without questioning if this is truly a good fit for them.

Not having a clear reason “why” you want to go into group practice ownership may translate to feeling lost or unmotivated when running your business. You want to set yourself up for success, and being a group practice owner requires taking on a lot of extra responsibility. On those long, tough days as a group practice owner, you’ll want to make sure you can come back to your “why”. It can help motivate you and get through those hard days.

Some common reasons therapists move into group practice ownership include wanting to:

• Increase their earning potential
• Increase their visibility in their industry or community
• Establish themselves as an expert or thought leader in their chosen specialty
• Diversify their income
• Transition one day to another phase of their career such as mentoring other therapists, providing consulting services, writing a book, or launching a course

Self-Assess: Weigh the Pros and Cons Using a Business Owner’s Mindset

A decision to practice solo or with a group can be informed by understanding and weighing the pros and cons of each option.

It’s beneficial to consider the level of autonomy you prefer, the amount of responsibility you want to have, the ways you want to connect with your colleagues, and the amount you want to take on administrative and marketing tasks.

If you’re contemplating whether it would be best for you to move forward as an individual therapist in solo practice or join a group practice, consider the questions below.

1. Do you prefer a built-in community of colleagues and peers who you can regularly exchange ideas and receive support from?
2. Is peer supervision or having a place to discuss difficult client cases important to you, your work, and your wellbeing?
3. Is the idea of managing and being responsible for your own business overwhelming or unappealing?
4. Do you like knowing that you're not alone and can get feedback whenever you may have ethical questions or concerns related to best practices?
5. Do you want to avoid shouldering the daily burden of administrative or operations work, even if it means that I’m not the one in charge at the end of the day?
6. Would you benefit from hands-on marketing support to help attract your ideal clients?

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If you answered yes more than no to the above questions then you may find joining a group practice to fit well as your next step in your personal and professional journey. You may be someone who feels your best when you’re connected to a like-minded community of peers. You thrive when given the right tools, and may feel overwhelmed at the prospect of having to start from scratch, or go at it alone.

If you found yourself answering no more than yes, you may thrive in a solo private practice. You may be a highly creative and entrepreneurial individual who’s invigorated by the idea of creating and managing the aspects associated with running a business. If consulting with colleagues or receiving support from administrative staff isn’t high on your list of must-haves, going solo in private practice may align with your goals and style.

These questions have helped me guide therapists as they consider their own goals and personal working styles. After all, you won’t enjoy going into solo private practice if you’re a people person who can’t stand to work alone.

Solo private practice means the freedom and creative power to define your own vision for your business. At the end of the day, you’re your own boss and you call the shots. This includes deciding where to locate, whether or not you’ll accept insurance, and how you’ll attract clients.

On the other hand, joining an established group can mean reducing isolation and risk of burnout while providing valuable opportunities that wouldn’t be available otherwise. Depending on the size, groups may offer administrative support with scheduling and billing, shared risk management, furnished office space that covers rent, internet, and utilities, EHRs and other technical equipment and tools, and have more marketing reach.

The Bottom Line: Let Radical Honesty Guide Your Decision-Making

No matter what you choose, make sure to be radically honest with yourself about your desires and needs and what will ultimately nourish you. What’s most important is that you take care of yourself and do what feels like a good fit for your personality, goals, needs, and overall lifestyle.

Be clear about who you are.

At the end of the day, nobody but you knows what’s truly best. Staying true to yourself and your needs will allow you to build an expansive life and decide whether solo or group practice feels most like you.