What I Wish I Knew Before Starting a Group Practice

By Maureen Werrbach, LCPC on June 24, 2020

As a group practice owner, I'm often asked, “What do you wish you knew before you started a group practice?”

If there’s one thing new group practice owners are hoping for, it’s to not make mistakes. They want to know it all, or at least come across that way. I’ll tell you: I’ve made enough mistakes to write a book, and it’s those mistakes that have made my business what it is today. The most important thing is to embrace the journey, especially the “not knowing it all” part, and get excited to learn as you go. 

But for those of you who really want to know, this is what I (and other group practice owners) wish they knew when they first started their business as well as advice for driving success.

Slow Down

Don’t try and do everything all at the same time. When you first start your group practice, you’ll certainly feel eager, excited, and ready to get as much done as possible in a short period of time. This excitement makes you want to move forward really quickly and level up your practice as fast as you can. The biggest piece of advice that I can give you—something that I wish I had known back when I first started—is to just slow down. It’s not about the destination; it’s about the journey and being present and mindful during that journey.

It’s not necessarily better to get there quicker. If you slow down, you end up making better decisions for yourself and for your group practice as a whole.

You set the tone for your productivity and how you want to work. When you fly through things, or when you don’t give yourself time to think, you set a tone that will open you and your practice up to errors.

One piece of this is knowing your mission, vision, values, and business plan. You end up making better decisions that are aligned with all of the above, ultimately leading you to success.

It Will Take Up A Lot of Your Time

I know this is something that we all know in the back of our minds, but we don’t know how much time it’ll take until we actually start, until we hire our first few people, and until we put our policies and procedures in place. It takes a lot of your time. A lot more than whatever it is that you’re thinking! Take the amount that you're thinking and multiply it by ten.

You need to make sure that you’re practicing self-care so that you don’t burn out. Your to-do list is not going to get smaller, so don’t fall for the trap of trying to get it done and trying to catch up. If you go that route, you’ll end up spending all your time crossing items off of your list and feeling like you’re never going to catch up. It’s going to take a lot of your time, and it’ll take a lot of your time for a long time. But, there is a light at the end of the tunnel. For example, once you can start to delegate tasks, you’ll find yourself with a bit more time on your plate to shift your focus to other areas. 

It's Okay to Stop

It's okay to let things go and start back up the next day. Your to-do list will always be there, so there’s no need to grind late into the night.

Watch out for the survival trap, a term used by Mike Michalowicz that refers to the need to always put out these small fires. Instead of focusing on the big picture that you should be focusing on, you’ll probably get emails that come in full of things that people need you to fix. There’s going to be billing issues and people taking off, people leaving, people you need to hire, clients who are unhappy, and people who are calling when you don’t have a front desk person (oh, the joys!).

There’s always going to be what feels like a fire that you need to put out. But don’t fall into the survival trap of needing to continuously put out these small fires. It is okay to let the small fires burn if you’re focusing on something that is actually more important to the success of your business.

Typically, there’s always something bigger underneath all of the small fires, whether it’s a policy or a procedure, that ends up rectifying a handful of small fires. So, instead of wasting your time putting out these small fires, go deeper and focus on the bigger things. Whether that’s a sales issue or a profit issue, it often ends up clearing out a lot of the small fires.

Everyone's Journey is Different

In this digital and social media age, it’s really easy to see the success of all the other group practice owners in the world. You might see people with a hundred clinicians, people with 20 locations, people who have built 7-figure salaries, etc. But don’t compare yourself to that. It’s great to have goals and ambitions. It is great to be excited for other people’s group practices and their successes, but don’t start comparing yourself to where they are. Eventually, you’ll convince yourself that you’re not moving fast enough or doing good enough.

Focus on your journey, and remember that we all have a different pace. We all have different goals. Where you’re at is where you should be right now. If there’s somewhere else you want to be, take the steps that you need to take to get there, but don’t look at other people’s journeys and think, “What am I doing wrong? I should be there.” It’s a great recipe for disaster and something I wish I would have paid more attention to.

There's No "Perfect" Time

This might sound kind of contradictory to my advice to slow down and take your time, but don’t wait for the perfect time. It’s kind of like pregnancy. I don’t know if any of you who have had kids went through a period where you thought “I have to wait for the right time.” And then you realize, at some point, that there’s probably never going to be a perfect time.

There’s always going to be things that feel like might be an obstacle. There’s always life that gets in the way. There’s always struggles in your personal world happening, things you need to take care of. 

I want to give permission to those of you that are waiting for the perfect time that it’s okay to not feel like it’s a perfect time. If it’s something that’s a part of your business plan and it’s a goal to do it, then take that first step in and start.

Stick to Your Non-negotiables

Whether it's the staff that you’re hiring or in rates that you want to set for your business and for your team, it’s really important to know what your non-negotiables are. It’s really easy to fall into the trap of settling because you’re eager to grow or because you’re afraid that nothing better is going to come along. So know your non-negotiables before you start seeking those people out or putting those processes to put in place.

You Don't Know All the Answers, But Others Can Help

Whether it’s through business coaches, partnerships, friends who own businesses, accountability groups, masterminds, other people in your community, or your local Chamber of Commerce, seek help when you need it. Find people that you can talk to about what it feels like to own a business, whether that’s someone that’s a practice owner or not.

Seeking help is especially important when it comes to legal and ethical matters, so take special care to find a good employment attorney, malpractice attorney, and accountant. These people will save you in many ways. An employment attorney and malpractice attorney are going to help make sure that you are employing people in an ethical and legal way. An accountant will help make sure that your business is profitable.

You Must Grow Your Leadership Skills

I don’t care if you were the CEO of a company or if you’ve supervised a couple of clinicians before. When you own a business, leadership is a different experience. It will test you. You might not feel good enough as a leader, or that people don’t value your input. You’ll need to embrace your imposter syndrome. 

Leadership is so important. Research shows that most employees who leave a business leave because of bad leadership. Leadership is just as vital as sales and profits. Make sure that you’re dedicating time every week to growing your leadership skills, whether that’s through reading books, listening to podcasts, having a leadership coach, or whatever works for you. Just make sure that you’re focusing on that.

Don't Be Afraid to Automate, Delegate and Eliminate

Automate, delegate, and eliminate processes in your practice. Make sure there are no redundancies, streamline things so that they don’t take a million years and 15 people to get done. This phrase is something that someone posted in my Facebook group, and I loved it so much. 

You Won’t Do as Much Clinically

Many folks who start a group practice do not anticipate that they would need to reduce their client caseload. This is something I wish I would have been more aware of getting into group practice. If you really want to be a clinician first and foremost, think carefully because it is impossible to own a good practice and have your main hat be a clinician. It can be one of your many hats, but owning a business means that your primary role in that business is ensuring it’s health.

* The content of this post is intended to serve as general advice and information. It is not to be taken as legal advice and may not account for all rules and regulations in every jurisdiction. For legal advice, please contact an attorney.


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