Solo practice vs group practice

Solo practice vs group practice? There comes a time, or multiple times, in a therapist’s career when they are ready to leave their current practice and move on to another. At that crossroads they are faced with a decision, “Do I work for a group practice or start a solo practice?” 

Before they make that choice, it is a good idea to reach for the old pro and con list first as there are benefits and drawbacks to each practice environment. If you are a therapist looking to make this choice, this article is for you. This article will outline some of the considerations about a private practice vs group practice that you should take into account before you sign on the dotted line.

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Going solo

For therapists that dream of being a business owner, but don’t want the high overhead and managerial stresses of employing other staff, a solo practice can have many benefits. 

Solo practice benefits

• Full autonomy in all practice-related decisions including hours, pay, clientele, location, time off, patient case load and pay structure (insurance vs cash based)

• You can choose to specialize in a patient population that fits your interests. For example, if you’re a physical therapist, you can choose to work with running athletes, only with older adults with balance impairments or solely with vestibular patients

• You can select how much 1:1 time you spend with your patients which can improve patient outcomes and satisfaction

• You can choose a location that is convenient for you or for the clientele you wish to target

• You may be able to see clients in their homes or in other locations outside of a clinic

• You may have time to pursue other professional interests as you get to choose when to take time away from treating

As you can see, there are many great benefits to opening a solo practice and nowadays more and more therapists are choosing to go into business for themselves, and take more control over their professional practice. Before you open the doors on your solo practice, though, make sure you familiarize yourself with some of the inherent challenges as well so that you can be prepared to address them as they appear.

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Challenges of a solo practice

• You are responsible for understanding the state and federal practice acts, licensure and insurance requirements for your business as well as any other laws related to providing healthcare

• If you choose to accept insurance as part of your solo practice, you will need to initiate and educate yourself on the process of getting in network with insurance companies, negotiating rates and understanding all of their authorization and billing requirements. For example, contracting with a medical claims clearinghouse may be needed

• You are in charge of marketing yourself. New practices are always in competition with already established ones. Other professionals tend to refer to familiar practices where their patients have consistently experienced good results and convincing them to take a risk on a new provider can take time 

• Earning money in a new practice does not happen right away. In order to get your solo practice off the ground you need to spend money on equipment, insurance, marketing and either travel expenses or leasing expenses at the very minimum and it can take time before you have enough patients that your expenses turn in your favor

• You are responsible for handling every aspect of the job from marketing to cleaning the equipment, ordering supplies, scheduling, billing and invoicing which means you may invest many more hours in work than you did when you worked for a group practice

Getting in a group practice

Now that we have explored the benefits and challenges of owning a solo therapy practice, let’s do the same for working in a group practice. 

Benefits of a group practice

In a group practice, you will typically focus on only one or two primary tasks such as treating patients and mentoring therapists or treating patients and handling student contracts.

Typically there is dedicated staff available to handle insurance verifications, claims, invoicing and scheduling, etc.

• Though you may have documentation to take home, most group practices limit the amount of work therapists perform outside of working hours. For example, you likely won’t be coming into the clinic on weekends

• Your income is likely to be more stable from the start as a group practice most likely already has a great referral network with patients coming in regularly

• You will typically have access to benefits like CEU reimbursement, paid time off, health insurance, sick time and possibly formal mentoring

• You may have access to research, state of the art equipment and an interdisciplinary work setting which can be a great benefit

• You get to work alongside other therapists which has both an educational and a social benefit

Challenges of a group practice

• You may have little control over the length of time you spend 1:1 with your patients or the size of your daily caseload

• You may end up treating diagnoses you would prefer not to treat or have fewer opportunities to specialize in those you are really excited about

• You may not have as much PTO as you would like or flexibility in taking vacation time

• You are beholden to the productivity standards of the practice

• You have less autonomy overall in terms of how the clinic is run and you may or may not have much influence in practice decisions that affect you

• The location of the clinic may or may not be convenient for you