7 Business Models For Private Practice
/In school we are taught that there are a few different places we can work as mental health and wellness professionals.
Community agencies
Hospitals
Private practice
While in school we don’t really understand the inner workings and behind the scenes work of all these settings; after we graduate, we don’t always figure out much more. We graduate, get a job and for the bulk of us forget that we have other options out there.
For those of us that end up going into private practice (full or part time) we still aren’t all that educated on the different options we have under the “private practice” umbrella. We just say we are going to do private practice join an established practice or hang our own shingle.
Hold up. Not how it should go!
This is a big decision you are making and I believe that if we are more educated on all the options out there for mental health and wellness professionals in private practice we could make more informed decisions about where we want to work and therefore lowering the chances for burn out and compassion fatigue.
This post will focus on the private practice sector and the subcategories associated with it. Keep reading to learn about the 7 most common models for therapists, counselors and other wellness professionals in private practice.
Solo model
Number of people: 1 person + any contracted non clinical assistants (website designer, virtual assistant, biller…)
Day to day: Clinicians exchange their time spent with clients for a stated fee. They are also responsible for running the business side of things (tracking expenses, marketing, networking, documentation, billing…) by themselves or with outsources assistance (attorney, accountant, marketing professional…).
Growth comes when you increase client volume or fees
Downside: It is just you and your clients. Easier to fall into the isolation of private practice world and run into safety concerns. To combat this make sure your office is located around other professionals (preferably like-minded professionals) and that you have a strong clinical network to consult and grow with.
Co-op model
Number of people: 2 or more clinicians
Day to day: In this model several solo-practices simply share costs of running the practice (a set monthly fee - not a % of what you make). Some just share the expenses of the physical space (rent, utilities, supplies, décor, furniture…) and others include a marketing budget for website management, etc. Each clinician operates as a solo provider under their own business entity and simply splits the costs with the other providers in the space. These clinicians can then refer to each other and draw on each other for support but are not contracted to split a % of their earnings with each other.
Growth comes when you increase your personal client volume or fees and/or add on other clinicians to lower your monthly shared costs value
Downside: Less independence and autonomy on the design of the physical space and marketing materials due to splitting the costs with others therefore having to compromise to ensure it meets all your needs and not just your own.
Contract model
Number of people: 2+
Day to day: Practitioner works as a solo clinician with their own business entity providing services for an established practice as an independent contract provider (1099 filer). Usually the established practice will provide you with credentialing, referrals and sometimes even an office space to practice out of (some allow you to practice out of your own office).
Growth comes when you increase client volume or renegotiate your split fee schedule with the established practice
Downside: Dependent on the practice you contract with they may have strict guidelines about your scheduling, billing, your clinical work etc. Ensure that you have an attorney review your contract before signing to ensure that it is in your best interest to contract vs being an employee vs solo practitioner.
Group model
Number of people: 2+
Day to day: Practitioner owns the practice and hires either contract providers or employees to see clients for a percentage of their earnings. Typically, an office space is provided with this model, receptionist, referrals, EHR, assistance getting credentialed with insurance panels…etc.
Growth comes from adding more clinicians to work under the group name
Downside: Decreased financial autonomy due to being contracted to provide your practice owner with 30%-60% of your earnings to cover the practice overhead, referrals and amenities. Ensure that you have an attorney review your contract before signing to make sure that it is in your best interest and know that you are allowed to negotiate with these contracts.
Sublease model
Number of people: 2+
Day to day: Practitioner subleases office space to other clinicians. Some office spaces are rented furnished, and some are not. Clinicians in the space may or may not be under the same practice name, and often all have different licensing backgrounds and work with varying presenting concerns. b.mindful Louisville is a shared workspace for mental health and wellness professionals in Louisville, KY that is a great example of this model.
Growth comes from adding clinicians and filling the office space available
Downside: As a landlord you have limited say on how your tenants run their businesses. Ensure that a trusted attorney draft your contract to ensure that you and your office suite are appropriately covered in case of a malpractice or liability concern from one of your tenants or their clients.
Employment model
Number of people: 2+
Day to day: Clinician simply works as an employee of an established private practice. Could receive benefits and a regular salary based on the contract with the practice.
Growth comes from getting salary raises
Downside: Possible decreased freedoms with your schedule and autonomy as a clinician given the established practice policies and culture. Make sure to have a trusted attorney review your contract before signing and know that items within the contract can be negotiated.
Non-traditional services model
Number of people: 1+
Day to day: Practice is built using non-traditional services delivery models (such as teletherapy). Clinicians can solely offer their services online or they can do a hybrid of online and in person services.
Growth comes from adding clients or increasing fees
Downside: Can be more restrictive by nature due to the clientele that are ethically appropriate to be seen via telehealth. Therefore, limiting the populations of people that would be good fits for this line of work.
There is no right or wrong path to private practice and a lot of these can be used in combination. I know tons of therapist who use the solo model and contract model together to fill their caseload and I know tons of mental health and wellness professionals that belong to any of those models and also do the sublease model on the side renting their unused space to other professionals. Mix and match to make a combo that works best for you and your life at that moment and allow yourself to adjust accordingly down the road.
Like I said before, having the knowledge of all the different ways one can do private practice can allow us to pick the best fit for us therefore (hopefully) lowering the chances of regret and burn out in the future.
b.mindful Louisville provides safe, clean, practical offices for those in private practice. Our spaces are designed with mental health and wellness professionals in mind.
Shannon Gonter, LPCC, Owner and Founder of b.mindful Louisville