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Practice Management Blog

Should You Expand Your Solo Practice to a Group Practice? (+ Downloadable Practice Growth Cheat Sheet!)

If you have a solo practice, there are several ways to grow your business without bringing on additional staff. While the hours when you can see clients may be limited, you could add groups, Saturday sessions, or create downloadable assets to build a passive income stream.

Alternatively, you could follow the well-trodden path of building a team and forming a group practice, which has the long-term potential to increase your revenue and introduce greater flexibility.

Group practices can be very successful, but they’re not for everyone. So, if you’re trying to decide whether you’re ready to take the next step, these eight questions should help clarify whether it’s something you actually want and what you need to do to give yourself the best chance of making it a success.

1. Why Do You Want to Start (or Grow) a Group Practice?

There are many possible reasons for wanting to grow, but you need to have them clear in your mind before you take the plunge.

Here are some common ones:

Your Schedule is Full

You may be turning away clients because your schedule is full, which is a problem that could be solved by hiring an additional practitioner for overflow work. But, this isn’t cut and dried; if you’re a solo practitioner, the answer might rather be to hire a part-time admin assistant or a virtual reception service to take care of some of your non-client-facing work such as invoicing, appointment scheduling, marketing and follow-ups. This would free up some of your time to take on more clients. If you don’t have EMR software, finding a system that works for you is another option to streamline your admin further and improve efficiency. On the other hand, if an assistant won’t fill the gaps in your practice, it might be time to expand.

It Has Always Been Your Goal

For many health professionals in private practice, solo practice is the first step in a business plan that’s bigger than just you. Expanding your practice may be the next logical step if you want to grow a business, employ a team and build for the future.

Economies of Scale

If you grow your practice by a few team members, you can split the costs of an administrative person (depending on your team structure), negotiate better rental agreements and ensure that you’re no longer turning away potential clients because your schedule is full.

Marketing Scope

You can grow your brand quicker by pooling marketing resources and benefit from the ability to offer a broader range of services.

Greater Flexibility

While you may be passionate about the work you do, taking time for yourself is important. That’s a lot easier to do in a group practice where your colleagues can cover for you, and where you may be able to scale back your hours at a later stage.

Enhanced Range of Services

Expanding to a group practice means you’re able to offer a more diverse range of services or complementary services, such as a group practice that focuses on paediatrics, with an occupational therapist, physical therapist, speech therapist and paediatrician that all offer support to small children.

Opportunity to Niche Down

When you started out as a solo practitioner, there’s a good chance that your clientele was quite diverse. For example, as a physical therapist in your early years, you might see elderly patients with arthritis, young children rehabbing after broken bones and athletes recovering from injuries, all in the space of a few hours. If you work in a bigger team, you can niche down and focus on the areas that interest you the most.

It’s the Next Logical Step

If you find yourself mentally nodding at this one, it should be a red flag.

Just because it seems like a good idea, or you feel like you need to do something growth-focused, doesn’t mean that group practice is the way to go. In the beginning, at least, there are going to be long hours and lower pay, so running a group practice is something that you need to see yourself doing in the long run if you want to stay motivated through the tough times.

If you prefer to work independently, dislike managing people or struggle with the administrative side of running a solo practice, owning a group practice might not be right for you. Don’t let yourself be pressured into something that isn’t the right fit for your personality and goals.

On the other hand, if you enjoy working with others, are comfortable with leading a team, are a natural go-getter, and thrive under pressure, you might thrive in a group practice environment.

2. Do You Have a Business Plan?

Your solo practice should have an existing business plan that you can adapt to include any new expected expenses (such as higher insurance premiums and office costs). If you move into more of a management role, your income might go down for a while as your caseload will need to be lighter, so you’ll need to prepare for higher overheads and lower revenue initially. A business plan is essential if you need outside funding from private investors or a bank.

Ensure that you cover:

  • Current and target market share
  • Planned marketing efforts
  • Projected revenue and expenses

If you don’t have a business plan, you’ll need to get started on one right away! Here you can find an article that covers everything you need to know about how to write a business plan.

3. Do You Have the Right Tools and Processes in Place?

Hiring practitioners doesn’t lighten the administrative load. If anything, it makes it much more complex. So, to cover for this, you need to implement EMR software that fits the needs of your practice, from appointment scheduling to invoicing, reporting and marketing. There are a lot of balls to juggle going forward, and you don’t want to drop any as your practice grows.

In addition to practice management software, a Practice Operations Manual is essential as it ensures that all team members are on the same page.

The practice manual should include policies such as:

As you grow the practice, automated processes and streamlined procedures will become more important. And, you’ll need to get buy-in from your team so that everything runs smoothly and your clients have a consistent experience.

4. What Are the Legal Implications?

It doesn’t matter where you are in the world; transitioning from solo to group practice comes with a lot of extra red tape. The best idea would be to set up an appointment with an attorney who specialises in healthcare and who’ll be able to point you in the right direction. It might seem like a costly step, but it could save you a lot of money, time and headaches in the long run.

Cover topics such as:

  • What business structure to use
  • How to maintain compliance with regulatory requirements
  • The wording of client and staff documents (such as intake forms, consent forms and staff contracts)

5. Do You Have the Leadership Skills to Run a Group Practice?

Most skills can be learnt, but many of the skills you need to run a successful group practice may not have been covered in your professional training.

As a leader, you need to build a cohesive, collaborative team that works towards a common goal. And growing a team comes with significant responsibilities, such as paying monthly salaries, supporting your team’s mental health, and ensuring that your team continues to deliver excellent service to your clients.

Managing others isn’t for everyone. Interpersonal dynamics are a factor in any working environment, so you must be honest about your ability to deal with conflict, communicate clearly and remain calm in heated situations.

6. Do You Have the Right Insurance?

With a growing practice, the stakes are higher as you’ll need business malpractice insurance that covers everyone working in the practice. Depending on your country, there will also be other types of insurance that you need, such as renters insurance and workers’ compensation. This is another area that an attorney can help with.

7. Can You Afford to Expand?

While taking on additional practitioners may seem like a surefire way to make more money, the reality is that in the first year, in most instances, there are a lot more costs, and it can take a while for the revenue to catch up.

You should talk to your accountant about the business taxes you’ll need to pay, and how employment contracts should be structured to reduce those costs. And you’ll need to set aside a financial buffer that can cover the additional insurance premiums, office rental and admin costs in the short term.

8. Who Do You Want to Hire?

Growth means onboarding new team members, but take a moment to look before you leap. You need to know the positions you’re hiring for and the skills you need your new team members to have.

Consider:

  • How you structure contracts, decide if you want to hire employees or independent contractors and whether it makes more sense to have full-time or part-time practitioners.
  • What roles will you fill; are you building a speciality group or a multidisciplinary practice? If you have a group therapy practice, do you all offer the same type of therapy?
  • Whether you have partnership opportunities, if you can work with a partner who you trust and respect, there may be synergies, especially if you offer complementary services.

This checklist is a starting point of things to consider, but it’s not exhaustive, and there’s no single checklist that will be right for every situation. But, if you’ve reached the end of this article and feel that you can confidently answer each question, you’ve covered a lot of ground and may be ready to expand your practice.

However, if this list has raised even more questions in your mind, it might be worth holding back until you’re completely comfortable with going ahead.

Expanding has many benefits, such as being more marketable (with a greater range of services), having more time if you can share management duties and a team dynamic that supports learning and collaboration. And, as a business owner, you have the satisfaction of building something bigger than yourself (as well as the potential to make more money).

But owning a group practice isn’t for everyone, and there are a number of things that might mean expanding isn’t the right choice for you. These include needing to manage a team, which covers everything from management skills to monitoring the quality and consistency of care offered by each practitioner. You also have to be prepared for increased liability as you can’t prevent every error your team makes. There’s also the issue of more expenses and interpersonal challenges where you may need to step in and resolve conflicts.

So, the decision of whether or not to transition to a group practice rests on you. There’s no right or wrong answer, but before you make the call to expand, it’s essential to know whether it’s going to be the best solution for the type of business, and life, you want to build.


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