From Solo Clinician to CEO: Your Guide to Building a Sustainable Group Practice

You can only see so many clients in a week.

At some point, even the most dedicated solo therapist hits the ceiling:
your schedule is full, your waitlist is long, and the only way to grow seems to be working more hours.

But scaling your impact (and your income) doesn’t mean burning out.
For many therapists, the next step is transitioning from private practice to a group practice.

Here’s a simple, actionable guide to help you make that transition with clarity.

Expansion isn’t just about increasing revenue — it’s about increasing freedom.

A sustainable group practice helps you:

• Reduce dependence on your own billable hours

• Offer more availability to clients

• Bring in clinicians with diverse specialties

• Build a long-term, stable business

• Step into leadership instead of doing everything

1. Get clear on your vision 

Before hiring anyone, ask yourself: 

• Why am I expanding?

• What kind of practice do I want to build?

• What values will guide my team?

• Do I want a boutique, highly specialized group… or a large, multi-clinician practice?

Your vision determines everything: who you hire, how you market, and how clients experience your practice.

2. Understand the Financial Foundation

Running a group practice shifts your financial model.

Before you hire clinicians, make sure you understand:

• Your current monthly revenue

• Your operating expenses

• What you need to pay yourself

• What you can afford to pay employees or contractors

• Insurance vs. private-pay considerations

• How caseloads translate into profitability

Don’t expand based on hope. Expand based on numbers.

3. Decide on Your Hiring Structure.

You have two main options:

Employee Model

• More control over schedules & policies

• Higher long-term stability

• Higher upfront responsibility (payroll, benefits, taxes)

Independent Contractor Model

• Lower overhead

• More autonomy for clinicians

• Less control over consistency and operations

Neither is “right” — it depends on your vision and capacity.

Before deciding, consult an employment attorney who understands your state’s regulations and your specific business structure (PLLC, PC/MSO, LLC, Sole  Proprietorship).

State laws differ on what qualifies as a W-2 vs. 1099 relationship, and choosing the wrong model can create legal and tax issues. An attorney can help you determine the structure that’s compliant and aligned with your long-term goals.

4. Build Systems Before You Build a Team

The biggest mistake new group practice owners make?
Hiring before they have systems.

You need simple, reliable workflows for:

• Client intake

• Matching clients to the right therapist

• Scheduling

• Payments

• Documentation

• Communication

• Marketing

• Tracking availability

When your systems are clear, onboarding new clinicians becomes easy, and your client experience stays consistent.

5. Start Small: Hire Your First Clinician

Your first hire sets the tone for your entire group.

Look for someone who:

• Aligns with your values

• Communicates clearly

• Works well independently

• Shares your commitment to client care

• Adds something new (a specialty, modality, population)

Start with one clinician, learn the process, refine your systems, and then scale.

6. Create a Smooth Client-Matching Process

One of the biggest challenges in group practices is matching clients with the right clinician.

A clear process helps you:

• Reduce no-shows

• Improve fit

• Increase client retention

• Support better clinical outcomes

• Maintain high satisfaction across your team

Think through:

• What criteria do you use for matching?

• Who handles intake?

• How do you track availability?

• How do you ensure new clients aren’t “lost” between first contact and first session?

This is where many group practices leak revenue, and where automation can make the biggest difference.

7. Let Technology Do the Heavy Lifting

Scaling manually leads to burnout.

Tech supports you by:

• Automating repetitive tasks (intake, reminders, follow-ups)

• Reducing manual scheduling

• Centralizing messages

• Helping you track availability across your team

• Making client–clinician matching more accurate

• Ensuring nothing slips through the cracks

• Offering the visibility you need as a leader

And if you’re expanding, you’ll need a system that supports multiple clinicians, not just one provider.

Final Thought:

Transitioning from solo practitioner to group practice owner is one of the biggest steps in your career, but it doesn’t have to be overwhelming.

When you build the right systems, understand your numbers, and trust your vision, you create a practice that supports you, your clients, and your team.

And if you want support making that transition smoother…

Breksey helps group practices streamline intake, match clients with the right clinicians, and manage operations — all in one simple platform.

If you're growing or planning to hire your first therapist, we’d love to help.