Group Practice: Pay Yourself and Your Employees Well
Group Private Practice: How to Pay Yourself and Your Team Well
zynnyme has been coaching group private practice owners since 2010 — at every stage, from the first hire to scaling a team of 20 or multiple locations. We know that many therapists assume we only work with solo practices but we don't! This free training is for group private practice owners who are tired of being told that overwork and thin margins are just the way it is.
In this training, you'll learn:
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The financial model that actually works — why the model you started with may not scale, and what to build instead. What works with one employee doesn't work with five, and what works with five rarely works with fifteen.
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W-2 vs 1099 — the real risk picture — why so many group practice owners start with 1099 contractors, what the legal and retention risks actually are, and why an hourly W-2 model protects both you and your clinicians.
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Fee splits vs hourly pay — and why splits rarely work — the psychological and financial case for hourly pay with a clear pay scale, and why there is no percentage split that employees don't eventually resent.
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How to create an equitable pay scale — one that gives your clinicians a clear path for growth, supports retention, and still allows you to profit as the owner.
This training is jam-packed with specific things to track and timelines to track them. Have something to take notes with.
The group private practice problem nobody talks about honestly
You hear other group practice owners normalizing 70-hour weeks, being available 24/7, and single-digit profit margins on seven-figure revenue. The message — spoken and unspoken — is that this is just how group practice works. You scale, you hustle, you sacrifice, and eventually it pays off.
We have worked with hundreds of group private practice owners over 15 years. We have seen this play out in every variation and the honest truth is: the overwork and the thin margins are almost never inevitable. They are almost always the result of a financial model that was never built to be sustainable in the first place.
The person who started their group practice with one hire and a simple split — then added three more clinicians using the same model — and then wondered why things got harder as they grew. The model didn't scale because math was never going to work at five clinicians in the way that it worked at one. And surprise! It barely worked at one.
Ditch the comparison. Your group private practice needs to be built around your financial situation, your life, your cost of living — not around what someone else presented at a conference or shared in a Facebook group. The business that works for a practice in a small Texas city is not the same business that works for a practice in San Francisco. Start from your own numbers, not someone else's model.
Everything translates into numbers — including your time
When group practice owners talk about profitability, they usually mean money. We mean money and time. Both are numbers that have to be part of the model.
We've worked with group private practice owners who did the money math — or thought they did — but whose time numbers were significantly off. They accounted for clinician payroll but not for the 20 hours a week they were spending on administration. They planned for session revenue but not for the time cost of managing HR issues, payroll errors, and employee turnover created by a compensation structure that people kept leaving.
A sustainable group practice model accounts for both. What does this practice require of you, in hours per week, to run at a level where you're still showing up well for your clinicians and your clients? What does it pay you for those hours? Is that a rate you would accept from an outside employer? If not, the model needs work.
W-2 vs 1099 — what you need to know
Most group practice owners start with 1099 contractors because it feels like less risk and less upfront cost. We understand the logic. We also see, consistently, that it creates more risk and more cost over time.
Hiring a 1099 means bringing another business owner into your business. They have their own processes, their own schedules, their own priorities. The odds of a true contractor staying long-term are low — and a financial model built around contractor retention is built on unstable ground.
More importantly: if the relationship is ongoing, if the contractor is providing the same core service your practice is built around, and if you're directing their work in any meaningful way — courts and labor boards are increasingly ruling that this is an employment relationship, not a contractor relationship. California has already codified this. Federal regulation is moving in the same direction. What seems like lower risk today may become significant legal and financial liability tomorrow.
Harper Therapy — featured in the training above — started with 1099 contractors. The retention was poor. They couldn't control schedules, couldn't provide clinical feedback in the way they wanted, couldn't build the culture they were trying to create. When they shifted to W-2, retention changed dramatically. What seemed like less risk actually brought more, because high turnover has real costs: recruiting time, onboarding, lost client relationships, and clinical disruption.
Fee splits vs hourly pay — why splits are harder than they look
The percentage split model is the default in group private practice — 60/40, 70/30, 80/20. It feels intuitive: the clinician does the session, they get a percentage, you get a percentage. Simple.
The problem is psychological as much as financial. There is no percentage split we have ever seen where the employee doesn't eventually feel like they are giving you their money. The employee starts from the gross session fee — the number coming in — and sees the split as a deduction. Their money, going to you. The framing of "I earned $150 and you took $60" is very different from "I earned $60 per hour for my clinical work."
Hourly pay with a clear pay scale changes the psychology entirely. A clinician coming from an agency at $30/hour who joins your practice at $60/hour experiences that as doubling their income — not as giving away 50% of what they brought in. The number they focus on is what they're earning, not what they're losing. That shift matters for retention, for morale, and for the clinical work.
It also matters financially. Even a 50/50 split, after taxes, after expenses, after payroll taxes, after the real cost of benefits and administration — rarely leaves the owner with a margin that justifies the risk and work. The calculator we use in Business School for Therapists models this in detail, because the number that looks reasonable on a whiteboard frequently doesn't survive contact with real expenses.
Shamon and Yolanda Harper built Harper Therapy in the Tampa Bay area into a 18-person trauma-focused practice. Their journey: started with 1099 contractors (path of least resistance), moved to W-2 with hourly pay, and eventually transitioned to salaried positions with a four-day workweek, healthcare, paid time off, an education stipend, and retirement contributions.
How did they get there? Conservative financial modeling. Building reserves before making each transition. Never assuming the most optimistic growth projections. Reinvesting profits strategically rather than extracting them. And being willing to think outside the conventional group practice compensation structure to create something their team genuinely valued — which in turn created the retention and stability that made their numbers work.
"We wanted to be offering things that other people weren't. That's what brings in the best people." — Shamon and Yolanda Harper
What a sustainable pay structure looks like
There is no single right answer — your pay structure has to be built from your numbers, your market, your specialty, and what your practice needs to be profitable while taking genuinely good care of your team. But here are the principles we consistently see in group private practices that get it right:
- Hourly base pay with a clear progression scale — clinicians can see exactly how their compensation grows as they develop their caseload, their clinical skills, and their tenure. Transparency builds trust.
- Model the full cost of employment before setting the rate — employer payroll taxes, benefits, PTO, education stipends, the cost of turnover — all of it. The hourly rate that looks sustainable in isolation frequently isn't sustainable when the full cost of employment is included.
- Pay yourself as an expense, not as profit — one of the most common accounting errors we see. If you're working in the practice, your labor has a cost. That cost should be modeled as an expense before you calculate your profit margin. Otherwise your profit margin is fictional.
- Build for the caseload you can actually sustain — not the optimistic projection. What happens to your model if three clinicians reduce their caseloads by 20%? If one leaves? Stress-test the numbers before you commit to a pay structure.
- Reevaluate regularly — the needs of your team change. The capacity of your clinicians changes. What made sense when everyone was full and energized may not make sense after two years of heavy trauma work. Build in regular check-ins and be willing to adjust.
Business School for Therapists — Group Practice Track
The training gives you the foundation. Business School gives you the financial modeling software, the group practice calculator, the live coaching, and the community of group practice owners working through the same decisions. If you're ready to build a group private practice that actually works — for you, your team, and your clients — get on the interest list.
Get on the BST Interest List → Includes a dedicated group practice track · 32 APA-approved CEs · lifetime access