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ShannonGonter Feb 9, 2021

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, and private practice. While in school, we don’t understand the full inner workings of all these settings; after we graduate, we don’t always figure out much more. We graduate, get a job and the bulk of us forget that we have other options out there. 

For those of us who end up going into private practice, 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. 

But hold up—that’s not how it should go! 

This is a big decision to make. If we are more educated on the options for mental health and wellness professionals in private practice, we could make more informed decisions about where we want to work, therefore lowering the chances for burn-out and compassion fatigue. 

The following list highlights the seven most common models for therapists, counselors and other wellness professionals in private practice. Keep reading to learn more about the subcategories associated with this type of work.

Many of these can be used in combination—for example, some therapists use the solo and contract models together to fill their caseload. Other mental health and wellness professionals belong to any one of these models and also use the sublease model to rent their unused space. 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. 

  1. Solo model 
    • Number of people: 1 clinician + any contracted non-clinical assistants (i.e., website designer, virtual assistant, biller)
    • Day-to-day: Clinicians exchange time spent with clients for a stated fee. They are also responsible for running the business side (i.e., tracking expenses, marketing, networking) by themselves or with outsources assistance (i.e., attorney, accountant, marketing professional). 
    • Growth: With increased client volume or fees
    • Downside: Easier to succumb to the isolation of private practice and to run into safety concerns.
    • Helpful hints: Locate your office near other professionals. Have a strong clinical network to consult and grow with. 
  2. Co-op model 
    • Number of people: 2+ clinicians 
    • Day-to-day: Several solo provider practices share costs of running the practice. Some just share the expenses of the physical space (i.e., rent, utilities, supplies, décor, furniture) and others include a marketing budget for website management, etc. These clinicians can then refer to each other and draw on each other for support but are not contracted to split a percentage of their earnings with each other. 
    • Growth: With increased personal client volume or fees and/or adding 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.
  3. Contract model 
    • Number of people: 2+ clinicians 
    • 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: With increased client volume or renegotiated split-fee schedule with the established practice 
    • Downside: Dependent on the practice, they may have strict guidelines about your scheduling, billing, your clinical work, etc.
    • Helpful hints: Have an attorney review your contract before signing to ensure it is in your best interest.
  4. Group model 
    • Number of people: 2+ clinicians 
    • 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 a receptionist, referrals, EHR, assistance for credentialing with insurance panels, etc. 
    • Growth: With 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.
    • Helpful hints: 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.
  5. Sublease model 
    • Number of people: 2+ clinicians
    • 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
    • Example: b.mindful Louisville in Louisville, KY
    • Growth: With adding clinicians and filling the office space available 
    • Downside: As a landlord, you have limited say on how your tenants run their businesses.
    • Helpful hint: Have a trusted attorney draft your contract to ensure you and your office are appropriately covered in case of malpractice or liability concern from one of your tenants or their clients.
  6. Employment model 
    • Number of people: 2+ clinicians
    • Day-to-day: Clinician works as an employee of an established private practice and may receive benefits and a regular salary based on the contract with the practice. 
    • Growth: With salary raises 
    • Downside: Possible decreased freedoms with your schedule and autonomy as a clinician given the established practice policies and culture.
    • Helpful hint: Have a trusted attorney review your contract before signing and know that items within the contract can be negotiated. 
  7. Non-traditional services model 
    • Number of people: 1+ clinician(s)
    • Day-to-day: Practice is built using non-traditional services delivery models (i.e. teletherapy). Clinicians can solely offer their services online or they can do a hybrid of online and in-person services. 
    • Growth: With 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. This limits the populations that would be good fits for this line of work. 

Shannon Gonter is a professional counselor in Louisville, KY who works with young adults and specializes in mens issues. She strives to create a counseling environment that men and young adults can relate to, feel heard in and find new solutions to their negative patterns in. Learn more about her and the services she provides at www.therapybyshannon.com


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