When Jon Gorman, PsyD, decided to go into private practice last year, he realized that both solo and group practices had their advantages and disadvantages. What he ended up with was the best of both worlds: He and five other mental health practitioners remain separate business entities but work in the same building in Towson, Md., and are known as the Towson Therapy Collaborative. As the collaborative's website puts it: “Independent practices; shared dedication to helping others.”
How do you decide what practice model is best for you? Several practitioners discuss the pros and cons:
Group practice. The desire to help early career psychologists start their careers is what prompted Bill Heusler, PsyD, to leave solo practice behind in 2011 to launch a group practice with former practicum supervisee Tyson D. Bailey, PsyD. “It can be really hard to make it as a solo practitioner right out of the gate,” says Bailey, noting that many health-care experts are discussing concerns that the changing health care landscape may create barriers to solo practice. The goal of Seattle-area Spectrum Psychological Associates is to help its practitioner employees find their footing.
For Bailey, the main attraction of a group practice is the built-in support and consultation it offers. “There’s always a place to go,” he says of his colleagues. And as Spectrum grows, its power to negotiate with payers may too, says Bailey, especially if the practice eventually adds other health care professionals. One local multidisciplinary practice has reimbursement rates 30 to 40 percent higher than Spectrum’s, simply because it’s so large, he points out.
Solo practice. For Allison Splaun, PhD, a solo practice’s biggest draw was flexibility. Pregnant when she launched her Charlottesville, Virginia, practice, she wanted freedom to set her own schedule and see a broad variety of patients. “In some group practices,” she says, “they’re looking for therapists to fill very particular roles and see specific client populations.” Money was another factor. While group practices offer a steady stream of referrals, the trade-off is having to hand over a percentage of your earnings to cover shared expenses.
Of course, a downside of running your own business is the steep learning curve it can entail. A mentor clued Splaun in on topics like city business licenses and tax identification numbers. Other local practitioners have helped her overcome another disadvantage to working solo — isolation — by offering regular peer support sessions plus rapid-response consultation.- Co-located solo practices like the Towson Therapy Collaborative are another option. In addition to sharing a space, the practitioners also share other resources. The practitioners share a website, for example, but clicking on a therapist’s name takes users to that therapist’s own page — a way of underlining that practitioners share a building but are separate businesses.
For Gorman, this model offers advantages like shared expenses, in-house consultation and in-house referrals to specialists in substance use and eating disorders. Meanwhile, Gorman’s wife — a psychologist in a group practice — is happy to trade a percentage of her income to not have to worry about marketing and other business-related tasks. “It just depends on your mindset,” says Gorman.
This column is geared toward early career psychologists working in practice settings. "Running start ... to a great career" features topics typically not covered in graduate school and includes tips and advice from psychologists.