Staff Meetings

Why I Only Hire W-2 Therapists (W-2 vs. 1099 part 3)

Why I Only Hire W-2 TherapistsI've noticed that private practice therapist tend to hire additional therapists as 1099 contract employees. Reasons frequently cited for choosing to hire therapists as 1099 employees is that they don't have to pay the therapists taxes. While it may be more "affordable" to hire therapists as contractors, in my experience, there are also "costs." (For an summary of the difference between W-2 and 1099 employees read part 1 in this series. To hear about my employment tax audit adventure read part 2.)

According to the IRS website, the general rule for classifying 1099 independent contractor is "if the payer has the right to control or direct only the result of the work and not what will be done and how it will be done" (italics added). It also states that an employee is not a contract employee if the services "can be controlled by an employer (what will be done and how it will be done)" and if "the employer has the legal right to control the details of how the services are performed."

In consulting with therapists around the U.S. I've heard about some of the "costs" of hiring 1099 employees. Some of the costs high turnover rates due to the part-time and often temporary nature of contract employee relationships. Some of those "costs" include lack of control over how and where therapy is done, inability to require specific paperwork, inability to require attendance at staff meetings or trainings, inability to request that therapists network and participate in community outreach to boost referrals.

Here are the four main reasons I only hire therapists as W-2 employees:

1) Overall Cohesiveness

My vision for Wasatch Family Therapy has always been to build a cohesive team with a shared long-term vision of providing excellent clinical services to clients across the lifespan from an attachment perspective, not just have a group of therapist doing any kind of therapy they choose.  Now that we have grown into a clinic of 18 therapists at 3 locations cohesiveness is even more crucial. When therapists are hired as 1099 contractors employers are not supposed to tell the contract worker how to do therapy, or make other specific requirements of the worker, such attendance at trainings.

2) Higher Level of Quality Control

If a therapist is going to work under my name and my practice name or "brand", I want to be able to have a say in how, where, and when they do the work.  I've spend over 10 years building trust, credibility, and presence in my region and I want to be able to be able provide mentoring, direction, and training in how my clinical team provides services.

3) Ability to Require Certain Activities

I want to be able to require certain activities from my team members that hiring them as 1099 workers does not allow me to do. We have streamlined forms for notes and documentation in our EHR system. I require each therapist to engage in at least one outreach or networking activity each month in order to create strong referral sources. I require attendance at two monthly staff meetings, and a certain level of professional appearance at the office.

4) Implication of Long-Term Relationship

I am not interested in hiring temporary therapists to provide services. Hiring 1099 workers generally implies a short-term relationship. I am interested in hiring therapists who have a shared vision and who I can invest in long-term, and who will invest in building the practice long-term. I want to build mutually beneficial relationships not just provide services. Hiring therapists as W-2 employees shows a greater long-term commitment to them to build their practice for the long haul. I also allows me to expect a greater commitment from them.

 

 

A Day In The Life Of A Private Practice Therapist

After reading my recent posts on multiple income streams for therapists, Psych Central Associate Editor and blogger, Margarita Tartakovsky asked me how I, and other therapists, juggle so many different aspects of private practice. I've been thinking about her question and thought it might be fun to start a series that peeks into "a day in the life" of therapists in private practice. I thought I'd start with me, and start with--today. Just to give you a little background...I'm a wife and a mother of 4 children ages 5 to 21. I've been in clinical practice for 16 years and I serve as director of  Wasatch Family Therapy, a private outpatient clinic that I founded in 2002. Recently, because my clinic has grown significantly, I've stopped taking new clients in order to spend more time leading, training, and pursuing other passions, like writing, media contributing, etc.

You'll notice that my "day in the life" doesn't include seeing any clients. I am currently on a month-long sabbatical from clinical work, and from as much administrative work as possible, during the month of November to dedicate time and energy to finishing up my first book. After being approached by a publisher a few months ago I decided that it was an opportunity I didn't want to pass up, but it would require cutting back on a lot of other responsibilities in order to make the deadline. I will resume seeing clients, running staff meetings, and training therapists the first week in December.

A Day In The Life

November 15, 2011

7:30--9:00AM

Woke up and get kiddos off to school, morning routine...

9:00-9:30AM

Worked on some rough song lyrics and musical ideas at the piano.

Ate breakfast. Contemplated exercise but decided to dig into book writing.

9:30AM-12:30PM

Worked from home on writing my first book on women's emotional self-care due to publisher by end of the month. Yikes. Totally overwhelmed by the thought. Reviewed my survey data to integrate into book.

Reviewed bank accounts, bills, etc. online.

Consulted for a few minutes with an old friend via Facebook who is in a family crisis.

Talked with my clinic office manager regarding tomorrow's staff meeting agenda items and other miscellaneous office stuff.

12:30-1:00PM

Talked with my TV producer and brainstormed about next week's segment "Should you keep your kids believing in Santa?" Read over blog responses to a recent parenting question about how moms handle the question, "Is Santa real?". Researched the topic online and sent in rough outline for tomorrow's production meeting.

1:00-2:00PM

Picked up daughter from preschool and got a birthday treat on the way home.

Responded to a reported request for interview.

Ate lunch.

2PM-3:30PM

Worked from home answered 30 business emails.

Phone consult with my Dir. of Child & Adolescent Services to discuss some difficult cases and recent referrals. She gave me updates on the status of our new Provo, UT location that opened last month.

Scheduled videographer to come to tomorrow's staff meeting to shoot footage of new therapists for our practice website.

Scheduled and posted social media updates on Twitter and Facebook(s).

Updated websites JulieHanks.com, WasatchFamilyTherapy.com, and added a few elements to a new site for emotionally focused couples therapists in the greater SLC area that I'm working on while my daughter colored and did art projects at the table.

3:30-4:00PM

Home assistant arrived and I give her the day's assignments - laundry, dishes, organized pantry. (I have a high school girl come 2-3 afternoons a week as a "home assistant" to run errands, fold laundry, organize, etc. Best thing I've ever done for my own self-care.)

More research and book writing.

Added more 2012 calendar items - trips, book tour, holidays.

Researched Christmas gifts for my staff online.

Downloaded a new Christmas CD Mindy Gledhill Winter Moon.

4:00-5:00PM

Napped. YES!

5:00-5:30PM

Helped 9 year old with spelling and vocabulary homework.

6:00-7:00PM

Pick up teenage daughter and went out to dinner as a family for 5 year old's birthday.

7:00-8:00PM

Son went to scouts, husband went to church meeting and I helped daughter open and put on ballerina costume from grandma and dance around the family room.

Social media updates.

Uploaded photos from birthday party.

8:00-9:00PM

Help get kids ready for bed, read, snuggle.

9:00-11:00PM

Wrote this Psych Central blog post.

Installed Photoshop updates to crop logos of recent media quotes for websites.

Did website and social media updates.

11:00-12:00PM

Check in with hubby, talk, watch TV, bed.

OK, it's your turn! I'd love to hear from other private practitioners, or students planning on going into private practice. Track your activities for a day and Email me your "day in the life of private practice" here. I just might feature you and your practice in his blog series!