The 'Dark Side' Of Joining A Group Private Practice (part 2)

Last week, I blogged about the benefits of joining a private practice group. Today, I'll discuss the downside of being in business with other practitioners. I briefly worked in a group practice where all therapists owned equal parts of an LLC (Limited Liability Company). At first it sounded like a good idea. After a while, I could see that it wouldn't work long-term for me and for my practice.

The Drawbacks of Joining a Group Practice

1) Liability concerns

After several months in a group practice, I realized that the drawbacks far outweighed the benefits. One of the biggest drawbacks was sharing liability for other mental health provider's actions and decisions, of which I ultimately had no control. Therapist Melissa J Templeton, MA, LPC, LMFT agrees, “It's really important to be aware of the legal entanglements of being in practice with another mental health provider, as it exposes you to all kinds of liability. Being in the same building even without a formal partnership agreement could open you up to being sued by someone who was injured on the property or who accuses your co-leaser of a criminal or civil action.”

Psychologist Wes Crenshaw PhD, ABPP of Family Psychological Services, LLC strongly cautions other therapists against creating legal partnerships in group therapy practice.

The best advice I ever received was to avoid creating a partnerships, and I ignored it. When one is say, a 25% owner of something, one is an owner of nothing. The only groups that work well this way are those with a clear 51% managing partner. Unfortunately, psychotherapy practices are not traditional businesses in the sense that they produce a profit above payroll sufficient to take distributions. They are instead a conduit by which money flows from the client/insurance company pockets into the provider. Without the attributes of a normal business (e.g. a profit margin above salary) there is no good reason to form a fiduciary obligation with other providers.

2) Loss of autonomy

When I joined a group I realized that the decision making process, even for minimal office expenses, was extremely inefficient. It was frustrating and even painful for me. I like see things change and move forward quickly. Since everyone owned equal shares no one was really "in charge" and able to make quick decisions, or to create a cohesive vision, or to take the lead of the group.

Arizona psychologist Christina G. Hibbert, Psy.D. was employed by a group practice but now is in solo private practice. Of her group experience Hibbert says, "Sure it’s great to have less responsibility but that also usually means having less input into decisions regarding everything from office décor to how things run." Illinois counselor Melanie Dillon, LCPC, at Center For Wellness, Inc also notes that a drawback of a group practice is the loss of say "over who I counseled and what my hours would be.”

3) Less control over income

Like Dr. Crenshaw warned, when you're legally partnered with others they have a say in business decisions that affect your income. When you're part of a group, others may have already dictate the cost of joining the partnership, or the amount you'll be paid when employed by a group practice. “I had put off joining a group practice because of the dramatic decrease in hourly income," Dillon adds.

When I was in a practice group with five other therapist I was contributing 1/5 of the overhead even though I was practicing part-time.  I quickly realized that, although I enjoyed working with other therapists, I could run a solo practice for a lot less that I was paying to be a part of the group. I decided to venture out on my own and started Wasatch Family Therapy.

Since then, I have built my solo private practice into a private clinic with a dozen employees. I am the sole owner and can make decisions quickly. In upcoming articles I'll walk through the pros and cons of going into solo private practice.

Based on your experience, what are the drawbacks of being in a group private practice?

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Sharing Office Space With Your Spouse (part 2): Peek Inside A Rural Dental/Therapy Office

Last week Dr. Christina Hibbert contributed a guest blog highlighting her experience of sharing an office with her husband in rural Flagstaff, AZ. (If you missed it you can read part 1 here.)

In this post, Dr. Hibbert gives us a tour of the office space she shares with her husband, Dentist O.J. Hibbert. Peek into a rural Dentist/Psychologist office and see how this clinical psychologist keeps business "in the family."

Would you like to let other shrinks peek into your office space and be featured on this blog? Get details here.

Sharing Office Space With Your Spouse (part 1)

Today's guest post is by Christina G. Hibbert, Psy.D., Clinical Psychologist and expert on Postpartum Mental Health, Women’s Emotional Health, Grief & Loss, Motherhood and Parenting. Dr. Hibbert runs a successful private practice in Flagstaff, Arizona, housed in the same location as her husband's dental practice.

A few years back, after I had my fourth baby and we inherited our two nephews (that’s a long story for another day!), I quit working in the group practice I’d been with for four years. After staying home for two years to put our new family together, I felt it might be time to open a practice of my own. Being a mom of six, I was very nervous about adding a private practice to my already jam-packed “to-do” list. Thank goodness my husband was thinking for me.

“Why don’t we build you an office behind mine?” he suggested one day. My husband has a dental practice in downtown Flagstaff, Arizona.  The office is a little historic home that was converted years ago. It has a white picket fence and a hand-painted sign hanging from a shingle out front. Very quaint. Flagstaff is known for its interesting combination of businesses (airport/beauty salon; antique shop/physician), so why not dentist/psychologist? It seemed to make sense.

My husband and a couple of his buddies began construction in what was the small parking lot behind his office, and a few months later, my 12' x 12' little “house” was ready to go. I painted the outside blue with white trim and a flower box, decorated the inside comfortably, hooked up a new phone line, and we were in business.

There are a few definite perks to sharing an office space with your spouse:

1) No or low rent

The biggest perk, of course, is that I don’t actually pay rent. I added a line to his phone line and only use minimal utilities, so it is a real money saver!

2) No wasted space

My husband uses my office as a consultation room or lounge on the days I’m not there. Since I work part-time, it feels good to know I’m not wasting my space. It’s also a handy place for our kids to hang out on the off days when I’m out of town and they need to go to work with dad. We put toys and a TV in the office, so it’s ready for visitors of all kind (including all the babies that come in with the postpartum moms I see!).

3) Double-duty staff

Another perk is that I can utilize my husband’s staff to help me as needed. Though I take all my own phone calls and do my own scheduling, I am able to count on his office manager to help me check in clients, take payment, and give them a “waiting room” in the snowy winter months. His staff also helps clean my office, water my plants, and take care of the weekly postpartum support group that still needs to meet with my co-facilitator when I am out of town.

4) Built-in referrals

Sharing office space is an excellent referral network. Many of my clients end up in his dental chair and several of his patients end up on my couch.

5) Time together

Though it may not be a perk for all couples, my favorite thing about sharing office space is that we are working together. I don’t run his office and he doesn’t run mine, but we help each other out. We give suggestions and share tips. We chat in between clients and some days we get to “do lunch.” I always get to end my day with a hug goodbye as he stays to support the family financially and I leave to support the family as chauffeur and chef.

So, if you’re looking for a way to make a part-time practice work for you, consider office-sharing. In my case it’s with my husband, but whether it’s with your spouse, a friend, or a colleague, it just might be the solution you’re looking for!

Dr. Christina Hibbert is a Clinical Psychologist and expert on Postpartum Mental Health, Women’s Emotional Health, Grief & Loss, Motherhood and Parenting. She received her BA from Brigham Young University and her MA and Psy.D. from California School of Professional Psychology in Los Angeles. Dr. Hibbert is the Founder of the Arizona Postpartum Wellness Coalition, and is the producer of the internationally-sold DVD, Postpartum Couples.  Dr. Hibbert is a dynamic and engaging speaker and is currently finishing up her first book, This Is How We Grow. Mostly, though, Christina Hibbert is a happily married mother trying to keep up with six energetic children!

(c) Can Stock Photo