How to Go from Accidental Group Practice Owner to CEO

If you’re running a group practice and find yourself juggling client hours, therapist schedules, and admin fires more than leading a business, you’re not alone.

Many of the people I work with never set out to be a group practice owner. They were clinicians with full caseloads who thought,

“I’ll bring on another therapist so I don’t lose clients,”
or “I’ll hire someone so I don’t have to do this alone,”
or even “It’d be nice to create a bit of passive income.”

That path often leads to becoming an accidental group practice owner. But the real transformation happens when you stop reacting and start leading — when you step into your role as CEO.

In this post, we’ll unpack:

• What an accidental group practice owner is

• What being a CEO actually means in this context

• And the key mindset shifts and systems that help you move from clinician-owner to confident CEO.

What Is an “Accidental Group Practice Owner”?

The term might sound casual, but it describes a common reality for many therapists.

You might be an accidental owner if:

• You started as a full-caseload clinician and brought someone on so you wouldn’t “lose” clients.

• You saw others with group practices and assumed that must be your next step.

• You wanted passive income or a sense of collaboration.

• You genuinely wanted to create a space where therapists and clients could thrive—but building a business wasn’t your original dream.

• You now find yourself handling operations, clinical supervision, hiring, and scheduling—without much time to actually lead.

You didn’t plan to build a business; it grew around you. Now you’re ready to take the reins intentionally.

What Does “CEO” Mean for a Group Practice Owner?

“CEO” can sound corporate, but in your context, it simply means you’re the head of your business. You set the course, steer the ship, and lead your team.

A CEO:

• Understands the health of the business — and the numbers behind it.

• Makes strategic decisions for growth, sustainability, and alignment with vision.

• Leads the team, shapes culture, and creates systems that work.

• Is no longer just another therapist in the practice—they’re the visionary leader behind it.

• Ensures the business serves them (not the other way around).

Being a CEO isn’t about titles—it’s about intention and leadership.

Why the Transition Matters

If you stay in “accidental owner” mode, you risk:

• Burnout from doing everything yourself.

• A lack of scalability and structure.

• Constant stress from reactive decision-making.

• A business that depends entirely on you.

When you step into your CEO role, you gain:

• Clarity on your direction and goals.

• Freedom of time and energy.

• Strong systems and empowered team members.

• A sustainable business that can grow—or even run—without you.

Your future self will thank you for it.

What You Need to Make the Transition

1. Intentionality

Intentionality is where leadership begins. You shift from reacting to leading.

Try this:

• Hold regular team meetings where you review goals and metrics.

• Clarify your “why” and where your practice is heading.

• Map out 1-, 5-, and 10-year visions.

• Ask strategic questions: “What’s our fill rate?” “What systems need improvement?”

This is how you move from survival to strategy.

2. Vision and Business Health

You can’t lead what you can’t see. Knowing your numbers is non-negotiable.

Track key data like:

• Revenue, expenses, and profit

• Clinician utilisation and turnover

• Referral sources and client retention

Then interpret what those numbers mean. Metrics are only powerful when they guide your next move.

3. Making Hard Decisions and Having Difficult Conversations

This is where many practice owners hesitate. Leadership requires courage.

That might mean:

• Letting go of a therapist who isn’t aligned with your values.

• Saying “no” to expansion until your systems are ready.

• Reducing your own caseload so you can lead.

• Holding team members accountable when needed.

These moments aren’t easy—but they’re what set CEOs apart from managers.

4. Stepping Out of the “Therapist” Role with Your Team

You’re still compassionate and relational, but you’re not your therapists’ therapist.

Lead with clarity and boundaries:

• Offer leadership and business support, not clinical supervision (unless that’s part of their contract).

• Separate emotional caretaking from strategic leadership.

• Remember: your business isn’t your “baby.” It’s a living system meant to serve you and your team—not consume you.

Healthy leadership balances empathy with structure.

5. Metrics, Measurement, and Momentum

CEOs measure what matters. Data helps you make informed, confident decisions.

Key metrics to track:

• Therapist utilisation

• Client conversion and retention

• Admin costs as a % of revenue

• Therapist turnover

• Average client value

• Net profit margin

Build a simple dashboard in Google Sheets or Excel and review it monthly. This transforms your decisions from gut feelings to data-driven choices.

6. Get Support and Surround Yourself with CEOs

You don’t have to lead alone.

Invest in your growth:

• Hire a business coach who understands the therapy world.

• Join a community (like The Group Practice Connection) where other owners think and lead like CEOs.

• Read leadership books that challenge your thinking.

• Attend workshops or masterminds that build your CEO skillset.

The people around you will shape how quickly—and confidently—you grow into this next role.

Join us in The Group Practice Connection

Practical First Steps for This Week

If you’re ready to start small but meaningful, try this:

1. Schedule a leadership meeting.
   Even if it’s just you and your admin, review one key metric and one goal.

2. Track one number.
   Choose a simple metric—like therapist utilisation—and commit to tracking it monthly.

3. Start learning.
   Pick one leadership book or podcast and make time for it this month.
   (Hint: the “Empowered to Lead” podcast is a great place to start!)

Each small, intentional step builds your CEO muscle.

Conclusion

If you’re an accidental group practice owner, it’s okay—you started from a place of care and connection.

But your next chapter requires intention, leadership, and structure.

When you step into your CEO role:

• You lead your practice with vision and purpose.

• You free your time and energy.

• You build a business that serves both you and your team.

You’ve already built something meaningful. Now, it’s time to lead it with confidence.

You’ve got this. And if you’re ready for support on your journey, join the Group Practice Connection community or book a coaching call today.