Leading a Group Practice: What It Really Takes to Be an Empowered CEO
Leadership is required to be an effective group practice owner. And yet, so many therapists avoid the title of leader altogether. Some don’t identify with it, and others aren’t sure how to define who they are in that role—especially when they didn’t get into this field to “command” anyone.
The standard definition of leadership is often uninspiring:
“The person who leads or commands a group, organization, or country.”
Let’s be real—many of us zero in on that word commands and immediately shut down. That’s not what we’re here to do. That’s not how we run our practices. So… what is leadership, if not commanding?
Let’s explore a few alternative definitions that resonate more with values-driven, relational practice owners:
John Maxwell: “Leadership is influence—nothing more, nothing less.”
Brené Brown: “Anyone who takes responsibility for recognizing the potential in people and processes and has the courage to develop that potential.”
Bernard Tyson (former CEO, Kaiser Permanente): “Leaders focus on the future vision while also addressing the present realities and lessons from the past.”
Hans Vestburg (CEO, Verizon): “Ensuring that people have everything they need to achieve the missions of an organization. That’s it. All else is footnotes.”
Keith Barr (CEO, InterContinental Hotels Group): “Leadership is showing up and stepping up at a time when people need you—and doing the right thing, no matter how hard it is.”
There’s a beautiful line in these definitions:
Leadership is about vision, responsibility, courage, and care.
Why Leadership Feels So Uncomfortable for Therapists
Many of the group practice owners I coach feel uncomfortable claiming their leadership. Some of that comes from how we’re trained as therapists—we’re taught to prioritize neutrality, avoid power imbalances, and “stay out of the way.” But when you run a business, staying out of the way isn’t an option.
You’re no longer just a clinician. You’re the steward of a company that supports clients and your team. That means making decisions, having hard conversations, managing money, and holding the vision for something bigger than yourself.
Another reason leadership can feel sticky is the pressure to keep everyone happy. I’ve heard group practice owners say:
“I feel like I’m constantly walking on eggshells.”
“I’m afraid my team thinks I’m making a fortune off their work.”
“I don’t want to come off as greedy or controlling.”
Let’s pause right there.
This idea that group practice owners are rolling in cash while doing less work? It’s a myth. In reality, most GPOs are underpaid for the sheer volume of emotional, logistical, and financial responsibility they carry.
You’re not just booking clients and processing payments. You’re:
Supporting a team through the emotional labour of clinical work
Handling marketing and community visibility
Managing referrals, admin systems, and client experience
Navigating HR issues, onboarding, offboarding, and retention
Planning for business growth while managing day-to-day stressors
Keeping therapists busy and fulfilled
Maintaining your own clinical or coaching caseload
Making sure you don’t burn out in the process
It’s a lot.
Leadership Is a Responsibility—But Also a Privilege
Being the leader of your group practice means carrying a unique combination of responsibilities, privileges, and struggles. You’re often the one making the tough calls, holding the boundaries, and setting the tone for how your team relates to each other and the work you do.
Yes, you carry the weight. But you also carry the vision. And that’s powerful.
When you step into your leadership fully—when you do the inner work of defining how you want to lead—you start to shift the culture of your practice from one that’s simply functioning to one that’s thriving.
What It Takes to Lead a Group Practice Well
Leadership isn’t about being perfect. It’s about being intentional. Let’s look at what that means in the context of group practice ownership:
1. Vision for the Business
A strong leader holds and communicates a clear vision. Where is your practice headed in the next 1, 5, or 10 years? What do you stand for? What kind of workplace culture are you cultivating?
When your team understands the “why” behind your decisions, trust deepens.
2. Connection with Your Team
Effective leaders build relationships. They foster trust, camaraderie, and loyalty by being transparent, supportive, and present. This doesn’t mean you have to be best friends with everyone—but it does mean showing up with emotional intelligence and care.
3. Courage to Have Hard Conversations
Leadership is not about people-pleasing. Sometimes you’ll need to talk with a therapist who’s struggling with retention. Or you’ll need to provide feedback when someone’s not living up to the standards of care you’ve set.
Doing this with kindness and clarity is key. Avoiding the conversation doesn’t protect the team—it fractures it.
4. Strategic Thinking and Boundaries
You must be able to zoom out and look at the big picture. What are the needs of the business? What are the needs of your team? How do those align or compete?
It’s your job to make decisions that support both—without sacrificing your own sustainability in the process.
5. Systems That Support You
Effective leadership isn’t all about charisma—it’s also about infrastructure. Strong systems allow you to focus on leading instead of constantly putting out fires. That means having clear onboarding processes, streamlined communication, and financial clarity.
It also means paying yourself a wage that reflects your actual time, energy, and emotional labour.
6. Inner Alignment
This one often gets overlooked, but it’s critical: Your business should meet your needs too. It should reflect your values, support your life outside of work, and give you space to lead from a place of wholeness.
Leadership burnout is real. Don’t build a business that drains you. Build one that sustains you.
So… What Kind of Leader Are You?
There’s no one right way to lead. But there is a right-for-you way. Reflect on these questions:
What values drive your leadership?
When do you feel most confident and effective as a leader?
What parts of leadership do you find hard to embrace?
What are you avoiding out of fear or discomfort?
Who can support you in becoming the leader you want to be?
You don’t have to do it alone. Whether it’s through coaching, peer support, or honest feedback from your team, you can keep growing into a leadership style that feels grounded, authentic, and empowering.
Final Thoughts
You didn’t become a group practice owner to be in charge. You became one to create something meaningful—for your clients, your team, and yourself.
Leadership is how you protect that vision. It’s how you set the tone for a culture of care, integrity, and growth. It’s how you make sure your practice works—not just financially, but emotionally, ethically, and relationally.
So if you’ve been hesitating to call yourself a leader, I invite you to consider this:
You already are one.
The question is—what kind of leader do you want to become?
Leadership Challenge
Before you go, I want to leave you with this:
👉 Where in your business are you showing up as a leader… and where are you hiding from it?
Take five minutes to journal on that today and if you’re comfortable, send it my way. Your clarity starts with your honesty.
