Before You Offer That Percentage: What It Really Costs to Run a Group Practice
As a psychotherapist, group practice owner, and coach to others building their own practices, I’ve heard two statements more times than I can count:
“The group practice I’m working for is taking 30%—or 35%, or even 40%—of my fees. Why are they taking so much? They must be getting rich off me.”
“I work so hard to make this group practice successful. I want my team to feel valued, but the percentage I’ve offered doesn’t even cover my costs. I’m struggling here!”
Both of these perspectives are valid. And both reflect how complex and often misunderstood the financial and emotional terrain of group practice really is.
Let’s unpack what it actually takes to run a successful, sustainable group practice—especially if you’ve found yourself in the “accidental owner” role.
The Rise of the “Accidental Group Practice Owner”
If you’re like many therapists I work with, you didn’t set out to become a business owner. You were simply full—emotionally, energetically, and in your caseload. Referrals kept coming, and it felt too painful to turn people away. So you brought on an independent contractor. Then another. Then one more.
Before you knew it, you weren’t just running a private practice—you were running a business with a team.
But here’s the catch: most therapists in this position didn’t count the cost—literally or figuratively. They didn’t run the numbers or look at the full range of responsibilities that come with the shift from solo therapist to CEO of a group practice.
So that’s where I want to start with you today.
What Exactly Are You Paying For?
Let’s talk percentages. That 30–40% “cut” that many practice owners take from contractor fees isn’t about padding your paycheque. It’s about covering the very real—and often invisible—costs of running a business.
Here’s a breakdown of what that percentage actually goes toward.
Financial Costs: The Tangible Stuff
These are the numbers you can plug into a spreadsheet (and should):
Rent & Utilities
Whether you’re in a physical office or managing virtual overhead, rent and associated costs (cleaning, electricity, internet, etc.) can eat a significant portion of your revenue.
Liability & Business Insurance
Adding team members usually requires increased insurance coverage. And that’s not cheap.
Office Set-Up & Furniture
Chairs break. Lamps burn out. You need to budget for both setup and ongoing maintenance or replacement.
Advertising & Marketing
Think Google Ads, directory listings, or professional SEO help. Depending on your goals, this can range from $500–$2,000/month.
Social Media Costs
Let’s say you spend 4–6 hours/month creating posts. If you paid a VA $30/hour, that’s $200+ right there. Add in scheduling tools (like Later or Planoly) and time to manage interactions, and the cost goes up quickly.
Practice Management Software
It’s essential for booking, charting, and billing, but it’s not free. Plus, the more practitioners you add, the more features (and cost) you need.
Credit Card Fees
Processing fees can add up—especially at 2.9% to 3.5% per transaction.
Client Inquiries & Admin Work
Hiring an admin to handle inquiries, billing, forms, and client communication for a team of 8–10 could easily cost $2,000+/month. If you're not hiring out these tasks, you’re the one doing them—and your time has value.
Administrative Tasks
Reviewing contractor invoices
Managing third-party insurance billing
Following up on missed payments
All of these things take time—and often, a good chunk of it.
Energy Costs: The Invisible Weight
Now let’s talk about the less tangible—but no less important—side of the equation.
Constant Problem Solving
The middle-of-the-night “what did I forget?” spiral is real. Practice owners juggle competing priorities and decision fatigue daily.
Team Support & Supervision
Even without offering formal supervision, you’re likely fielding texts, emails, and check-ins from your team. This emotional labour adds up.
Community Building
Networking, relationship-building, and brand visibility don’t happen by accident. They require time, consistency, and often a lot of unpaid effort.
Caseload Building Support
Helping contractors fill their caseloads means creating marketing funnels, checking website performance, writing content, tweaking Psychology Today profiles, and tracking conversion metrics. It’s not just “word of mouth.”
Personal Costs: You’re Still a Human Being
Starting a group practice requires more than just good intentions. It takes a toll.
Time Investment
For the first 6–12 months, you’ll likely work evenings, weekends, and early mornings. You're building systems, refining workflows, learning to lead—all while keeping your own caseload afloat.
Emotional Load
There’s a vulnerability that comes with leadership. You care deeply about your team, your reputation, and your community. Balancing those competing needs can be exhausting.
Compensation Gaps
Too often, owners try to “absorb” all the costs themselves. They underpay themselves to make it work for their team. This is not sustainable—and it’s a fast track to burnout.
The Big Picture: It’s Not About Greed, It’s About Viability
Offering a lower-than-sustainable contractor split might feel generous in the short term, but it puts you and your business at risk. Eventually, you’ll burn out or have to make difficult decisions—like cutting expenses, dropping services, or raising rates unexpectedly.
What would it look like to build in sustainability from the start?
Start by reverse-engineering your numbers:
Know your expenses. List them all—fixed and variable.
Decide your role. Are you a full-time clinician and business owner? Or are you gradually moving into a CEO role?
Factor in your time. What would it cost to replace you with paid support for admin, supervision, and marketing?
Build in buffer. Businesses need profit to grow. Period.
So, Is It Worth It?
In my opinion—yes. Group practice can be an incredible way to expand your impact, create jobs in your community, and generate income beyond your own clinical hours.
But only if it’s done with intention.
You can offer great pay, strong support, and a clear vision for your team and make a fair living yourself. But you have to go into it with eyes wide open.
Want Support Building a Practice That Works—for Everyone?
If you're building (or rebuilding) a group practice and want support mapping out your costs, refining your systems, and leading with clarity, I’d love to invite you into The Group Practice Connection.
Inside, you'll get practical tools, real-world advice, and a supportive community of people who are building sustainable, purpose-driven practices—just like you.
Let’s make sure the numbers add up and your energy stays protected.
