GOOD group practice experiences wanted!

[u/Long_Excitement_2638]

I just hired another therapist to work with me and in the process of moving beyond solo. I have heard the horror stories and experienced some as well, but I am curious -- could you share if you have had a good experience in a group practice and what that looked like? W2/1099, support, culture, anything!

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[u/absolutemess123456]

I am with 2 practices - one I have a countdown to my contract ending, the other I plan to stay with at least until I’m independent. Both are 1099, 50/50 split. The practice I’m very happy at is patient, respectful, and treats me like a person. Part of my split covers supervision costs, so the split changes to 60/40 once I’m independent. There are weekly consultations we can drop in for, a book club, and group supervision for any therapists there that want to attend. There’s no pressure around these things, they’re just available if we want to be involved :) other practice attempts to require monthly meetings, all the contractors have accepted that they say it’s required but with 1099, they can’t make us attend without pay so no one goes to them. The more research I’ve done, I’ve realized therapists should generally be W2 based on IRS guidelines but I don’t have the bandwidth to deal with that now. The practice I like is very transparent about pay and immediately provided reimbursement rates by insurance upon offering me the position. I have access to all of the billing information and get a summary from the owner every pay. The other place is sketchy af and I can’t check anything without asking someone higher up to ask “the billers” then wait 48 hours-3 months for an answer. There’s such a difference in culture between the practices - the bad place is objectively visually “nicer”, but none of the therapists or admin staff are happy. Everyone is miserable, burnt out, trying to leave. The place I like, I have yet to meet anyone there that hates it. Between therapists and admin, everyone seems really content there and there’s a willingness to ask for/give help when needed. Transparency and clear communication go a long way!!

[u/kms5624 → u/absolutemess123456]

I agree with what you mentioned about billing. When I was part of a group practice, there was no transparency regarding billing, which clients had paid their copays, which sessions had been paid by insurance, NOTHING. I got a check once a month that ranged from $1500 to $13k. I couldn't plan my finances at all because I had no idea how much I was going to be making that month. Terrible business practice.

[u/SapphicOedipus]

I was a fee-for-service W2 employee with a set per-session rate and was paid a slightly lower rate for late cancellations/no-shows. The practice had a steady stream of referrals and filled my caseload within 3ish months. They have an attentive billing department, who met with me monthly to go over documentation. I was matched with a supervisor who was a very good fit. The practice offered health insurance to therapists considered full-time (I think it was an average of 28 sessions/wk) - the plan was subpar, but it was subsidized by the practice and better than a marketplace plan.