The Private Practice Success Podcast

57. Busting the 10 Biggest Myths about Group Private Practice - PART 1

• Gerda Muller • Episode 57

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In Episode 57, Gerda busts the  first 5 of the 10 Biggest Myths about Group Private Practice.

Why? Because right now there is so much misinformation floating around in the allied health industry and it’s keeping incredibly capable clinicians and practice owners stuck, overwhelmed, and on track to burnout.

If you’ve ever considered building a group practice (or you’re already in one and quietly thinking, what the hell have I done?) then this episode will help you separate myth from reality. 

Gerda shares what she knows to be true after running her own two group practices and mentoring hundreds of group practice owners over the past decade.

In this Episode, you will learn (among others):

  • The myth about practice owners and money that keeps the industry divided and what’s actually going on behind the scenes.
  • The common contracting myth that creates resentment and the mindset antidote to fix it.
  • The belief about risk that keeps practices small and owners stressed.
  • The story owners tell themselves about burnout and why it’s not inevitable.
  • The fear of losing control and what control actually becomes as you grow.

Who This Episode Is For:

  • Clinicians thinking about starting or joining a group private practice and wanting the truth (not the rumours).
  • Group practice owners who feel stuck, overwhelmed, or like they’re constantly on the brink of burnout.
  • Practice owners who want to grow sustainably, without losing quality, control, or their wellbeing.

Tune in for an honest, no-fluff conversation that will challenge what you’ve been told and help you build a group practice you can’t stop smiling about.

Want Gerda's Help with your Business?

Gerda helps allied health group practice owners go from overwhelmed, overworked, and underpaid to fully empowered and financially thriving. If this is you, then make today the day you reach out. Complete this super short Triage Form here bit.ly/triageformpps and Gerda will personally reach out to you. 

Here to help you build a practice you can't stop smiling about :)

Connect with Private Practice Success & Gerda here:

Well, hello there spectacular private practice owner. My name is Gerda Muller, and you are listening to the Private Practice Success Podcast, and this is episode number 57. Today we are going to be Busting the 10 Biggest Myths about Group Private Practice. 

Now, if you've ever thought about building your very own group, private practice, or maybe you are already in group private practice for yourself and you are quietly wondering What the hell have I done? Then this episode is for you. Because unfortunately, there are a lot of myths floating around within the allied health and private practice industry, about what group private practice really involves. And honestly, most of those myths are keeping incredibly capable clinicians and current practice owners stuck playing small, continuing to be overwhelmed, and on track towards inevitable burnout.

Today I want to walk you through the 10 Biggest Myths that I have seen. And then what I'm going to do is I'm going to walk you through what I know to be true after many, many years of running my very own group private practices. I've got two group practices. I started one in 2007, and started the second in 2011, and still have both of those. I've also, for the last 10 years, been mentoring and coaching hundreds of allied health group practice owners. So I do think I know a thing or two about the myths out there in the industry, and the actual truth about what it is that is happening. 

Now I'm going to warn you that you might be hearing things today in this episode that you are not going to like hearing. And if that is the case, that is perfectly fine. It is not my job here to tell you what you want to hear. It is my job to tell you what I know to be true from my knowledge and my experience, and you may, (and you have the right) to disagree with me on that. And if that is the case, I would love for you to listen to the whole episode first. And then at the end, if you feel really strongly about something, please feel free to email me. My email address is gerdam@privatepracticesuccess.com. I'm very happy for you to email me because I know that the format of podcasting is very one way. I talk and you listen. But I really want to invite you to make this a two-way conversation, so feel free to email me and say, ‘Hey, Gerda, I think you've got this wrong and this is why.’ And if you agree, I would also love to hear from you, even if it's just ‘Spot on, I totally agree.’ Always know that you're welcome to do that. 

Okay, so we are going to walk through these 10 Biggest Myths, and please note that I'm not addressing this in any particular order. It's not in order of importance, most prevalent or most significant. I'm just going to do one at a time, and we are going to get through 10 of them. I'm pretty sure there's more than 10, but these are really the ones that I have identified as really holding people back, that really scares people, that stops people from making decisions and taking the actions that they need to take. Because at the end of the day, if we stay stagnant as a result of a freaking myth, well that does not serve anybody. It most certainly doesn't serve you as the current or potential practice owner. It doesn't serve your clinicians. It doesn't serve your admin team members. And it sure as hell doesn't serve the clients in the community that you are here to impact. So thank you for going there with me by having this conversation.

I am excited to talk about this, and you'll probably know that I get quite passionate about some of these things. Because I've seen it so often and I've seen how it impacts clinicians and practice owners, and I just hate that. So I am taking the opportunity today to set the record straight when it comes to these myths. Let's do this.

Myth #1: Practice Owners are Lining their Pockets off the back of their Clinical Team Members

We are just going to call it like it is, and that is the fact that there is this belief out there in the industry that group practice owners are lining their pockets off the back of their clinical team members? Yes, I've said it. If you are a group practice owner, have you heard this? Have you noticed it? A lot of times this is not very overt - the messaging that tells us that the myth exists, a lot of times it's very covert. But you know what? If you are in Facebook groups and other platforms and communities where a lot of allied health professionals hang out, you have probably seen conversations that are sometimes overtly and sometimes covertly implying, and sometimes they are stating it totally outright, that ‘You know what? That practice owner is just in it for the money. They're just lining their own pockets.’ 

And you know what? Nothing can be further from the truth. Now, of course, there's no absolutes in life, and I am sure that there are some people that are doing that, okay, but I am talking in general. And in general, this is not the case.  I am yet to meet a practice owner that is doing that. Maybe I've just not met them yet. I've been doing this for 10 years, and within the allied health private practice industry, and I've not seen that. You might go, ‘Well, how do you know Gerda? You are just saying that because you are a group practice owner, so obviously you're going to say that. You are always advocating for group practice owners, so obviously that's going to be your belief.’  

The thing is, I've looked at the data. And again, I've not looked at every practice owner in Australia, I know that. But I'm thinking that my sample size is pretty good, because like I said, I've been doing this for 10 years now. When somebody comes on board and they join, for example, my Private Practice Success Academy, one of the first things we do is we send them an onboarding questionnaire. One of the questions in that questionnaire is very straightforward and direct and it says: How much do you pay yourself as a practice owner? And I'm very clear that what I mean with that, is you need to include money you pay yourself as a wage. Some people employ themselves as an employee within their own company - that's what I do, by the way. 

I pay myself a weekly wage, I take out pay as you go, (my tax is therefore sorted), and I pay myself super. So if you've got a company structure, you have the potential to employ yourself.  It could be that, or maybe you are doing owner's drawings. If you are still a sole trader setup, you're probably doing owner's drawings.  Some people take a small salary or wage as an employee, and then they will top that up with owner's drawings. So I'm always clear you need to include both of those. If you are a bit of a bigger business, you might be doing dividends, where you pay money out from your profits. So I'm very clear that you need to include in the amount that you give me any money that you are paying yourself, because obviously businesses are set up differently. Businesses come to my world at various different stages and sizes and levels of private practice development, so it'll be different. But I want one total figure that you, as the business owner, are getting remunerated for the work that you are doing within this practice. And I can tell you people aren’t lining their pockets. 

And you're probably going, ‘Well, Gerda, give me specifics. Give me a number.’ So I'm going to give you a number. Are you ready for this? Think first, what do you think is a good number? Especially if you are not a group practice owner. If you are not a group practice owner listening to this and you are looking to join a group practice, what do you think a practice owner should be earning per annum? And if you are a practice owner already, I want you to be thinking, do you know what your total amount is? If you don't, that's a red flag. You should know what it is. You should know exactly how much you get paid. What is that number right now? Just think about that. Make sure you have that number in your head.

So the majority of group practice owners who start consulting with me (they've not had any business consulting in the past), they've just been winging it, trying their best to build their business through Google Research - these days, people come and they tell me they've consulted ai, but it's still not working. Or they've consulted other peers and Facebook groups and communities, but they're just not there yet. So these aren't people that haven't tried to build their business? They have. They've worked really hard. They've put in a lot of effort. They've put in a lot of research. But they're not there yet - but they've not had what I would refer to as specialist Allied Health Business Consulting, the type of consulting that I provide.

So they come in and I ask that question because I want them to benchmark that number so we can make sure we know, okay, this is what it was - pre-intervention. Right. And the intervention is the Private Practice Success Academy. So did we can in six and again in 12 months. Do another assessment of what that number looks like, which is their post intervention number. So the majority of group practice owners are paying themselves on average between 80 and a 100  thousand dollars per annum. That's that average range. Let that sink in. I don't know about you, but if I'm the business owner (the one that's carrying all the risk and all the responsibility on their shoulders), it's like, geez, you know, I don't know if that's worth it. I don't know. Because I can probably go and get a job at Queensland Health earning that and I can knock off at 5:00 PM and I don't have a care in the world - I don't have a worry. I don't have to do the dinner, bed, bath time routine, and then sit down with my laptop and do work until 12 midnight - and that's the life of a lot of practice owners - and then get up tomorrow morning and do it all again.  Like why? There's no reward in that. 

I don't know about you, but that's a very low number. And you know, the other thing, when I speak with practice owners, I also ask them, so tell me about your org structure, how many clinicians do you have? What are their wages? What do you pay them? In a lot of instances, the practice owner is earning way less than their clinical team members. Now, I don't know about you, but that doesn't seem right to me, because a practice owner should be, you know, should be rewarded adequately. It just doesn't make sense. If I look at any other business, the business owner generally should be earning the most money because they take on all the risk and responsibility. But for some reason in Allied Health, that's not allowed to happen or occur. And you know why? I've got a lot of thoughts around why, but I'm not going to go into that today. I'm going to pull myself back because that's a whole different podcast episode.

The purpose for today is to tell you that the myth is: people believe group practice owners are lining their own pockets off the back of their clinical team members. When in actual fact, the facts are that group practice owners are earning on average less than their clinical team members, and they're earning on average between 80 and a 100 thousand dollars per annum, and this is across disciplines. What I will say is that the majority of disciplines I work with is psychology, second most is occupational therapy, and I work with social workers, speech pathologists, physios, music therapists, dieticians, a whole range of others. The majority is psychology and OT, so my data is probably skewed to some extent there, so maybe just keep that in mind, but that is what I'm seeing. And in my opinion, that is not okay. 

It's not fair for people to think that practice owners are lining their own pocket, when in actual fact they're not. The thing is, practice owners aren't going to tell you how much they pay themselves, because they’re private. Are you telling the world how much you earn? I don't know, I don't do that. It's private. I also think that there might be some shame attached to the fact that it doesn't matter what I do, I can't pay myself more. Maybe I want to pay myself more, but I can't because if I pay myself more, I won't be able to pay my bills and I won't be able to pay my clinical team. So when I work with a practice owner that comes into my world, and they are earning between 80 and a 100 thousand dollars per annum, and they're earning less in their team members, that tells me that there is a fundamental flaw in their business model, that their business model has not been set up in a profitable and sustainable manner. In a manner where yes, they can pay their clinical team well above award wages, at least market wages so they can be competitive within the market, but so that they can also pay themselves well. 

Because why do this if you, as the practice owner, are consistently the one that's under pressure and not getting any financial reward from it. Why? Why would you do that? A lot of people do it because they want to help. They want to have an impact. And I love that for them. But that's also not sustainable. And when a practice owner burns out because they don't have a sustainable business model, they're going to close their practice doors. They're going to feel like failures. Their clinicians are going to have to go and look for other jobs, and their client's going to have to go and look for other providers. And I won't let that happen, not on my watch. So that was myth number one.

Myth #2: The 'My Money' Myth 

I am thinking that for myth number two, I'm going to stick to the theme of money, seeing that we've just had a bit of a money conversation. I'm going to call myth number two, the ‘My Money’ Myth. Hmm. What do I mean by that? Well, have you ever been in a Facebook group where a clinician is saying, ‘Hey, I'm looking to start contracting with this group practice. They're offering me X amount of dollars. (Let's say they offer me $100 per appointment). And you know what? I figured out that that means that they are keeping $100 dollars of ‘my money’ because they charge the clients $200.’ (I'm just making these numbers up now for ease of sharing it with you). And then they go, ‘They are keeping $100 of my money.’ And this is why I'm calling this the ‘My Money’ Myth. 

It is a mindset issue, and it is a knowledge issue. Because generally this is somebody that has signed a contract as an independent contractor, and they would say, I'm contracting, I'm doing independent contracting. People get very upset about the fact that the practice is keeping X amount of dollars of their money. And if they are contracting and it is a percentage split, they will talk about the practice is keeping 30% of my money, or 40% of my money, or 50% of my money.  I can imagine if that is the way you're thinking about that money, you are not going to be happy, right? Because gee, somebody's keeping your money. That doesn't feel good. I would not be happy with that. I would be going, ‘Hang on here, this doesn't feel good. Why is this business retaining my money?’ And as I said, this is often a knowledge gap, because when you are doing true independent contracting -  independent contracting as defined by the Australian Tax Office - then the practice isn't keeping or retaining any of your money if you are the contractor, okay? That's not how independent contracting works.  

When you are an independent contractor, the client pays the practice, and the practice then pays the independent contractor the agreed upon dollar amount or the agreed upon percentage. What the client pays the practice is irrelevant to the independent contractor, or while it should be irrelevant, let me say that. People don't think it is irrelevant. But that's because they don't understand independent contracting in the true legal sense of the word.  Let's say you are a clinician, and you want to do independent contracting, and you start talks with a practice owner, and the two of you decide, yes, it's a good fit and we want to work together, but we want to bring you on board as an independent contractor. What needs to happen is that you, as the independent contractor, should be quoting the practice owner what you want to earn per billable client appointment. So you might tell them, I want 60% of billings, please. Or, and I prefer a dollar amount, you might go, I want to earn $120 per billable appointment. I'm registered for GST, so I want GST on top of that. And if you are doing therapeutic work, that probably needs to also then incur super on top of the $130. 

Again, this is not legal or accounting advice, this is for purely sharing with you what you need to think about and what you need to consider. So you need to quote that business, the business, AKA practice owner, then need to decide, can we pay you that, yes or no? What the business charges, the client is actually irrelevant. Okay? Because they might have one type of referral stream coming in, they might have 20 referral streams coming in. Which means that on average, what they would be bringing in in revenue is going to change per billable appointment. Okay? Now, when there's a percentage split, that means it's going to be different for you every billable appointment. So for you as an independent contractor, being paid a dollar amount is way more consistent and there's a lot more security in that for you, which is why I recommend that you negotiate a dollar amount, so you know. It doesn't matter whether it's a DBA client, victims assist, Work Cover, EAP client, a private client, a Medicare client, a whatever else client - that you, for the time, the skill, the knowledge and experience that you are delivering in that same 50-minute session - that you still get paid as an independent contractor, the same amount of money.  I think that's the better deal for you as the independent contractor, because now the risk is on the business because they are deciding what type of referral streams to take on board.  Again, I don't want to go down that rabbit hole now because that's a whole conversation, but that's how it should work.

So my money as the independent contractor is what I have negotiated with the practice owner to pay me per billable client outlet. That is your money. But then what people do is, they start thinking of the whole client revenue for that whole hour as their money, which it is not. Let's say for argument's sake, the client pays for a set billable appointment, the practice $230, and you've negotiated to get paid $130 plus GST and super, whatever that, let's just say at the end of the day, after all of that, you get $150. That means that all of the money of the $230 is the businesses, the practice's money. Your money is not the $230. Your money is the $130 plus GST plus super. If you're going to get hung up every time you look at what the client pays, you are not going to be happy, okay. And then it probably tells you that you should not be doing independent contracting. What you should be doing then probably is either opening up your own solo private practice, or you are potentially more suited towards a services and facilities agreement.

When we do a services facilities agreement, yes, now it is your money. But you can't say it's my money when it's independent contracting. Within the industry, I would say that independent contracting is still more the norm than services, facilities agreement. But people are thinking about independent contracting as if it is services, facilities, agreements, and then when we don't understand how the model truly works, we get resentful. We feel like we're being taken advantage of as the contractor. When in fact we just don't understand the model. And sometimes practice owners even don't understand it fully, and they don't have a good way of explaining it to people. So if you are a practice owner, wanting to take on board, independent contracting, it's really important for you to understand what model you're going to have within your business and get really good at explaining it to this person coming on board. The problem that we have in the industry is that that person then goes into a Facebook group where there's 2, 3, 5, even 10,000 other psychologists or OTs or whatever the discipline, and the majority of people in there don't understand how independent contracting truly works. And then this person goes, ‘This is what I've been offered.’ And they go, ‘No, they're keeping your money. No, you're being taken advantage of.’ And they're making comments from a place of ignorance. And this just frustrates the hell out of me. It's like nobody knows what they're talking about. Which is why I always go, yes, it's great asking for advice in a Facebook group, okay, I love the sense of community that you can get in there. But a lot of times, I almost want to say 9 out of 10 times, the advice you're getting is not accurate, not correct. People are trying to be helpful. They are trying to be there. They're trying to support you and stand up for you. But a lot of times they just don't know how it works, and they're giving you the wrong information, and then you get unhappy with the business you are working for. When in actual fact the practice is running it properly. 

So please people, you need to familiarise yourself with the model that you are entering into. You need to understand the difference between independent contracting and services, facilities agreements. Those two are vastly, vastly different. I'm not even talking about employment here. Generally, employees have a better understanding that my money is my wage and my salary, and that the money the client pays belongs to the business. I'm getting paid a set wage. It's very similar to independent contracting. It's not a wage, but it's a set payment that you get. Because independent contracting, again, the practice has gone - we've got all this work, we don't have enough people to do it, we want to contract you in to look after our clients on behalf of our business, and we are now negotiating and coming to an agreement of what we are going to pay you as the independent contracting. Totally different model than services, facilities, agreements.  That is where I'm going to leave this one.

So the My Money Myth, as it applies to independent contracting, it's not the contractor's money. The money that the client pays belongs to the practice. And the contractor's money, the money that belongs to the independent contractor is whatever was negotiated at the time of signing the contract - that is your money as the independent contractor.

PS. Let me add this in. I have a 9 minute video where I talk through the difference between independent contracting and services and facilities agreements. I will put a link to download that video in the show notes of today's episode. It is free for you to access. Go and download it, watch it, and get really clear. And please, feel free to share that with anybody else. If you feel like your clinicians aren't understanding it, feel free to share it with them. Feel free to use what it is that I share in there to explain it to them as well. The more people who understand this, the better it will be for our entire industry.

Myth #3: The Bigger the Practice, The Bigger the Risk

Myth number three is that the bigger the practice, the bigger the risk. Now take it from me, I am a psychologist, us psychologists are very risk averse, we do not like risk. I think that health professionals in general, again, I'm generalising, a lot of us are risk averse. A lot of us therefore believe the myth that the bigger the business that I'm going to be creating, the bigger and the more risk I will be taking on. This stops a lot of people from expanding into group private practice, or from growing a larger group private practice.  A lot of people will say, I just want a small, tiny group private practice, like one or two clinicians, that's all I want, you know, I don't need anything larger than that. But the truth is this, your risk doesn't really increase with size. You know what increases your risk? Poor structure that is built on poor foundations. That is what increases your risk.

In fact, a well-run group practice - and I'm not talking about like 10 sites and locations, when I refer to group practice in general, it's like 8, 10, 12 clinicians - a well-run group practice often has less risk than a smaller practice. And even less risk than a solo practice, because if you are a solo private practice owner, guess what, everything is on your shoulders, all the risk. You alone carry all the risk, all the systems, policies, processes are in your head. You make all the decisions all by yourself. When you are in a group practice, yes, ultimately the buck will stop with you as the group practice owner. But you've got an amazing team, hopefully, of people there with you who can support you, who can help you make decisions. Because as a collaborative group practice owner, you will be consulting with your team members. You will be asking their opinion. You will be problem solving with their help and support. So there's actually less risk as you grow, if you are putting the right foundations in place. And that's often where people go wrong, because growing a group practice is actually not that hard.

You can actually grow pretty quickly, and I've experienced that myself, especially in a time of high client demand, it is so easy to grow. Very often when we grow that fast, we don't make the time to make sure that the frameworks and the foundations are put in place. Because there's certain foundations that need to occur when you go from solar practice owner to hiring your very first one or two clinicians. So when you go from what I refer to as a Level 1 Private Practice to a Level 2 Private Practice, and then when you are at Level 2, now you need to put in new foundations in order to go to Level 3. And when you are there, you need to put in new foundations to go to Level 4 and 5, right. A lot of people just go, ‘No, I've done what I needed to do when I went from solo to group, but there's always new foundations as you grow bigger and bigger. And again, I'm not saying you need to have a team of 30, 40, 50. But if you want a long-term sustainable and profitable group practice of between 8 to 12, even 14 clinicians, then you need to put in the time to make sure that you've got the right foundations for every level of growth in place. If you do that, you are minimizing risk. 

Because if you've got, let's say, 12 clinicians in your practice and one person leaves, and let's say that for some reason at this particular point in time, you are not able to find a new clinician to come in and take over that caseload. Generally, what would happen is that if you are a larger group practice, you can generally absorb the caseload amongst the rest of the team.   If you've got only two or three clinicians on your team and somebody leaves, you can't absorb those clients. So now you lose the revenue from an entire caseload and, and that will impact your ability to pay your bills, to pay your people. It impacts not only your top line, your revenue, but also your bottom line, your profit. So that's more risk. So you might think, oh, it's going to be easier just to stay small, but that increases risk.  A lot of times when things like that happen, guess what happens then? You as the practice owner goes, oh, I need to make sure those clients are looked after. I'll just add more hours to my day. I'll just do another day of clinical work so that we can make sure we see those clients. And that's how practice owners burnout. What I have seen, in my opinion, is that the rate of burnout is much higher in solo private practice as well as in smaller group practices. And I think that's going to bring us to our next myth.

So just to recap, the myth is that the bigger the practice, the bigger the risk. When in fact, the fact is, that risk doesn't increase with size, it increases with poor structure and lack of proper foundations.

Myth #4: Group Practice Ownership is an Unsustainable Journey Towards Inevitable Burnout

Okay, so I've alluded to burnout, so I'm going to go with this one. Myth number four is the belief that group practice ownership is an unsustainable journey towards inevitable burnout. Now you might be hearing that you're going, ‘Hang on, Gerda, this feels to be contradicting myth number one, because in myth number one, we were talking about the fact that there's this belief that group practice owners are lining their pockets of the back of their clinical team members, which means that they should be doing pretty well, shouldn't they?’ But the thing is that myth, myth number one, is a belief that's within the marketplace amongst people who are generally not practice owners. So they're looking from the outside at group practice ownership, and they believe that. 

Myth number four is a belief that I find amongst people that are group practice owners, people that have been working incredibly hard for many, many years. And it feels to them that they just aren't growing, that the business just isn’t growing, and that they are just on this constant treadmill, this constant hamster wheel, and they're giving it their all. But they're staying in exactly the same place, and they feel stuck. They feel incredibly stuck, and they feel incredibly tired and overwhelmed. They feel like they are consistently on the cusp of burnout, and that they get to the end of the calendar year just in freaking time to have one week, hopefully two weeks of recovery, so that come the first week of January, they can put on their running shoes again and start running again. Start on that treatment again. Get on that hamster wheel again. On that roller coaster, just hanging on for dear life so that they don't drown.

That is an incredibly difficult journey to be on, and a lot of group practice owners are on that journey ,on that treadmill, that hamster wheel, that rollercoaster inside whatever metaphor speaks to you. And a lot of people do burn out. A lot of people go, I just can't do this,  I'm closing the practice doors. Or I'm going back to solar practice because I just can't deal with the responsibility of having the livelihoods of my admin and clinical team members on my shoulders day in and day out. That financial pressure to make sure that the business does well, so that we can pay our bills, pay our team, and keep the doors open. It's just too much. Or they go, I don't even want to do solo practice. I can't face, you know, client after client, after client. I want to try something else. Because what they've created is not sustainable. But the good news is that yes, that is a myth. I'm not saying it's not happening. It's happening there every freaking day, but it doesn't have to be like that. 

The fact is that there are a lot of group practice owners out there with highly sustainable businesses that are impacting lives every day that are paying their team well, who are also paying themselves well, and who has created the time, the money, and the freedom that they were after when they decided to take that leap into private practice ownership. I don't know about you, but the reason why I started my private practice was to be my own boss so that I can have time freedom. As a mum of young children, that was incredibly important to me. I wanted to be able to take the day off to go and help out at the tuckshop or to go and attend the swimming carnival without having to ask permission, because I'm a really hard worker, I'm very committed to work. I'm dedicated and I would always feel bad asking for time off. Even though I was entitled to it, I didn't like it. I wanted to have full control over my calendar, over my diary. That control to me was freedom. That's the ultimate level of freedom, deciding when I work and how much I work. That's what I wanted. And that's what each and every group practice owner deserves, because we all need to put in the hard yards. I'm not saying you get a sustainable group practice without working hard, I would be lying to you if that's the case. 

But what I have come to learn is that a lot of people stay stuck, when in actual fact their reality could be vastly different, vastly different. And that was me for the first four years of my own group practice ownership. I was doing all the research. I was doing my utmost. I was working incredibly hard. I was doing what I thought was all the right things. And yes, I had incredible growth, but it was growth during times of economic stability, and then when the global financial crisis set in and the consequences of that started to reach communities in 2010, that's when the pawpaw hit the fan. Because you can build a business that can thrive during good times, but a true business can thrive during difficult and challenging times as well.  That is what differentiates a pretend business from a real business. And unfortunately, I had to get to that place where I had to realise that I had a pretend business, because there were very important foundational pieces that I did not have in place. And when I started working with my very first business coach back in 2012, I had to go and undo a lot of shit that I thought was great stuff that I implemented. And in fact, I was doing the wrong thing because you don't know what you don't know until you know what you don't know, right?

My message to you today is this, you need to be mindful of where you at in your group owner journey right now. If you have been dealing and struggling with the same challenges for the last 12, 24, 36, 48 months, then that is your red flag that something ain't working. If you've been getting to the end of every calendar year, like on the cusp of burnout, it's telling you that there's something that you are doing that's not working. And I'm here to tell you that there is a better way, that there is a way out from your current reality. But you need to be willing to take the steps towards that reality. First, you need to be willing to acknowledge that there is a different reality, that there is a different future available for you. Because if you've had the same shitty calendar year in 2025 than you had in 2024, maybe even worse, and in 23 and 22, what's really going to change? You're going to feel all nice and motivated and re-inspired for the first week of January, and then reality is going to set in again. You need to consciously decide that it's going to be different, or you're going to get to the end of 2026 and it's going to be the same shitty experience of another year. Thank goodness it's all done. I survived it. Next year's going to be better. 

I love the optimism. I'm a very optimistic person. But optimism can only take you so far. And yes, optimism, there's a lot of research that it's amazing and great. But until you change what you're doing right now, nothing's going to change. And I'm here to tell you that the fact is this, you can have a self-running practice. A practice that can run in your absence, a practice that can require only 45 minutes a week of you as the business owner, that my friend is a sustainable business. That my friend is a business that does not burn you out.  So the myth might be that group practice ownership is not sustainable because of your current reality, and because it feels like you're constantly on the brink of burnout. But I'm here to tell you that the fact is that that does not have to be your reality, because it sure as hell isn’t mine and I'm still the owner of two legal and financially independent group private practices, not just different locations, they are independent practices. I'm still the owner of those two and I spend 45 minutes a week coaching and mentoring the person that runs it on the ground. I have not been pulled back into that business in more than five years. So even though things happen, challenges occur, crises pop up, I do not get drawn back into that business. And if I can do it, so can you. I'm not freaking special. You can have it too. You deserve to have it, but you need to decide that it is going to be yours for the taking. And if that's what you want, you know where to find me.

Myth 5: Growth Means Losing Control

Myth Number five, growth means losing control. I speak to solo practice owners all the time that tell me one of the biggest reasons stopping them from expanding into a group practice is the fear of losing control. Losing control of the quality of service being provided, and therefore losing control over their reputation. And this can be directed towards even taking on board administrative team members that are now going to be calling clients back, and booking them. Of course, it also relates to clinical team members now needing to trust somebody else with the quality of the clinical work that your clients and your referring community has become accustomed to. Now, this fear around losing control actually shows up at every level of practice development. So even once somebody addresses this fear and goes, ‘Okay, to hell with it. I'm doing it, I'm getting a clinician or I'm getting a virtual assistant, or I'm getting some admin support.’ Then they settle into that level of growth, and then it shows up again in a different form when they want to go to the next level of growth. So it actually shows up across all levels and sizes of group practice ownership. But the fact is this, that as your practice grows, you actually don't have to lose control, obviously, you need to do it right, okay. But you generally don't lose control. What you lose is the illusion of control. The belief that being personally involved in every aspect and in everything is what keeps the business safe, what keeps the practice ethical, and therefore also what keeps you successful. When in reality that kind of control is actually really fragile,and it only works if you as the owner are consistently present, available, and not exhausted. Because when those three things set in, you actually don't have control. Even if you think you do, you don't. 

As your group practice grows, your control doesn't disappear, it just changes form. And if you do this right, it moves up a level. So you move from controlling all the activity, towards controlling the architecture of your business. So what does this mean? So instead of micromanaging appointments, room allocations, and individual clinical decisions, you are now stepping into controlling the things that genuinely determine business outcomes. Such as the vision for where the practice is going, the standards that's going to guide ethical, clinical, and operational decision making, the culture that's going to shape how your team shows up every day, and of course, the direction that keeps the business aligned, sustainable, and future focused. And unfortunately, this is where many group practice owners get stuck. Not because their growth is out of control, or because they've lost control of it, but because they are trying to lead a bigger practice with a small practice mindset. So when you as a business owner cling to day-to-day control, your growth is going to feel really chaotic and really scary. Because the thing is, you can't control it all. But when you know and you decide to lead at this next level, or this next altitude of growth, that's when your growth becomes predictable, contained, and intentional.

So true control as a group practice isn't about knowing everything that's happening every day. I sure as hell don't know about everything that's happening at my group practices. It's about knowing that what should be happening is actually happening, and that is the shift when you realise that you, as the business owner - you are actually replaceable in your business and you should be replaced. I've replaced myself a long time ago, because you need to move and you need to be okay with that. That's the ultimate losing control, but it's also the ultimate control. Because this is where you are now building a business that can stand, grow, and thrive without you. Without leading to burnout, and without costing you your wellbeing. So the myth again here is growth means losing control, but the fact my friend, is that control isn't lost with growth. It's elevated. As the right kind of growth will now happen, and it will happen in a way where it creates more safety, consistency, and predictability, and that my friend, is the ultimate control, and you can have that too.

Conclusion

Okay, so this episode has already gone for way longer than I thought it should. I was really hoping to do the 10 myths in under an hour, but we've done five. So what I'm going to do, I'm going to call this part one, and part two will be the next episode, and in that episode, I will share with you the last five biggest myths about group private practice. 

Thank you so much for tuning in. And as always, remember that I am here to help you build a practice you can't stop smiling about.  😊

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Gerda Muller

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