As someone who’s been running a group practice for the past seven years, I’ve developed a bit of an obsession with other practice owners. I joined all the Facebook groups, listened to the podcasts, joined the masterminds. I came for connection and business tips. I stayed because I couldn’t look away.
Because, wow. Some of what I’ve seen in those groups? It’s wild.
There are practice owners who fell into their roles by accident. Some think being a clinic owner means sitting back and collecting 40% of someone else’s labour. Others are so burned out they’re openly talking about shutting down their clinic and getting a “real job.”
And in the middle of all this? Good clinicians just trying to find a place to work where they can do their best work, help people, and not lose their minds.
So, if you’re looking to join a group practice, this post is for you. Here’s what to look out for—and what to run from.
🚩 The Owner Is Constantly in Crisis Mode
The issue:
Leadership sets the tone. If the owner is always stressed out, panicked, or flying by the seat of their pants, the whole clinic becomes reactive and unstable.
What unhealthy looks like:
Every day is a fire. The owner is juggling too many balls, answering every email at midnight, and changing policies on a whim. One minute your intake process is X, the next it’s Y. You never know what’s coming, and neither do they.
What healthy looks like:
The owner is calm, clear-headed, and has boundaries. They’ve built systems so the clinic doesn’t depend on their every breath. They take vacations, they delegate well, and when things go sideways (as they sometimes do), they don’t implode.
Why it matters:
You deserve to work in a place that doesn’t feel like a war zone. A grounded owner creates a grounded clinic. That stability trickles down to you and your clients.
🚩 They Talk Like You Work for Them
The issue:
This isn’t a traditional employment model. Most group practices hire independent contractors. That means you don’t work for them; they work for you.
What unhealthy looks like:
The owner treats you like staff. They make unilateral decisions that affect your practice without consultation. They expect you to be grateful for the opportunity to work there, and remind you of that any time you raise a concern.
What healthy looks like:
The owner sees their job as supporting you. They understand that their role is to keep the clinic alive, support clinicians, and ensure clients are well-served. They recognize that their business exists because of the work you do, not the other way around.
Why it matters:
Power dynamics can get messy. You want to work somewhere that respects your autonomy, values your input, and understands that their success depends on your ability to thrive.
🚩 The Fee Split Is Too Good to Be True
The issue:
Yes, fee splits matter. But how that split is being used matters more.
What unhealthy looks like:
You’re being offered an 80/20 or even 90/10 split. You feel like you’ve won the lottery… until you realize there’s no admin help, no marketing, no supervision, no infrastructure, no support. And a year later? The clinic folds. Or worse, they can’t afford to pay you.
What healthy looks like:
A sustainable split—usually around 60/40 or 55/45—that funds admin, marketing, leadership, systems, and support. The owner can clearly articulate where that money goes and how it helps you do your job better.
Why it matters:
A thriving clinic requires resources. If there’s no money to invest back into the business, the business dies. A healthy split means the clinic can take care of you and itself.
🚩 There Are No Systems (or They’re a Secret)
The issue:
Systems are what keep a clinic running smoothly. Without them, you’re stuck relying on guesswork, micromanagement, or the group chat.
What unhealthy looks like:
Everything is ad hoc. You’re told to “just ask” when you need something. Information is scattered, inconsistent, or gatekept. You spend more time trying to figure out how to do your job than actually doing it.
What healthy looks like:
There’s a handbook. A shared drive. A clear process for everything from intake to offboarding. You’re set up to succeed without needing to rely on the owner for every single detail.
Why it matters:
Good systems mean more time and energy for client care. They reduce burnout, improve outcomes, and signal that the clinic is built to last.
🚩 They Don’t Know Their Numbers
The issue:
Metrics matter. A clinic owner should know whether their business is thriving or floundering.
What unhealthy looks like:
They shrug when asked about retention rates or average caseloads. They have no idea if the clinic is profitable. Or they say things like, “I don’t do this for the money” (which is usually code for: I have no idea what I’m doing).
What healthy looks like:
The owner tracks key metrics like no-show rates, client retention, revenue per clinician, and client outcomes. They use that data to make informed decisions, and they’re transparent about it.
Why it matters:
Financial health = clinic health. If the numbers don’t make sense, the clinic is not sustainable. And if it folds, you’re out of a job.
🚩 They Expect You to Do Your Own Marketing
The issue:
Unless you’re being hired as an associate with a personal brand, it is my opinion that marketing is not your job.
What unhealthy looks like:
You’re expected to build your own caseload, post on social media, or go hustle for referrals. You’re told to “just put yourself out there,” even though the clinic takes 45% of your income.
What healthy looks like:
The clinic has a cohesive brand, a referral pipeline, and a marketing strategy that drives the right clients to you. Your only job is to be a great therapist.
Why it matters:
You should be paid to do therapy, not to market. If you’re responsible for finding your own clients, you shouldn’t be giving up part of your income.
🚩 The Clinical Culture Is… Weird
The issue:
Culture isn’t just about vibes. It impacts everything from job satisfaction to client outcomes.
What unhealthy looks like:
Nobody talks to each other. Or worse, there’s favoritism, passive-aggressiveness, and behind-the-scenes drama. Meetings are skipped, suggestions are ignored, and people seem vaguely terrified of the owner.
What healthy looks like:
The team feels connected. Clinicians attend meetings and actually want to be there. There’s room for feedback, collaboration, and even a little fun.
Why it matters:
Isolation breeds burnout. A strong culture helps you grow, stay regulated, and feel like you belong.
🚩 Clinicians Keep Leaving
The issue:
Attrition tells a story. People don’t flee healthy workplaces.
What unhealthy looks like:
Every time you blink, someone’s gone. The team page is constantly changing. The owner insists it’s just “life stuff,” but you notice no one sticks around for more than a year.
What healthy looks like:
People stay. They grow within the clinic. New hires are excited to join because of the people who are already there.
Why it matters:
In the current mental health market, there are endless options for clinicians to find an environment where they can thrive. People will not stay where they are not valued. A revolving door means instability. It also means you’re probably next.
🚩 The Owner Doesn’t Understand Business Law or Finance
The issue:
A group practice is a business. There are rules. And they matter.
What unhealthy looks like:
The owner doesn’t know what they’re legally allowed to do. They hire people improperly, misclassify contractors, or get caught off guard by tax obligations. (True story: I once saw a clinician use their tax account to fund a trip through Europe dining at only Michelin star restaurants… their clinic promptly folder after because they couldn’t pay their taxes).
What healthy looks like:
The owner is legally and financially literate, or they work closely with professionals who are. They make choices based on facts, not vibes. And they keep themselves (and you) out of legal hot water.
Why it matters:
If they’re not running a compliant business, your job isn’t safe. Full stop.
So… What Should You Ask Before You Join?
Here’s a quick checklist:
- What’s the onboarding process like?
- Who handles marketing?
- What does the fee split cover?
- Are there written policies and systems?
- What kind of team culture exists?
- How long have current clinicians been with the clinic?
- How are decisions made?
- What metrics does the clinic track?
- What happens if the owner is away for a month?
- Do they understand their legal and financial responsibilities?
Final Thoughts (and a Not-So-Subtle Pitch)
If you’re already in a group practice and half of this list sounds familiar… it might be time to rethink your options.
And if you’re a sex therapist or couples therapist in Ontario? Tri Health Clinic might be the place you’ve been looking for.
We exist to help clinicians thrive. We handle the business stuff so you can focus on therapy. We don’t ask you to market yourself. We invest in systems, in support, and in community. We’re serious about ethical business, financial transparency, and long-term sustainability.
You do the therapy. We take care of the rest.
Interested in joining us? Click here to learn more and apply.