After my training, I joined a busy employee assistance program with lots of paperwork and corporate politics. I also received onsite supervision and enjoyed a varied, interesting caseload. It was the perfect start to my career. At the same time, I couldn’t wait to go out on my own! It was exciting to start a private practice. Once I got it off the ground, I never looked back and later, I started a successful group practice.  Here is some information to help you decide what’s best for you: agency, group or individual practice.  Reflecting on the differences, I see pros and cons to each.

My first job at the EAP offered the guardrails I needed to make appropriate clinical decisions and to practice the boundaries that are necessary in our profession. Even the act of filling out a long treatment plan and talking to insurance companies set the stage for an ordered and ethical clinical relationship with my clients and structured my day when the time came to go out on my own. I would recommend to a beginning clinician that working in a clinical setting with set protocols is a wonderful way to learn how to run your own business.

For me, it was similar to joining a group practice, learning the ropes and then, taking what I had learned and going out on my own. It’s not for everyone, though. Marketing, developing professional referral relationships, negotiating a rental agreement and building a website take time, perseverance and the willingness to learn new things while you are seeing clients. I respect those clinicians that decide to leave that to someone else and concentrate only on the clinical. For me, I am interested in all aspects of running a practice and gladly spend time each day doing just that.

Currently, my group practice is a hybrid; It’s a carefully curated group of independent contractors working together and apart. We have the advantages of group consultation, hallway camaraderie, shared rental expenses and lots of interoffice referrals.

Each of us markets our own niche and all of us market the group and our individual talents. I started the group but I don’t take a percentage of fees; we are all responsible for our client loads.

The most important part of this calculation is the “carefully curated” part. It’s important that clinical styles mesh, work habits are compatible and ethical boundaries are iron clad. If you decide to join a group (whether they handle all the details of running a business or not), carefully make the decision. Interview as many of the clinicians you can, take note of location, commute and consultation. In your deliberation, ask yourself if you would refer to the clinicians in the group, if you would trust them with your clients and if you admire their clinical expertise. This is the most important part of joining a group.

Whatever setting you choose, be sure to make an informed decision about how you will spend your day. All clinical? Running the business and clinical? Or running the business for yourself and other clinicians. Choose wisely the practice that works best for you.