Why Group Practice Owners Burn Out (And Why You’re One Crisis Away from Moving to a Remote Cabin)
You didn’t start a group practice because you love HR paperwork, tax forms, and the existential dread of managing other people’s schedules. No, you had a vision—a thriving practice, a supportive team, and (dare you even dream?) passive income.
Fast forward to today, and instead of sipping tea while watching your dream practice run itself, you’re on the phone with an insurance company, trying to prove that yes, a 60-minute therapy session actually happened. Meanwhile, a therapist just emailed to say they’re quitting (but it’s not personal, they swear), and you just discovered the office Wi-Fi is out again.
So why do group practice owners burn out? Let’s break it down before you pack your bags for that remote cabin in the woods.
1. You Accidentally Became Everyone’s Parent
You thought hiring therapists meant you’d be surrounded by highly competent, independent professionals. Turns out, you’re now running an adult daycare.
One therapist is overbooked and on the brink of collapse.
Another has two clients and is confused about why they aren’t making six figures.
Someone still doesn’t know how to use the EHR and is documenting their notes in Microsoft Word.
Your admin just called in sick, which means you have to answer the phones (and you really thought you were done with that).
At this point, you half-expect someone to ask if you can pack them a snack for their afternoon clients.
2. Payroll Is a Monthly Horror Show
Ah, payroll. That magical moment where you take all the money your practice earned and give it to everyone exceptyourself.
You started this business to create financial stability, but now you stare at spreadsheets, whispering, Where did all the money go? Like, you know it went to rent, liability insurance, office coffee, and the one million software subscriptions, but still—where did all the money go?
And just when you think you’ve got things under control, someone asks, “Hey, can we get a 401(k)?” and you consider just paying them in emotional support.
3. Insurance Companies Exist to Ruin Your Life
At this point, you’re convinced insurance companies actively try to break your spirit.
Denied claims for literally no reason.
Random audits that make you question if you even know what therapy is.
“Reimbursement rate adjustments” that somehow always mean less money.
You’ve now spent so much time on hold with insurance reps that you recognize their voices. You’ve debated billing your own therapy to compensate for the emotional damage. And you’ve started referring to claim rejections as “a fun surprise.”
4. You Still Have to See Clients (Because Rent Is Expensive)
You thought group practice meant stepping back from client work. But somehow, you still have a full caseload—because:
You don’t have enough referrals to fill everyone’s schedule, so someone has to keep the revenue coming in.
You’re covering for a therapist who’s taking an extended break (aka slowly disappearing into the ether).
You’re too emotionally exhausted to fire the therapist who cancels half their sessions but swears they’re committed to the practice.
Now, instead of scaling back, you’re squeezing in clients between payroll meetings, compliance checklists, and the occasional nervous breakdown.
5. The Office Drama Rivals Reality TV
Somehow, your highly trained, emotionally intelligent team still finds ways to create chaos.
One therapist loves diagnosing everyone at staff meetings.
Another hasn’t turned in notes for weeks but promises they’re “almost done.”
Someone has beef with the front desk staff and is now just passive-aggressively breathing in their direction.
And of course, there’s always one person whose clients keep accidentally not paying, but it’s “weird, right?”
At this point, you could charge an entry fee for your next team meeting and market it as live theater.
6. You’re Always Stuck Between “I Need More Clients” and “I Can’t Handle More Clients”
Hiring more therapists sounds great—until you realize you don’t have enough referrals.
But then, just as you start scaling back hiring, three therapists quit in the same month, and suddenly, you’re googling “how to clone employees.”
Your marketing budget is basically just “manifesting” at this point, and every time you think you have enough clients, you remember that half of them are sliding scale.
7. Work-Life Balance? Never Heard of It.
You preach boundaries to your team. You tell them to prioritize self-care. You encourage time off.
Meanwhile, you haven’t taken a vacation since your group practice opened.
You answer emails at midnight.
You take “quick work calls” on your “day off.”
You spend your weekends researching tax deductions (while sobbing).
Your friends have stopped inviting you to things because you always respond with, “Ugh, I want to, but I just have to finish payroll.” And your dog—who used to love you—now only tolerates your presence.
How to Avoid Becoming a Burnt-Out Shell of a Human
Before you give up and start a simpler business (like, say, herding wild buffalo), consider:
Outsourcing EVERYTHING you can. Hire a biller. Get a VA. Let someone else suffer for once.
Enforcing real boundaries. If your employees get work-life balance, so do you. Put your phone down.
Not hiring out of desperation. A bad hire is worse than no hire.
Setting policies—and actually enforcing them. No, you cannot keep a therapist who never does their notes just because “they’re a great clinician.”
Remembering WHY you started. Despite the chaos, you did build something meaningful. Maybe even something great.