Expanding to a Group Practice: Key Considerations and Best Practices

Transitioning from a solo private practice to a group practice can be both exciting and daunting. Having navigated this journey myself, I’ve learned some valuable lessons along the way. Here are my key considerations and best practices for expanding your practice.

1. Hire Within Your Niche

When I hired my first dietitian, I made the mistake of choosing someone with a different niche than mine. She was new to the area and didn’t have her own referral sources. Instead of marketing my services, I found myself marketing for her and keeping her busy with administrative tasks. She saw very few clients, resulting in a significant financial loss. Thankfully, she went on maternity leave and decided not to return. The lesson here? Hire someone who can seamlessly take on the referrals you’re already getting.

2. Timing is Everything

Fearful from my first hiring experience, I was cautious the next time around. However, my motivation to move to Bend, Oregon, without losing my Portland practice pushed me to try again. At the end of 2019, I interviewed and found not one, but two perfect candidates—one specializing in pediatrics and the other in eating disorders. Just in time for the pandemic, we transitioned to virtual work, making the move much smoother.

Pro tip: Start hiring when you have a waitlist, or better yet, before you’re booked out for months. Credentialing can take a minimum of three months, so plan ahead to avoid turning away clients.

3. Create an Employee Handbook

When hiring your first team members, an employee handbook can be invaluable. It outlines your company’s mission, policies, and procedures. This is essential for employees, though not as much for contractors. An employee handbook can evolve with your team, providing a clear framework for expectations and standards.

4. Employee vs. Contractor

Deciding whether to hire an employee or a contractor is crucial. I chose to hire employees to duplicate myself as I moved. Employees can be trained, follow protocols, and maintain consistent branding. Contractors, while often more affordable and flexible, work independently, and you have less control over their work. Consider your needs and long-term goals before making this decision.

5. Pay Considerations

Research local pay rates for dietitians. I used Indeed to gauge acceptable pay ranges. It’s also important to calculate your average revenue per client hour. This helps determine a fair and sustainable pay rate. Remember, contractors typically earn 50-60% of the revenue, while employees earn around 40% or less, depending on benefits. Plan for annual raises and potential bonuses.

From my first hire, I learned to differentiate pay for administrative work and client work. I offer $10 more per hour for client work and set a limit on admin hours to ensure a balance.

6. Logistics and Practicalities

Writing a clear job post and knowing where to share it is essential. Develop a set of interview questions to evaluate each candidate consistently. Draft an offer letter detailing pay, start date, and expectations. Decide whether to share office space or work virtually, and determine how to handle credentialing and payroll.

Once hired, use an onboarding checklist to ensure a smooth transition. I’m happy to share my checklist—download it here.

Growing My Team

Expanding my team has been incredibly rewarding. While I now focus more on management than client care, after eight years in practice, this change feels right. Seeing my practice grow and thrive with the help of a dedicated team has been fulfilling in ways I hadn’t imagined.

Download My Free Guide

To help you navigate onboarding your first team member, I put together a checklist called “Hiring Your First Dietitian Checklist” that will ensure a smooth onboarding process. 

I hope these insights help you on your journey to expanding your practice. If you have any questions or need further guidance, feel free to reach out. I’m here to help you elevate your practice to new heights.