Thinking of Joining a Clinic as an Independent Contractor? What Every Therapist Should Know When Joining a Group Practice

Starting out as a therapist often comes with tough choices about how to build your practice. One of the most common paths is joining a clinic as an independent contractor—but what does that actually mean, and how is it different from being an employee?

In this article, we’ll break down the key considerations every therapist should keep in mind before signing an independent contractor agreement. Whether you’re a new grad or a seasoned clinician exploring your next step, this guide will help you make an informed decision.

What Therapists Should Know Before Becoming an Independent Contractor

Many therapists enter the field excited to do the clinical work they love—helping clients heal, grow, and thrive. But when it comes time to join a clinic or group practice, one of the most common questions is: What does it really mean to work as an independent contractor instead of an employee?

If you’re considering this path, here’s what you need to know.

Independent Contractor vs. Employee

As an independent contractor, you’re not an employee. Instead, you’re essentially running your own private practice under the umbrella of a clinic or center. You provide therapy, invoice the clinic for your work, and get paid accordingly.

Unlike employees, independent contractors:

• Must carry their own liability insurance

• Are responsible for their own taxes and benefits

• Cover business-related expenses, either directly or through the “split” they pay the clinic

• You are responsible for your own training and supervision

  
  

If what you’re looking for is paid vacation, benefits, or the security of a salaried role, then an employee model is a better fit.

Understanding the “Split”

One of the most confusing aspects for new therapists is the concept of a revenue “split.”

Clinics may advertise a 60/40 or 70/30 arrangement, where you keep a percentage and the clinic retains the rest. At first, this can feel like money is being taken from you—but in reality, that portion goes toward covering the costs of running the practice, such as:

• Office space and utilities

• Practice management software

• Marketing and website costs

• Administrative support

• Supplies and other overhead

  
  

Think of it this way: if you were running a solo private practice, you’d be paying these expenses yourself. At a clinic, the “split” is how those costs are shared.

What matters most is not the percentage alone, but the actual dollars per session and the services you’re receiving in exchange. Sixty percent of $120 is different from sixty percent of $175.

Don’t focus on the percentage, but on what you are getting paid per session and what it would cost you in time or resources if you had to do your marketing and administration. 

Building a Caseload Takes Time

Another important reality: even in established clinics, building a full caseload doesn’t happen overnight.

Many clinics provide an average of 1–2 referrals per month. In the beginning, that may feel slow, but once you have a few clients, getting 1-2 referrals will be enough to sustain your caseload.  In the beginning, you may be an unknown to your community, and it will take time to grow your reputation and trust in the community.  One to two referrals a month equals 24-48 new clients a year.   Those referrals add up. Patience and consistency are key.

When looking for a clinic, join one that has strong SEO (search engine optimization), years of experience, and a good reputation, that can accelerate your growth—but it still takes time to establish yourself.

Business Responsibilities

Even though you’re working within a clinic, you’re still running your own business. That means:

• You pay for expenses whether or not you’re seeing clients (e.g., during vacations)

• You’re responsible for client records and professional liability

• You won’t be paid for everything you do—consultation calls, marketing, and other business-building activities are part of running a practice

• You may need to support in marketing efforts to get your name out

  
  

If this feels frustrating, remember: these are the same realities you’d face if you were on your own. The benefit of a clinic is that much of the heavy lifting (marketing, admin, referrals) is done for you by the clinic.

Motivation and Intentions

Before signing an independent contractor agreement, ask yourself:

• Why am I choosing this model?

• Do I want to avoid the hassle of running a business, or do I have an entrepreneurial drive?

• Am I joining to gain experience, community, and support?

• What are my long-term goals with this clinic?

  
  

It’s also important to enter with the right intentions. Joining a clinic simply to “build a caseload and then take the clients with you” is both ethically questionable and short-sighted. Clients should always be given options if you leave.  It is highly unethical to allow clients to become dependent and enmeshed with you.  While it is flattering and honouring when a client values your work, it is also essential for their growth that they learn from others.  Healthy boundaries and professional ethics protect both you and your clients.

Is It Right for You?

Being an independent contractor is a great fit if:

• You love the clinical work but dislike the business side

• You want the support of a team and community

• You value flexibility without the burden of managing everything alone

  
  

On the other hand, if you’re entrepreneurial, enjoy marketing, and want complete control over your business, a solo practice may be a better route.

Final Thoughts

Becoming an independent contractor can be an excellent way to grow as a therapist, gain experience, and focus on client care without the stress of running a practice from scratch. However, it’s essential to enter with clarity about what the role entails, what you’re paying for, and your long-term objectives.

Ultimately, the decision comes down to knowing yourself: do you want the freedom and responsibility of being fully independent, or the structure and support of working within a clinic?

Both paths are valid—it’s about choosing the one that aligns best with your goals, values, and lifestyle.