The Four Biggest Struggles of Group Practice Owners (and How to Not Lose Your Mind Over Them)

Welcome back to The Culture Focused Practice Podcast! I’m Dr. Tara Vossenkemper, and today we’re getting real about the top four struggles that make group practice owners question their life choices. If you’ve ever felt like you're drowning in hiring headaches, role confusion, caseload overload, or financial uncertainty, you’re in good company. But don’t worry—I’ve got some solid fixes to help you navigate this mess.

1. Hiring & Retention: The Ultimate Headache

Hiring is a whole thing, right? And lately, it feels like finding the right people is trickier than ever. One of the biggest mistakes I see? Hiring based on what people say they can do instead of making them prove it. Stop trusting resumes at face value—make candidates demonstrate their skills before signing that offer letter.

And don’t even get me started on cultural fit. You don’t just need someone who can do the job; you need someone who won’t make you and your team miserable. Ask value-based questions, loop in a hiring committee, and trust your gut (but also, back it up with an actual process).

2. Defining Roles & Responsibilities (Because You Can’t Do It All Forever)

When you first start a group practice, you’re everything—therapist, admin, biller, office supply replenisher, part-time IT support. But as your practice grows, you need to start handing off responsibilities before you completely burn out.

Enter: the accountability chart. Think of it as a super clear roadmap of who does what so you don’t end up micromanaging or, worse, assuming people magically know what they’re supposed to do. Every role should have five key responsibilities, max. More than that, and you’re just setting people up to fail (or setting yourself up for a million "Hey, can I ask you something?" interruptions).

3. Managing Caseloads (a.k.a. You Can’t Be Everything to Everyone)

Look, I get it—stepping away from client work can feel like breaking up with a best friend. But if you’re drowning in sessions and trying to lead a practice, something’s gotta give. The goal? Shift from working in the business to working on the business.

Find the balance. Maybe you see a handful of clients, maybe you phase out completely—either way, you need enough breathing room to actually lead your team and make strategic decisions instead of constantly putting out fires.

4. Understanding Financials (Even If You’d Rather Not)

Listen, avoiding your numbers isn’t a strategy. If you don’t know where your money’s going, you’re setting yourself up for a very stressful tax season (and, you know, general panic).

You don’t have to be a financial wizard, but you do need a clear picture of your revenue, expenses, and profitability. If numbers aren’t your jam, hire a bookkeeper or CPA who can break things down without making you feel like an idiot. Trust me, future you will thank you.

Wrapping It Up: What’s Next?

These struggles? They’re normal. But they don’t have to derail you. The key is tackling them before they take over your life (or make you consider selling everything and moving to a remote island).

If you’re nodding along to all of this, make sure to subscribe to The Culture Focused Practice Podcast—because I’ll be breaking down more of this group practice chaos on the regular. And if you want hands-on support, check out The EOS Collective for Group Practices—a community for practice owners ready to implement EOS and actually run their business instead of letting it run them.

Want even deeper support? Join the Culture Focused Practice Membership–monthly guidance, strategy, and resources for practice owners who want to get their culture and leadership right.

Alright, that’s it for now. Go forth and build a practice that doesn’t drive you to the brink. See you next time!

About the Author

Dr. Tara Vossenkemper is a gently-candid consultant who’s been in the trenches of group practice ownership since 2017. With a hearty blend of depth, irreverence, and a solid dash of humor (or so she hopes), Tara helps practice owners navigate the can-be-messy process of hiring, culture-building, vision generating, people-y issues, and all the other things that keep you up at night. When she’s not consulting, she’s probably wrangling her animals or homeschooling her kids—because why not add more chaos to the mix?

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