Welcome therapists and group practice owners! I’m Nicole McCance, a psychologist turned business coach for therapists. I scaled my group practice to 55 therapists and multiple 7-figures in three years with toddler twins at home, and one of the most important decisions along the way was how to build admin support. Should you hire virtual only, in person only, or both?
P.S. Not a huge fan of reading blogs? (I’m more of a podcast girl myself) You can listen to my podcast episode all about this topic by clicking here!
What Kind of Admin Do You Actually Need?
That’s the burning question, right? Which option is *actually* going to benefit your group practice the most?
If you’re answering phones between sessions, resetting rooms, and chasing invoices, you already have your sign. Admin is usually the first hire that gives you time back to lead your team (if you have one) and actually scale. Hiring an admin is how you shift from working IN your practice to working ON your practice. Here are my thoughts on an in person admin vs. virtual admin.
Where a Virtual Admin Shines:
- Billing, invoicing, and reconciliations
- Email and phone intake
- No-show and inquiry follow-ups
- Reports, insurance forms, and back-end systems
- Work that requires focus without interruptions
Hot Tip: I highly recommend Ginger Desk for VAs that specialize in health and wellness practices! Click here to learn all about them and if you book a Discovery Call, don’t forget to mention you heard about them from Nicole McCance and get $250 off their services!
Where an In-Person Admin Shines:
- Greets clients, sets the tone, and lowers anxiety in the waiting room
- Handles same-day schedule changes while therapists stay with clients
- Stocks rooms, resets after sessions, prints forms, and keeps the space client-ready
- Reduces therapist interruptions so sessions start and end smoothly
Think of your waiting room as the warm-up. A warm hello, eye contact, and “we’ve got you” energy improve client retention more than most owners realize. Seriously, client retention begins in the waiting room!
Hot Tip: If you’re using Jane for booking, billing, and charting, train your front desk to watch arrivals and status updates so clinicians don’t need to peek into the waiting room. Click here to try JaneApp FREE for 2 months!
The Setup I Recommend For Most Practices: Hybrid
What I generally recommend for most practices is a hybrid approach. Keep your virtual admin for deep, back-end work and add in-person front-desk support for client experience and on-site logistics. They truly do complement each other! Here’s a potential outline of how that would work for your group practice:
Virtual Admin
- Intake emails and calls
- Billing, invoices, reminders
- Report pulls, reconciliations, and templates
- Follow-ups that convert inquiries into booked sessions
In-Person Admin
- Client greeting and room flow
- Supplies, printing, shredding, and room resets
- Same-day problem solving for late arrivals and no-shows
- Quick therapist support so clinicians can focus on care
Essentially, the VA runs your systems and the front desk runs your space. Together, your practice feels polished without you juggling a hundred micro-tasks (phew!).
Hot Tip: DM me “Admin Checklist” on Instagram and I’ll send you my Admin Delegation Checklist so you know exactly what to hand off first.
Hiring and Scheduling Your Practice Admin
Hiring can feel scary and overwhelming, which is why I want to remind you that you don’t have to jump into the deep end right away! Start small and then scale.
Start Casual, Then Grow
My first front-desk hire worked five hours a week (yes, really). As revenue grew, that became 10, then 20. A great pipeline is hiring a third- or fourth-year psychology student because they’re bright, compassionate, and love flexible hours. Plus, they have insight into the industry.
Two Part-Timers Beat One Full-Timer
Relying on one person creates a single point of failure. Two part-timers cover vacations and sick days and give you steady service without scrambling!
Cover Peak Hours First
Most clinics are busiest evenings and Saturdays, so start there. As flow stabilizes, a great base to start is:
- One shift 10–6
- Another, overlapping afternoons into evenings
If your practice runs 8am–8pm, this covers the heart of the day without you paying for empty hours. If you can’t offer that many hours yet don’t panic, just start with a part time shift in the busiest hours, that would be 4-8pm.
Do This Before You Hire
One of the most important pieces of advice I can give you is to systemize before you delegate!
Without a solid foundation, you could end up costing your practice a lot of money. For example: Record quick Loom videos of each task, create email templates in your voice, and print a one-page room-reset checklist with photos.
When your team starts growing, questions will pour in. If you haven’t built systems, you’ll drown in constant interruptions. A clear onboarding process and documented procedures free you up to actually lead your practice!
When to Level Up Beyond the Front Desk
Once coverage is consistent and you’re out of daily triage, it’s time to think about leadership structure (yay!).
Phase 1: Virtual Admin
Owns billing, intake, reminders, and back-end systems.
Phase 2: Front-Desk Admin
Owns client experience and on-site flow.
Phase 3: Clinic Manager
Supervises the front desk, handles coverage, tracks service metrics, and shields you from day-to-day fires, so that you’re no longer the “chief question answerer.”
Phase 4: Operations Manager
Supports hiring, improves processes across departments, and partners with you on growth. This role replaces you in the weeds so you can focus on vision, marketing, and leadership! Again, so you can work ON your practice and not IN your practice.
Scaling Your Group Therapy Practice
Your practice grows fastest when you’re in the CEO seat, not the front desk. Start with the smallest step that gives you the most relief, build a hybrid admin team, and let your systems and people carry the daily load!
That’s how you scale your dream practice with calm, keep clients coming back, and create a practice your therapists never want to leave.
Want even more tips on growing your practice? Follow me on Instagram and listen to my podcast for all the best support for growing your therapy practice and attracting more clients!
Your Business Bestie,
Nicole
