Clinical Directing in a Group Practice with Alli Ramirez | POP 926

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How do you structure leadership in your growing group practice? Are you considering hiring a clinical director? What are some of the standard clinical director duties that could be taken off your hands by hiring someone great for the role?

In this podcast episode, Andrew Burdette speaks about clinical directing in a group practice with Alli Ramirez.

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Meet Alli Ramirez

A photo of Alli Ramirez is captured. She works as the Clinical Director of Higgins Wellness, a large group private practice in  Asheville NC. Alli is featured on the Practice of the Practice, a therapist podcast.


Alli works as the Clinical Director of Higgins Wellness, a large group private practice in  Asheville NC. She is also the co-host of Notworking AVL, and the co-founder of WNC Therapist Culinary Club, both local networking organizations for mental health professionals in the WNC area.

Alli specializes in supporting cycle breakers who are the first in their family to seek healing and are overwhelmed by the daunting task of breaking through intergenerational trauma. Alli provides individual therapy and group therapy for people who are struggling with the day-to-day challenges of their lives, especially as it pertains to neurodivergence, LGBTQ+ issues, being in a larger body, and other marginalized identities.

Visit Higgins Wellness and connect on Facebook, Instagram, and LinkedIn.

In this Podcast

  • Adding leadership in a growing group practice
  • Considering a clinical director?
  • Some clinical director duties
  • Alli’s advice to private practitioners

Adding leadership in a growing group practice

In mid to late 2022 we had hired on at least 10 or 12 clinicians and then we had our doctor in Chinese medicine, our prescribers that we were looking to have join, so it did get to a point where it [became] a big undertaking for just one person to be managing all of those people. (Alli Ramirez)

A group practice that starts to grow needs to have support structures put in from early on so that the system doesn’t fall on one person’s shoulders to carry.

In the beginning, the owner may handle the management, but at a certain point, some help should be called in, and it helps the business to continue running smoothly for everyone involved. The current management and leadership structure within Alli’s group practice looks like:

  • Regular team meetings
  • A monthly consultation for fully licensed clinicians to discuss cases
  • Supervision group for provisionally licensed clinicians
I’m of course available for questions and anything that they need help with in the day to day. (Alli Ramirez)

So, much of the clinical system is in support of the clinical work that happens.

Considering a clinical director?

Alli spoke with the group practice owner about setting up a timeline for her to begin stepping into the leadership role as the new clinical director. She set up a short presentation to show the value that could be added to the practice by her stepping in as a clinical director, as well as the things that she was already doing well, and the administrative duties that she could take on in this new role.

So I had a meeting with her and shared all of [this] information and proposed the idea of me being promoted into that clinical directory role, and obviously it went well! I was awarded the promotion which is very exciting. (Alli Ramirez)

If you are interested in advertising yourself as a clinical director, or you want to hire one, look at the role that needs to be filled and consider the tasks that the person would need to fill. Alli still has a small caseload of clients while working as the clinical director.

Some clinical director duties

Some of Alli’s tasks include:

  • Co-facilitating the monthly team meetings
  • Running monthly supervision and consultation groups with the clinicians
  • Supervising provisionally licensed clinicians
  • Handling most of the incoming referrals
  • Organizing and scheduling social and team-building activities
  • Keeping track of KPIs
Really kind of anything that [on the] day-to-day needs to happen. I have helped with on-boarding new clinicians, figuring out how to share office space … There’s a lot, for sure! (Alli Ramirez)

Alli’s advice for private practitioners

Value communication! You need to be on the same page with the other leadership folks within your business for everyone to trust, understand, and implement the work that needs to be done.

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Check out these additional resources:

How Being an Ally Shows up in Clinical Supervision with Angela Brooks-Livingston | POP 925

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Meet Joe Sanok

A photo of Joe Sanok is displayed. Joe, private practice consultant, offers helpful advice for group practice owners to grow their private practice. His therapist podcast, Practice of the Practice, offers this advice.

Joe Sanok helps counselors to create thriving practices that are the envy of other counselors. He has helped counselors to grow their businesses by 50-500% and is proud of all the private practice owners who are growing their income, influence, and impact on the world. Click here to explore consulting with Joe.

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