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How do you actually know whether your group practice is profitable? What metrics should practice owners be tracking beyond revenue? And how can identifying operational bottlenecks help you grow more sustainably?
In this podcast episode, Brandon Shurn continues his breakdown of lessons from the Group Practice Conference, focusing on provider margins, operational systems, lead conversion, and the importance of identifying the real bottlenecks preventing growth in a group practice.
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In This Podcast
- Revenue Alone Doesn’t Tell You If You’re Profitable
- Track the Metrics That Actually Matter
- Build Systems Before Growth Creates Chaos
- Identify the Real Bottleneck
- Learning Never Stops in Group Practice Ownership
Revenue Alone Doesn’t Tell You If You’re Profitable
One of the biggest ideas Brandon explores in this episode is the difference between revenue and actual profitability.
A practice can appear successful on paper while still operating inefficiently behind the scenes.
“Revenue growth without margin awareness can make owners poorer.” — Brandon Shurn
The episode explores how provider margins are impacted by:
- Insurance reimbursement rates
- Payroll and benefits
- Administrative costs
- Supervision time
- Overhead expenses
Brandon also reflects on how different payer mixes can dramatically affect profitability, even between clinicians carrying similar caseloads.
“A high-volume provider with weak margin may be less visible than a lower-volume provider with strong margin.” — Brandon Shurn
Track the Metrics That Actually Matter
Throughout the episode, Brandon walks through several metrics group practice owners should understand if they want a clearer picture of how their business is functioning.
These include:
- Revenue per session
- Intake conversion rates
- Provider utilization rates
- Patient retention rates
The conversation emphasizes that growth is not always about hiring more clinicians.
Sometimes the real issue is improving systems, retention, or marketing performance.
“If your providers aren’t full, the investment is in the marketing intake, not more clinicians.” — Brandon Shurn
Brandon also highlights the importance of retention, explaining that clinicians with stronger long-term retention may ultimately produce more sustainable revenue than clinicians constantly cycling through new intakes.
Build Systems Before Growth Creates Chaos
Another major theme in the episode is operational infrastructure.
Brandon reflects on the idea that systems that work for a three-clinician practice often break as a practice grows larger.
“What worked with three clinicians often breaks at 15.” — Brandon Shurn
The conversation explores several operational areas practice owners should evaluate, including:
- Operations manuals
- Policies and procedures
- Outcome tracking
- Consistent client experience
- CRM systems
One quote Brandon repeatedly returns to is:
“The goal is to make quality repeatable, not personality dependent.” — Brandon Shurn
He also openly reflects on where his own systems still need improvement, particularly around tracking metrics and optimizing client experience.
Identify the Real Bottleneck
A major takeaway from the episode is that growth often comes from fixing the current bottleneck rather than simply adding more.
For Brandon, one of the biggest bottlenecks right now is lead conversion and tracking.
He discusses how CRM onboarding and better tracking systems could help:
- Improve intake conversion
- Track referral pathways
- Optimize client experience
- Understand where opportunities are being lost
Learning Never Stops in Group Practice Ownership
Brandon closes the episode by reflecting on the value of attending conferences and learning from other practice owners.
One insight that resonated deeply with him was hearing a mega-group practice owner admit that smaller practices sometimes have systems he wishes he had implemented sooner.
“I learned that there are people whose practices are smaller than mine that have systems in place that I don’t.” — Brandon Shurn
The episode ultimately encourages practice owners to stay curious, continue learning, and focus on strengthening the systems that support sustainable growth.
Useful Links:
Check out these additional resources:
- Group Practice Conference Part 2: Leadership Bottlenecks | GP 328
- Practice of the Practice Network
- Group Practice Launch
- Group Practice Boss: www.practiceofthepractice.com/grouppracticeboss $149 a month
- PoP Group Practice Owners Facebook Group
- Free resources to help you start, grow, and scale
- Work with us
- Practice of the Practice Network
Meet Prof. Brandon Shurn
Brandon Shurn, Ph.D., LCPC, LMHC, AFC®, NCC, is a licensed clinical professional counselor and the founder of EmPower Me Holistic Counseling, a fully virtual Maryland-based practice. He’s also a full-time professor in Seattle University’s online Clinical Mental Health Counseling program. With extensive experience launching and directing university training clinics, Brandon now focuses on helping therapists design and grow impactful, sustainable practices. Outside of his work, he enjoys fitness, yoga, Wing Chun, golf, reading, and spending time with his family and dogs.
Visit Empower Me Counseling, and connect with Brandon on Instagram and LinkedIn.
Email him at: [email protected]
