Should I Open Multiple Locations? | GP 89

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On this therapist podcast, Alison Pidgeon talks about should I open multiple locations.

Are you interested in expanding your business by opening multiple locations? Would another location help you to achieve the goals you have laid out for your practice? Which logistics should you focus on when opening a new office space?

In this podcast episode, Alison Pidgeon answers the question: Should I Open Practices in Multiple Locations?

In This Podcast

  • 8 questions to ask yourself first
  • Pros and cons
  • Logistics of multiple locations

8 questions to ask yourself first

1 – What are the priorities that you have for your business and its growth?

This question will help guide you in your decision-making process for how you should expand.

  • Do you want to cover the state?
  • Which income bracket do you want to be in?

Is it to grow to a certain size? Is it to grow to a certain income level? Having multiple locations could help you reach those goals, so you really need to be clear about that. (Alison Pidgeon)

2 – Does having multiple locations help you to reach the goals you have laid out for your practice?

The first and second questions work hand-in-hand: what are the priorities of your practice and your business growth, and will multiple locations help you achieve the goals of your practice?

3 – Could you achieve your business goals without a new location?

Sometimes opening a new office is a nice shiny achievement that some business owners go for because it feels like a clear line of expansion, but examine your business goals first. Would another location distract you from the goals that you want for your practice?

4 – Do I need another office, or can I expand to online therapy services?

Check your state licenses to make sure that you are viable to work online. Online spaces are more affordable and are most likely here to stay.

5 – How much office space do I really need?

Sometimes less is more.

6 – How much distance should you have between locations?

Some people choose to open multiple locations close to one another but consider spreading them apart because that enables you to market to a wider circle of clients and broaden your client base.

Now if I had to do it over again, I wouldn’t have done that, I would have made the locations further away because … we’re going to start pulling from a whole other population of folks who wouldn’t have ordinarily traveled down to our original office. (Alison Pidgeon)

7 – Do you want to stay in one state or expand to two or more?

Consider the logistics in terms of licenses and regulations if you are wanting to work in more than one state because some laws vary.

8 – Are you comfortable with delegating?

If you want to open multiple locations, you will need to get comfortable with delegating tasks to people who will run offices for you in each space.

You can’t manage everything, so build a capable team that you can trust and allow them to do what needs to get done.

Pros and cons


  • It would attract clients who live in that area who would not normally drive to your previous location.
  • There will always be a need for in-person therapy.
  • You can serve different communities in multiple states.
  • Having a brick-and-mortar business helps with marketing.

You can claim a Google My Business listing, people drive by and see your sign. Having a brick-and-mortar location adds to the legitimacy of your practice. (Alison Pidgeon)


  • You are going to have to pay for certain expenses.
  • Each office will need in-person staff at all times, such as a clinician and an admin person.
  • Multiple locations are more likely to be expensive in terms of overhead than if you have one central location.

Logistics of multiple locations

  • Are you going to keep your admin staff centralized or assigned to a specific location?
  • Will you combine all your marketing in one account or make different social media accounts for each location?
  • Which leadership positions will you need to hire to keep the multiple locations running smoothly?
  • Will you use the same systems (EHR, phone system, and so forth) in each system?
  • Would you track accounting information separately for each location or together?
  • If you are opening a location in another state, you need to trademark your name.
  • What do you need to register to do business in another state?

Check out these additional resources:

Meet Alison Pidgeon, Group Practice Owner

An image of Alison Pidgeon is displayed. She is a successful group practice owner and offers private practice consultation for private practice owners to assist in how to grow a group practice. She is the host of Grow A Group Practice Podcast and one of the founders of Group Practice Boss.Alison Pidgeon, LPC is the owner of Move Forward Counseling, a group practice in Lancaster, PA and she runs a virtual assistant company, Move Forward Virtual Assistants.

Alison has been working with Practice of the Practice since 2016.  She has helped over 70 therapist entrepreneurs start and grow their businesses, through mastermind groups and individual consulting.

Transformation From A Private Practice To Group Practice

In addition, she is a private practice consultant for Practice of the Practice. Allison’s private practice ‘grew up.’ What started out as a solo private practice in early 2015 quickly grew into a group practice and has been expanding ever since.

Visit Alison’s website, listen to her podcast, or consult with Alison. Email Alison at [email protected]

Thanks For Listening!

Feel free to leave a comment below or share this podcast on social media by clicking on one of the social media links below! Alternatively, leave a review on iTunes and subscribe!

Podcast Transcription

You are listening to the Grow a Group Practice podcast. Whether you were thinking about starting a group practice or in the beginning stages, or want to learn how to scale up your already existing group practice, you are in the right place. I’m Alison Pidgeon, your host, a serial entrepreneur with four businesses, one of which is a large group practice that I started in 2015. Each week, I feature a guest or topic that is relevant to group practice owners. Let’s get started.

Welcome to the Grow a Group Practice podcast. I am so glad you are listening today. I have a solo episode for you. Once in a while, I sort of give you a window into the different topics that we talk about in our Group Practice Boss membership community. So this membership community is for established group practice owners who have at least two clinicians hired and are ready to streamline their businesses, make more money, work less, expand all of the things. Every month we have a different topic. So just last month in September, our topic was expansion and one of the webinars that we did was about opening multiple locations.

So this is a question that I know I get asked all the time as a business consultant. You have a group practice established, maybe it’s running pretty well and then you start sort of questioning, do we grow bigger? Do we go bigger in our same space? Do we open multiple locations? So there’s a lot of things to consider if you are in that situation and I think that one of the interesting things about business consulting is that there are so many factors that go into making some of these business decisions and isn’t just kind of like a yes or no answer.

I think a lot of times our clients come to us and ask us these questions, should I open in another location and they just want us to say simply yes or no. Unfortunately it’s not that easy. So I have really more questions for you to ask yourself about whether or not you should open another location or multiple locations. So you really need to think through these in order to answer that question for yourself. So obviously this podcast would be super short if it was just a yes or no answer, and obviously it’s not. So we’re going to go through all of the different facets of this question. So yes, so let’s dive in.

So here’s sort of just general good questions to ask yourself. One is what is my long-term goal for my business? So if your long-term goal is, I want to cover the entire state of wherever you are then yes, probably makes sense to open multiple locations. Is your goal to grow to a certain size? Is it to grow to a certain income level? Having multiple locations could help you reach those goals. So you really need to be clear about that.

The second question you can ask yourself is how would opening multiple locations help me reach these goals or not? So again, just kind of reiterating what I just said. We, sometimes get distracted by the next shiny object and I think for a lot of people, opening multiple locations feels like a really like sexy thing to do. Like all of a sudden you have this big, legitimate business. I have multiple locations. I have all these people working for me. But if that doesn’t align with the goals of your business, then it’s not really going to be the right move to make.

The third question to ask yourself is, is there another way I can achieve my business goals without opening another location? So for example, could I reach my business goals, just having one big location? We’re going to talk about the pros and cons of having a big location versus multiple smaller locations.

The fourth question I have on my list is, do I really need to open another office or can I expand our online therapy services? So obviously COVID, the pandemic has changed our industry pretty dramatically with telehealth being widely used. There’s really no restriction obviously outside of just making sure you’re licensed in the state where you’re providing services. So I’m building a whole arm of my business that is all just folks who want to work a hundred percent online. So I think we have a lot of opportunities now. If your goal is to explain your business, why would you necessarily take on another office space, which is more expense and more management if you could just sort of expand your online services? So definitely something to think about. I think online therapy is here to stay. I don’t think it’s going to go away at this point.

Next question, ask yourself how much office space do I really need given that telehealth will likely be permanent? So for example, my own practice, we have about 27, 28 clinicians. We just have some starting actually in the next week. We have four offices, four physical offices. So obviously lots of people are working from home just because that was their choice. And yes, we just don’t really need as much office space as we used to. So, whereas I had at one time 10 offices, now we have four and four is still plenty. So that’s something else to keep in mind.

Next question you could ask yourself is what distance away would it make sense to open another location? So before COVID, when we couldn’t really do telehealth we had three locations all within 10 to 15 minutes of each other. Now if I had to do it over again, I wouldn’t have done that. I would have made the locations further away because we’re, for example, expanding into the county next to us and we’re going to start pulling from a whole nother population of folks who wouldn’t have ordinarily traveled all the way down to our original office, because it’s about 45 minutes away. So I think it makes sense for us to open that location because now we’re pulling from like a whole different kind of geographic area.

Next question is, do you want to stay in one state or expand it to more states? So some people are in the situation where you might be on the border of a state, like my colleagues who are in Philadelphia, you drive across the bridge and you’re in New Jersey. Maybe you want one office in Philly and one office in New Jersey or same thing with New York. It’s very common. I have had lots of consulting clients who have an office in New York city and they have an office in New Jersey. So if you are going to expand into more than one state, great, but you may just have to think through some of the logistics of that. You may have to register to do business in that other state. You just want to make sure you’re doing everything legally, obviously. You also might want to think about trademarking your name so nobody else could start a practice in another state with the same name as yours. So just a little bit different tasks that you have to do if you’re looking at expanding into multiple states.

So the last general question I have on my list that you want to ask yourself is, are you comfortable with delegating almost everything to someone else who is operating a location far away from you? So let’s say that you open a second location, it’s an hour away from you, you’re probably not running up there every day. You probably want to have somebody there who’s the point person, who can make sure supplies are ordered and everything’s functioning, how it should and the clinicians feel like they have someone to go to if they have a problem or a question. So I know for a lot of practice owners, that’s a very tough thing to do. And obviously if that is not something that’s super comfortable for you at this point it is something you can definitely work on, but you really will have to put somebody in charge of that other location. Because if you if you’re expanding into another location, it’s probably not realistic that you’re going to be kind of running back and forth between the two or the three on a regular basis.

So those are all questions that you can ask yourself. We are going to move into kind of talking about the pros and cons. So as you can see so far, this is not a very simple question to answer. A lot of it is based on your own circumstances and your goals. So let’s talk about the pros and cons. So the pros of having multiple locations, one is it would attract clients who live in that area, who wouldn’t normally drive to your other location, which is what we’re doing in my own practice. The new location is far enough away that folks wouldn’t drive into the next county to go to therapy.

Something else I think is a positive, is having a brick and mortar location helps with marketing. You can claim a Google My Business listing, people drive by and see your sign, et cetera. I think having a brick and mortar location adds to the legitimacy of your practice. Like I said, I don’t think you’re going to have to have as much office space as you used to pre-pandemic, but I don’t think physical office space is ever going to totally go away. At least, maybe not in the next few decades.

Another pro is there’s always likely going to be a need for in-person services. As we found out during the pandemic online therapy, doesn’t always translate well for everybody who’s seeking services. So yes, there’s just always going to be a need to see people in person. And then the other pro is you can serve different communities across your state or in multiple states. So that it’s really exciting because I know that my therapists do great work and if we can bring more services to areas, especially that don’t have enough that makes me feel really good. That makes me feel like serving one of my purposes in life.

So now we’re going to move into the cons. So here’s some of the downsides potentially of having multiple locations. So you are going to have to pay for certain expenses many times. So here’s an example. So we had, like I said, those three offices all within 10 to 15 minutes of you other, and what ended up happening was we kind of outgrew the first location and then needed more space. So just kept opening spaces in other spots, but they weren’t very far away from each other. So I was paying for an internet connection in all of those places and that gets to be expensive as opposed to, I could just have one location and be paying for one internet connection. So as I found out Comcast, who’s our internet provider, they don’t give you a discount if you have more than one business account. They’re just like, Nope, sorry, you got to pay full price for it. So that definitely obviously eats into the expenses.

The second thing that is a potential downside is you’re going to need to have someone at each office to take care of things that can only happen in person. Likely this would be both a clinical and an admin person. So like I was saying before, you probably would want an admin person to come and pick up the mail and make sure supplies were stocked and all of that kind of thing. And then I found that having a clinical person in place too is really helpful because it helps the therapist to feel supported like, oh, okay, I know if I run into a problem and so is here and I can ask them a question. So obviously if you’re having multiple locations, now you have more staff or you have more staff that you need to promote to take on these sort of leaders ship responsibilities. So that’s just another thing to keep in mind that would affect your budget as well.

The last potential con is that multiple locations are likely more expensive in terms of overhead versus having one large location and, or focusing on expanding telehealth services. So that is what I have kind of been saying throughout this podcast so far. It’s you really have to look at how is that additional location affecting your overhead. Does that make sense as opposed to other alternatives? So those are the pros and cons I thought of. I’m sure you could probably think of more than that. But this is just sort of the thought process that I go through and what I talk to my consulting clients about, and obviously we talked about it in Group Practice Boss.

So the last topic that I have is the logistics of having multiple locations; so things that you have to decide. These aren’t necessarily, there’s no kind of right or wrong. It’s kind of like your preference. So let’s say you have multiple locations or you’re planning to have multiple locations. So here’s some things that you need to think through. One is, are you going to keep your admin staff centralized or assigned to a specific location? So when I worked in community mental health, there was a central scheduling department and if you wanted to make an appointment at any one of their eight outpatient offices that spanned four counties, you called this outpatient central scheduling office, and you were able to make an appointment that way.

Or the alternative would be, you could have one admin assigned to a specific location. They just could schedule for that location. They have a separate phone number, all of that kind of stuff. And you could do it that way. Again, no right or wrong there. It just kind of depends on how you want to set it up and what makes the most sense for your practice.

Another logistical thing to think about is, are you going to keep everything combined for marketing purposes? Are you going to have the same website, the same phone number, the same social media accounts, or are things going to be separated? So again, not a right or wrong, probably just depends on your individual situation. But this is another thing to think through. What is this going to look like from a marketing standpoint?

Another thing to think about what leadership positions will you need to hire for a separate location. So like I talked about before, you probably want somebody on site, but depending on how big your practice grows, you’re probably going to eventually need some upper management. Like I have a COO right now, and she’s in charge of the managers who are over top of a team of 12 therapists. So she’s essentially managing the managers. So I would say by the time you probably hit 20 clinicians now you’re needing to look at, okay, what does this sort of upper management structure looks like because you alone cannot do everything anymore.

The next thing to think through is will you use the same system as you have in your current location? Will you use the same EHR? Will you use the same phone system, et cetera, et cetera, or do you need to pick different things for a particular reason? The next one is will you need to track accounting information separately or together? So this is where your income that you’re generating for all the locations could just go into one bank account and then obviously all the expenses for both locations could come out of the same bank account and that type of thing. You can actually have things in the same bank account, but maybe potentially still track it separately. So again, not a right or wrong, and this is a great question for an accountant, but do you want to individually track how each location is doing so you would know, oh, location A is doing great and turning a profit, but location B is really struggling and not turning a profit or does that not matter and you just think, no matter what location it is, all the money is together and we’re sort of all doing good or we’re not. So yes, definitely something to talk to your accountant about.

And then the last thing is if you’re opening a location in another state, I mentioned this before, do you need to trademark your name? That is something a trademark lawyer can do for you? it costs about between three and $5,000 in the United States, and it can be quite a lengthy process. So if you think that one day you might want to expand into another state, that might be something you want to start doing now. I’m actually almost at the end of that process. I don’t recall now how long ago I started, but I feel like it was at least a year ago and we’re not through it. But I am kind of in that trademarking process right now.

And then, like I mentioned before, just what do you need to do to register to do business in another state? So obviously that state is going to want their tax money. So they want to make sure you are, they know who you are, you’re sending your tax payments to the right place, all of that kind of stuff. So that may mean you need to get a lawyer involved or you may need to make sure your payroll company understands, “Hey, I have employees in multiple states,” and are you sure you’re paying the right taxes for this state and that state or whatever.

So those are just some of the logistical things. Obviously, that’s not an exhaustive list, but I just wanted to kind of give you those questions to help you start to through, okay, if I had multiple locations, what would this actually look like? And how would this be set up from a logistical standpoint? So that was the gist of our webinar on opening multiple locations. And like I said, many more questions than I necessarily have answers. But I hope those questions get you kind of thinking in the way of helping you make that decision. If you are a group practice owner and you have at least two clinicians hired and you want ongoing business support Group Practice Boss is definitely an awesome community to be a part of. We have weekly webinars. We have, I think over 130 or 140 practice owners now in our group.

We have a Facebook group where people can ask questions. Whitney Owens, and I both run the group. So you kind of get both of our perspectives on running group practices. And it’s just been amazing running this group. It’s actually about a year since we launched it and it’s just been awesome. So we don’t have particular times of the year where we kind of let people in. It’s kind of rolling admission as they say. So if that is something that sounds like it would be helpful for you to check out the website with more information. It’s and we would love it if you would join us in the group.

So I hope the podcast was helpful today, and I will see you all next time.

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This podcast is designed to provide accurate and authoritative information in regards to the subject matter covered. This is given with the understanding that neither the host, Practice of the Practice, or the guests are providing legal, mental health, or other professional information. If you need a professional, you should find one.