We’re having a lot of our 1099s resign. We offer a good split, billing, credentialing, scheduling, and even supervision. What else can we do to make it more appealing to work at our practice? Is anyone else seeing this turnover?
If this sounds familiar, you’re not alone. Practice owners across the country are seeing increased turnover among their independent contractors. However, this does not necessarily reflect your leadership, culture, or offerings. We’re experiencing a broader structural shift in how clinicians choose to work and what they expect from a practice.
The New Reality: It’s Never Been Easier to Go Solo
Technology has lowered the bar for starting a private practice in today’s landscape. Tools that once required a whole team are now accessible à la carte:
- PaaS billing companies like Headway and Alma handle insurance claims and pay clinicians directly.
- AI-powered charting tools take care of documentation in minutes.
- Telehealth platforms provide direct-to-consumer referrals with built-in credentialing and scheduling.
- Self-scheduling apps let patients book online 24/7.
- Shared office rentals and coworking spaces give clinicians professional space without long-term leases.
Together, these offerings allow therapists, psychiatrists, and mental health clinicians to launch a solo practice on the weekend—with minimal overhead and no need for a traditional group.
Why the Traditional IC Model Is Losing Its Draw
Independent contracting offered the best of both worlds: freedom from employment rules and relief from running a practice alone. But today’s PaaS solutions have taken over much of the “difficult stuff”—billing, scheduling, marketing, credentialing—and they’re doing it at scale.
So, the question many clinicians are asking is:
“Why give up a percentage of my collections to a group practice when I can do all this myself, more easily, on a platform?”
That’s a hard question to answer without reevaluating what your practice offers that is truly unique or valuable.
Understanding the Landscape: What Today’s Clinicians Want
To retain (and attract) 1099s, it helps to understand the appeal of each working model:
✅ The Draw of a PaaS Company
- No non-competes
- Minimal oversight
- Automatic billing and payments
- Built-in referrals
- Ease of scheduling and charting
- AI tools that reduce burnout
✅ The Draw of a W2 Role
- Stability
- Camaraderie and teamwork
- Clinical supervision and mentorship
- Benefits and admin support
- Opportunities to grow into leadership
✅ The (Diminishing) Draw of 1099 in Group Practice
- Historically, higher pay splits, autonomy, some admin support
- Today, it feels like a middle ground without the perks of W2 or the independence and ease of PaaS.
What Can You Do to Compete?
If you’re already offering strong splits, credentialing, billing, and supervision, you’re well on your way. But here are three ways to level up:
1. Offer PMHScribe as a Core Benefit
AI charting is no longer a “nice to have”—it’s becoming expected. Offering PMHScribe shows that you value your clinicians’ time. It speeds up documentation, ensures CPT-compliant notes, and helps them meet the standards of any PaaS they may work with on the side.
2. Lean Into Support Without Micromanagement
PaaS companies win on ease and freedom. If your 1099s feel over-scheduled, over-supervised, or limited in their practice style, they’re more likely to leave. Consider how you can maintain clinical excellence without taking away their sense of autonomy.
3. Reframe Your Practice as a Launchpad
Not everyone wants to build a fully private practice—but many want to feel in control. Position your practice as a platform that supports clinicians who wish to be independent with real backup when it counts: team connection, admin help, and tools that work across any setting.
Final Thought
In a world where private practice is easier to launch than ever, and platforms offer plug-and-play careers, group practices must provide more than just the basics. With PMHScribe, you give your clinicians the documentation support and CPT tools they want—whether they work with you full-time, part-time, or cross-listed on multiple PaaS platforms.
Being competitive doesn’t mean trying to be everything. It means making your practice the best version of what it already is—and meeting clinicians where they’re going, not just where they’ve been.
