Practice Owner Decisions


For many practitioners, moving up from being an associate where you were a staff member to now buying or starting your own practice was both an exciting adventure but also an ice water dip.

There are so many duties and responsibilities that are suddenly all yours while at the same time you are the main provider of service to your patients.  To have a stellar practice that reaches maximum capacity takes guts, patience, leadership skills, management tools, and much more.

Some practice owners have the urge to hire an Office Manager right off the bat to offload all these management duties onto, but is this the right move?

Hire an Office Manager?

As a new owner, here are some points to consider before hiring an Office Manager:

  • It is YOUR practice now, and so you need to learn how to do everything yourself so you can train and correct your staff to ensure they are doing their functions correctly and to YOUR standards. Control = income.
  • When you give the running of a practice over to an Office Manager, you are putting YOUR reputation, YOUR take-home pay, and YOUR professional licence into someone else’s hands. 99% of the time, they are not trained executives either.  Even if they have “experience” in running someone else’s practice, it will be at the level they are capable of and this will be the level of your take-home pay.
  • Running a practice with 2 – 8 staff is a piece of cake without an Office Manager if you are a trained executive. (This is why we train our clients on management tools and leadership skills so they can be in full control of their practice yet not be stressed.  Management time is limited to 2 hours per week when trained.)
  • Financially, a salary for an Office Manager is not usually a prudent expenditure right off the bat. Overhead should be kept as low as possible for the first couple of years of ownership.
  • Even if you hire an O/M, you are still the boss and will need to give the O/M exact directions and make major decisions as it is your practice. And if they are sick from time to time or quit, it will all be back on your shoulders.


The key to managing your team is to delegate and document exact duties that each staff member is required to perform, and there should be an overall policy manual with protocols also written up for all to follow.  If all functions are covered by the staff team, and you take your weekly management time and know what to do, there is little need for an Office Manager.

However, if you reach more than 8 people in the practice, and you are now starting to feel like having an interface between you and the team, then an Office Manager may be in order.  Some of our clients have managed up to 12-16 staff without an O/M and without going crazy.  Systems and structure enabled them to accomplish this.

Systems and Structure

Management and executive training should include:

  • how to give orders that actually get immediate compliance,
  • how to conduct effective and inspirational staff meetings,
  • how to train staff to follow the protocols of the practice,
  • how to be a good leader,
  • effective communication skills,
  • how to write projects to improve various aspects of the practice and implement new ideas,
  • how to engage the team in creating an ideal practice,
  • pulling everyone together to accomplish high levels of quality patient care,
  • how to deal with hiring and other staff issues,
  • and so on.

Not saying Don’t …

We are not telling you to never hire an O/M.  Just use the above criteria to decide if you really need to spend $60,000+ per year for a good Office Manager yet.






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You have nothing to lose –
except an opportunity to enrich
your practice!