What does it cost a therapy practice to lose a clinician?
Losing a clinician costs a private-pay group practice their monthly contribution (what they bill minus what they are paid) multiplied by the months the seat is effectively empty, plus the hard costs of replacing them. At typical private-pay group numbers, that lands between roughly $12,000 and $40,000 per departure. This is the Departure Cost, and you can compute yours exactly.
The Departure Cost formula
Departure Cost = monthly contribution × months the seat is effectively empty + hard replacement costs.
Contribution is the number no dashboard hands you: what the clinician bills minus what you pay them. It is what the seat actually earns the practice each month, and it is the number that stops arriving the day they give notice. The seat is “effectively empty” from their last full caseload month until the replacement is fully ramped, not merely hired: recruiting typically takes one to two months, and a new clinician builds to a full caseload over two to four more.
A worked example
A clinician bills $12,000 a month on a 60 percent split. Their contribution is $12,000 minus $7,200, so $4,800 a month. Four months from departure to a ramped replacement costs $19,200 in lost contribution. Add recruiting ads, the background check, credentialing time, and onboarding admin, call it $3,500, and the departure cost is about $22,700. Not a survey number: arithmetic you can rerun with your own inputs.
Why the numbers you find elsewhere run high
Most published figures come from physical therapy ($65,000 to $75,000 per departure) or physician turnover (upwards of $750,000). Those reflect insurance volume, referral machinery, and salaries that a 2-to-15-clinician private-pay mental-health group does not have. The honest mental-health number is smaller, but it is not small: at common private-pay group numbers (billings of $8,000 to $15,000 a month, splits of 55 to 65 percent, three to six months to a ramped replacement), the formula produces roughly $12,000 to $40,000.
What actually shrinks it
The months term dominates the formula, so the levers are the ones that shorten the empty stretch: a warm hiring pipeline before you need it, credentialing started the day the offer is signed where it applies, and a ramp plan that fills the new caseload deliberately instead of passively. Cutting the empty stretch from five months to three saves more than any recruiting discount ever will.
Run this on your own numbers, free, nothing leaves your browser: the cost-of-losing-a-therapist calculator →
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