The #1 Hiring Mistake Private Practice Owners Make
Most clinic owners wait until they feel “safe” to hire. By then, the opportunity to grow — and the best candidates — are often already gone.
The #1 Hiring Mistake Private Practice Owners Make
Most clinic owners wait until they feel “safe” to hire. By then, the opportunity to grow — and the best candidates — are often already gone.
Secure My SpotIf you’re a private practice owner thinking about hiring your first clinician, there’s one mistake I see again and again.
Most clinic owners wait until they feel safe to hire.
And by that point, it’s usually too late.
The business is already stretched, the team is exhausted, and the opportunity to grow has already started slipping away.
Hiring your first team member is one of the biggest decisions you’ll make in your business. Done well, it unlocks growth and stability. Done poorly, it creates pressure, burnout, and a revolving door of staff.
The challenge is that many owners misunderstand when the right time to hire actually is.
The Myth: Wait Until You’re Safe
The most common advice floating around private practice is that you should wait until you’re very busy before hiring.
Often the benchmark people use is something like:
“Wait until everyone is 90% utilised.”
In theory, that sounds sensible.
In practice, it’s already too late.
By the time your clinic is running at 90% utilisation, you are effectively understaffed. Your clinicians are working above their sustainable capacity, and the entire team is carrying more pressure than the system was designed for.
This is when the problems begin.
How Burnout Starts
A typical clinician might be comfortable seeing around 45–50 appointments per week.
When demand spikes and they suddenly jump to 55 or 60 sessions per week, they can sustain that for a short period of time — maybe a few weeks.
But that workload isn’t sustainable.
Once that acute workload continues long enough, fatigue begins to set in. The quality of work drops, stress increases, and frustration builds.
This is often where the seeds of burnout are planted.
If you only start thinking about hiring when your team is already operating in this red zone, you’re reacting too late.
And the consequences can be serious.
Burnout is one of the earliest signs that hiring has come too late. In fact, this is where many clinics begin to experience churn — something I’ve written about previously in Staff Retention Starts with Psychological Safety.
When Growth Turns Into Replacement
One of the most frustrating things I see happen in clinics is this.
A practice goes through a very busy period. The team works extremely hard to keep up with demand.
But because the workload has been so high for so long, one of the strongest team members eventually decides they’ve had enough.
They resign.
Now the owner is no longer hiring to grow the business.
They’re hiring to replace someone they couldn’t afford to lose.
Instead of building momentum, the clinic is suddenly scrambling just to maintain stability.
The Opportunity You Miss When You Wait
There’s another problem with waiting too long.
You miss great candidates.
The right time for your business to hire is rarely the same as the right time for the best practitioners in the market to be available.
While you’re waiting for the perfect moment, excellent candidates may have already accepted positions elsewhere.
By the time you finally start recruiting, you’re often choosing from whoever happens to be available rather than from the strongest possible applicants.
That’s not a great starting position.
This is exactly why many clinic owners eventually start thinking more seriously about recruitment strategy — because attracting the right candidate requires more than simply posting a job ad when things get busy.
Think in Peaks and Troughs
A better way to think about hiring is to understand the natural peaks and troughs in your business.
Every clinic experiences them.
There are quieter periods during the year — Christmas and New Year, school holidays, and certain seasonal slowdowns.
But there are also predictable peaks where demand increases significantly.
These are the moments you want to plan around.
Instead of waiting until you’re already overwhelmed, the smarter strategy is to hire ahead of a growth period so your new team member can ramp up during a busy season.
When a new clinician enters the practice during a period of rising demand, they naturally pick up patients as the clinic grows.
That ramp-up process becomes far smoother.
The Real Hiring Strategy
Hiring should never be purely reactive.
It should be planned with foresight.
That means looking ahead and asking questions like:
- When is our clinic likely to hit its next busy period?
- Where is our revenue trending?
- When will our clinicians start approaching full capacity?
When you can see growth coming, that’s the moment to start preparing for a hire.
Recruitment itself often takes several months.
If you only begin the process when everyone is already maxed out, the business will remain under pressure for a long time.
If you’re unsure whether the timing is right, I’ve also written a deeper breakdown of how to know if you’re actually ready to hire, including the financial and operational signals that suggest the moment is approaching.
Confidence in Your Growth Systems
There’s another piece to this puzzle that many clinic owners overlook.
Confidence in your lead generation systems.
If your clinic relies purely on word-of-mouth referrals, hiring can feel extremely risky.
But if you have systems that consistently bring new patients into the practice — whether through referrals, partnerships, marketing, or other channels — the risk of hiring decreases significantly.
The clinic has the ability to grow into the new capacity.
This is what allows owners to make calculated growth decisions rather than reactive ones.
And if your bigger concern is not just recruitment, but building a clinic people actually want to stay in, read Attracting and Retaining Quality Staff.
The Real Risk
Every new hire carries some risk.
That’s true.
But the biggest risk I see in private practice isn’t hiring too early.
It’s choosing not to grow when the opportunity is right in front of you.
When the upside of growth outweighs the downside, it’s time to act.
And that decision should be made with planning, foresight, and confidence — not when the team is already exhausted and the clinic is under pressure.
There’s also a strong evidence base showing how widespread burnout is across healthcare workforces, which is why overload and poorly timed hiring decisions should be taken seriously rather than treated as a normal phase of growth. Read the systematic review here.
Thinking about your first hire?
I’m running a live paid workshop for private practice owners who want clarity before they commit. We’ll walk through financial readiness, hiring risk, and how to approach growth without destabilising your clinic.
Secure My SpotRead the full transcript
So here it is, the number one mistake clinic owners are making with their hiring.
I’m Shane Gunaratnam and I’m about to talk to you about why waiting until you feel safe to hire is a mistake.
It’s the number one mistake because often what ends up happening is you are already exhausted and your team is already exhausted. Your revenue has been building for weeks and weeks and it’s started to plateau. You’ve hit the top of that mark.
You’ve likely missed some really good candidates because you’ve been holding back, waiting for the right time. So often, the right time for your practice is not the right time for the best people in the market.
Now, the reason this fails is because as a team, as a unit, the workload often just starts going up and up and people get busier.
And this is actually where the seeds of a lot of clinician burnout occur.
If you think about it, your average clinician might be doing 45 to 50 appointments per week. If suddenly they’re doing 55 to 60 just to keep up with demand, they are working well above their chronic workload.
That spike can be maintained for maybe three or four weeks before they start to get very fatigued and the seeds of burnout start to show.
If we miss that growth window, it tends to close.
And the most frustrating thing is if we’ve been through a really busy period, that’s often when some of your A players go, “You know what? This is too hard.”
And it only takes one of those people to fall over after that peak period for you to be going from hiring to grow your team into hiring to replace a key team member.
And that’s the problem I see time and time again.
The best way to model when to hire people is thinking in peaks and troughs.
There are some really classic trough periods we’re all aware of — Christmas, New Year, most of January, even early February. It tends to be a very slow time for the majority of clinics with their new patients.
On the contrary, months like May and months like October are absolute peak times. There are no public holidays, there are no school holidays, and people tend to be around a lot.
We want to have staff hitting our teams when we’re about to hit those peak moments. That’s a really key thing in order to get new practitioners growing quickly and efficiently.
Now, the biggest myth I see is that you should wait until you are 90% utilised.
I’m sorry, but that is too late.
You are waiting too late to get your next team member in and you are literally understaffed at that point. No clinician I know likes to be 90% busy. They just start running into their red zone.
With some foresight, with some planning, you can see this coming.
These are the exact things I do with my private clients, by the way. We sit down, we look at where you’re at today and where your growth is coming, and so often it’s a case of going: right, we need to pull the trigger on hiring because we’re about to hit peak utilisation in a couple of months’ time.
The other thing we need is to have confidence in the systems themselves. You can generate new leads and new clients beyond simply word-of-mouth referrals coming into the practice.
So instead of waiting too late to hire and being fearful and trying to hold onto everything until it’s about to explode, we need to take calculated risks.
Every new hire is a risk, but the biggest risk is choosing not to grow when the opportunity is there.
When the upside outweighs the downside — when you can move up another level as a business if you get the right person in ahead of a busy period — that’s a massive signal that says: let’s get you going.
And the most important thing, regardless of when you hire, is to back yourself to get busier and have systems in place that support this.
Be confident in your lead generation. Be confident going out to source new referrers and get those things happening efficiently.
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