What a new clinician costs, and when the hire pays for itself
A hire costs more than the salary: payroll tax and benefits, a software seat, supervision time and the setup before the first session come on top. The hire pays for itself in the first week the clinician's running total, what they collect less what they cost, reaches zero and stays there.
Work out your hire
Every number starts as an example. Replace each one with your own.
Months until the hire has paid for itself 9.2
Months until the hire has paid for itself
9.2
Counting the $2,400 spent before the first session.
- Cash to carry before that
- $9,598
- The deepest the running total goes. Earnings dip first and recover second.
- True monthly cost at a full caseload
- $7,813
- Salary alone is $5,667 of it.
- What that costs as a share of what they collect
- 83.1%
- A 60/40 split in the clinician’s favor is 60%. Compare that number with this one before offering a percentage rather than a salary.
- Monthly contribution once full
- $1,587
These figures use the example numbers, which are not an average. Replace them with your own.
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How the calculator gets its answer
- The true monthly cost is the salary with payroll tax and benefits added, spread over twelve months, plus the software seat and the supervision hours at the rate you give them.
- Each week the clinician collects the sessions they hold times the revenue per session. Sessions run only in working weeks, while the cost runs every calendar week, so a week earns its share of a working week.
- Sessions start at the day-one figure, never above a full caseload, and rise in a straight line to the full-caseload figure over the weeks you give.
- The running total starts at minus the one-off setup. The hire has paid for itself in the first week the total reaches zero and stays there. A total that touches zero and falls back does not count.
- Cash to carry is the lowest point the running total reaches before it recovers.
- If the total does not settle above zero within the years the calculator looks ahead, it says there is no payback instead of a month.
It counts only what you enter. Rent, marketing, billing fees and the owner's time beyond the supervision hours are not in it. Revenue is what your practice collects, so enter what reaches your account and not what you bill.
A worked example
Take the example numbers in the calculator. The practice pays the clinician $68,000 a year, with 22% added for payroll tax and benefits. Setup costs $2,400, the software seat $180 a month, and 6 hours of supervision a month are worth $120 an hour.
The clinician holds 5 sessions a week at the start and 20 at a full caseload, reached in 16 weeks. The practice collects $120 a session over 47 working weeks a year.
The true monthly cost is $7,813, of which the salary is $5,667. At a full caseload the cost is 83.1% of what the clinician collects, and the practice keeps $1,587 a month after paying it. The running total falls to $9,598 below zero before it turns, and the hire has paid for itself after 9.2 months.
Change the salary, the ramp or the revenue per session and the payback moves by months.
Where the starting numbers come from
Each starting number is an example for you to replace. None is an average, a survey result or a figure from a rule.
- Annual salary, starting at $68,000
- An example, not an average. Enter the salary you would offer.
- Payroll tax and benefits, starting at 22%
- An example, not an average. Enter your own rate.
- One-time setup, starting at $2,400
- An example, not an average. Enter what you would spend.
- Software seat a month, starting at $180
- An example, not an average. Enter your software cost for one more clinician.
- Supervision hours a month, starting at 6
- An example, not an average. Enter the hours you would give.
- What an hour of that time is worth, starting at $120
- An example, not an average. Enter what an hour of that time is worth to your practice.
- Sessions a week on day one, starting at 5
- An example, not an average. Enter the sessions you expect in the first week.
- Sessions a week at a full caseload, starting at 20
- An example, not an average. Enter what a full caseload means in your practice.
- Weeks to a full caseload, starting at 16
- An example, not an average. Enter how long you expect the caseload to take to fill.
- Average revenue per session, starting at $120
- An example, not an average. Enter what your practice collects for a session.
- Working weeks in the year, starting at 47
- 52 weeks less 5 for holidays and planned leave. Enter the weeks you expect.
The guide on this question
What it costs to hire a clinician, and when the hire pays for itself goes through each cost in the order an owner meets it.
Priced by the size of your practice
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