BetterHelp, Alma, Headway, Rula: What Private Practices Actually Need to Know
The Real Competitive Dynamics Between Platforms & Private
Practices, & Why the Biggest Threat Isn't What You Think
Overview of the Platform Landscape for Mental Health Practices
Walk into any room of group practice owners and bring up BetterHelp, Alma, Headway, or Rula. The temperature changes immediately.
There's frustration, there's anger, and there's a lot of uncertainty about what these platforms actually mean for the future of private practice.
Most of the conversation in the industry has centered on a single fear: these platforms are stealing our patients. And while that concern isn't entirely unfounded, these companies do dominate paid and organic search results in ways that individual practices struggle to match, the data tells a more complicated story. According to Jennifer Guidry, CEO of Solomon Advising, the most immediate and destabilizing threat these platforms pose to group practices isn't on the patient acquisition side. It's on the recruitment and retention side.
"Their biggest frustration does not come from them feeling like patients are going there," Guidry explains. "It's more from a recruitment and retention standpoint that it's a big threat. These platforms are enticing a lot of clinicians to come work for them, and they generally pay more than what a private practice can pay a therapist to take patients."
This reframing matters because it changes the strategic response. If the problem were purely patient acquisition, the answer would be to spend more on marketing. But when the threat is structural, when venture-backed platforms are reshaping clinician compensation expectations and making it harder for private practices to build stable teams, the answer requires a different kind of thinking.
This guide breaks down what each of these platforms actually does, where they genuinely compete with private practices, and where the conventional wisdom about them is wrong. It's designed to give practice owners a clear-eyed, non-reactive understanding of the landscape, not to villainize platforms that do serve a legitimate purpose, but to arm practice owners with the information they need to make smart decisions.
This topic is part of our comprehensive guide toTechnology & AI in Mental Health Practices, which covers the full landscape of how technology is impacting private practices and what owners need to know.
“We take a transparent approach with our therapists about the platforms that are out there, what they offer, what the risks and trade-offs are, and what we provide that's genuinely different. We'd rather have that conversation openly than pretend it's not happening. Most clinicians appreciate the honesty, and it reinforces why they chose to be here."
- Dr. Ronit Farzam, Owner of Center for Healing & Personal Growth
Understanding the Platform Landscape: What These Companies Actually Do
Before we can evaluate the competitive dynamics, practice owners need a clear picture of what these platforms are, how they work, and where they sit in the market.
BetterHelp: The Consumer-Facing Subscription Model
BetterHelp is the most recognizable name in online therapy, and it operates fundamentally differently from the other platforms on this list. Founded in 2012 and acquired by Teladoc Health, BetterHelp is a direct-to-consumer subscription service. Patients pay a weekly fee, typically ranging from $65 to $100, billed every four weeks, and receive access to a licensed therapist for messaging, live chat, phone, and video sessions.
Therapists on BetterHelp are independent contractors, not employees. The platform's compensation structure has been a persistent point of controversy: therapists report starting rates around $30 per hour on a tiered system that increases with hours worked, but the structure resets weekly, and the effective rate remains well below what most licensed clinicians earn in traditional practice settings. The platform's own review data reflects this; on Indeed, only 19% of BetterHelp contractors report feeling their compensation is appropriate for the work they do.
BetterHelp has also faced scrutiny beyond compensation. In 2023, the Federal Trade Commission investigated the company for sharing sensitive user data with third-party advertisers, including Meta and Snapchat. More recently, reports have surfaced of therapists using AI-generated messages in chat sessions, a symptom, critics argue, of a model that pushes clinicians toward unsustainable caseloads. The platform's parent company, Teladoc, reported a $1 billion net loss in 2024, with BetterHelp's user base contracting to approximately 397,000 paying members by early 2025, an 11% decline from the prior year.
For group practices, BetterHelp is less of a direct competitor for patients and more of a market force that shapes patient expectations about pricing, access, and convenience. It's also a cautionary tale about what happens when venture capital prioritizes growth over the therapeutic relationship.
Headway: The Free-to-Join Insurance Marketplace
Headway, founded in 2019, operates what might be the most aggressive growth model of the four. Unlike Alma, Headway charges therapists nothing to join. The platform handles credentialing, billing, and scheduling and now offers a free built-in EHR. Headway makes its money by negotiating rates with insurance companies and retaining the margin between what insurers pay and what therapists receive, though it positions this as securing "better rates than therapists could get on their own."
The numbers tell the growth story: Headway has raised over $321 million in venture funding at a valuation of $2.3 billion. The platform now works with over 34,000 providers and more than 40 insurance plans, facilitating over 600,000 therapy appointments per month. Its investors include Spark Capital, Andreessen Horowitz, Thrive Capital, and Accel.
Headway's competitive pitch to clinicians is compelling: free credentialing, guaranteed payment on a predictable schedule, and zero platform fees. For a solo practitioner who wants to accept insurance without the administrative burden, this eliminates one of the primary reasons clinicians have historically joined group practices. The platform has also been expanding into Medicare Advantage and Medicaid, segments where group practices often have established relationships but face increasing competition.
Headway has also faced scrutiny on several fronts. The company is currently being sued for allegedly sharing patient data with Google, a claim that, if validated, would represent exactly the kind of privacy concern that makes mental health data uniquely sensitive. On the provider side, the "free" model obscures a significant detail: independent analysis has found that Headway adds a 40-70% markup on top of what it pays therapists when billing patients' insurance, meaning patients with deductibles can face substantially higher costs than they would with a therapist who contracts directly with their insurer. And therapists who are credentialed through Headway are credentialed under Headway's tax ID, not their own, meaning if they leave the platform, they don't take those insurance contracts with them. They've built a caseload they don't fully own. In early 2025, Headway also announced significant reimbursement rate cuts for Optum-insured clients, in some cases as steep as 30%, prompting therapists in high-cost markets to report projected annual income losses of $13,000 to $28,000. Several clinicians reported that Headway's new Optum rates were actually lower than what they could have negotiated independently, undermining the platform's core value proposition of securing better rates.
Alma: The Membership-Based Practice Support Platform
Alma occupies a different position in the market. Founded in 2018 and headquartered in New York, Alma is a membership-based platform that helps independent mental health providers accept insurance and manage their practices. Clinicians pay $125 per month (or $1,140 annually) for access to insurance credentialing, billing tools, a telehealth platform, scheduling, a provider directory, and a community of other clinicians.
Alma's network has grown to over 21,000 providers across all 50 states, and the company has raised more than $220 million in venture funding from investors including Thoma Bravo, Cigna Ventures, and Optum Ventures. That last detail is worth noting: a significant portion of Alma's investment comes from the venture arms of the very insurance companies that therapists on the platform are billing through. A 2025 survey by the Psychotherapy Action Network found that 85% of therapists said they wouldn't use a platform if they knew it was owned by an insurance company, yet 70% were unaware of who actually owns these platforms.
In late 2024, Alma providers experienced reimbursement rate adjustments from some insurance partners, most notably UnitedHealthcare/Optum, that led to significant frustration. The platform also contracted with Upheal, an AI clinical documentation startup, to create a note-taking system that was subsequently reported to produce inaccurate clinical narratives.
For group practices, Alma competes most directly in the insurance-based space. It effectively enables solo practitioners to access the credentialing, billing, and administrative infrastructure that group practices have traditionally provided, without the clinician needing to join or stay in a group practice to get those benefits.
Rula: The AI-Driven Matching Platform
Rula (formerly Path Mental Health) is the newest and fastest-growing of the four. Founded in 2019, the company has raised approximately $263 million in total funding, including a $143 million Series C round in 2024 led by Hedosophia. Rula's estimated annualized gross revenue reached approximately $471 million in 2024, roughly doubling year over year.
Rula's model centers on algorithmic matching. Patients fill out information about their preferences, gender, specialty, cultural background, treatment approach, and Rula's system matches them with an in-network therapist. The company claims that 97% of searches result in a match, with appointments available as soon as the next day. The platform operates in all 50 states, works with over 15,000 providers across more than 80 clinical specialties, and covers more than 120 million lives through its insurance partnerships with Aetna, Anthem, Cigna, Kaiser, UnitedHealthcare, and most Blue Cross Blue Shield plans.
What distinguishes Rula is the scale and sophistication of its partnership strategy. In 2024, Rula partnered with Amazon Health Services to make its provider network discoverable through Amazon's Health Condition Programs, meaning Amazon customers can now search for mental health support using keywords like "anxiety relief" and be routed to Rula's network. Rula has also partnered with Curai Health, Sidecar Health, and multiple employer assistance programs, embedding itself into the infrastructure through which patients discover and access care.
For group practices, Rula represents perhaps the most direct long-term competitive threat in the insurance-based space. Its matching algorithm, its scale, its institutional partnerships, and its growing ability to direct patient flow through channels that group practices cannot access all point to a future where a significant volume of insurance-based patient discovery happens through platform intermediaries rather than through the practice's own marketing and referral efforts.
But Rula's rapid growth hasn't come without friction. On the provider side, therapist reviews reveal a recurring pattern: clinicians report being promised robust referrals during onboarding, receiving an initial burst of client matches that creates buy-in, and then seeing referrals dry up once they're no longer categorized as a "new provider." Multiple therapists have described this as a bait-and-switch. Others have flagged what they perceive as increasing micromanagement, including a system where clients rate their therapeutic alliance with their therapist, and the therapist is then expected to discuss those ratings in session, a practice that some clinicians view as an intrusion into the clinical relationship. Rula also halted annual pay increases for therapists in 2024, even as the company continued securing new insurance contracts and partnerships. And in at least one reported case, a therapist's contract was terminated with less than an hour's notice before a scheduled patient session, with Rula then emailing the therapist's patients to notify them of cancellation, raising serious questions about continuity of care and how platform decisions impact the therapeutic relationship.
These companies are not all the same;
They operate different business models, serve different segments of the market, and interact with private practices in different ways.
These Four Aren't the Whole Story
It's worth noting that BetterHelp, Alma, Headway, & Rula are the most prominent players, but the platform landscape extends well beyond them.
New entrants continue to appear, and existing platforms continue to expand their services and partnerships.
Grow Therapy, which claims over 15,000 providers and operates a model similar to Headway's, is growing rapidly. Talkspace is publicly traded and has pivoted toward insurance-based care. SonderMind operates a hybrid model connecting patients with both in-person and virtual providers. Zocdoc, while not a therapy-specific platform, increasingly surfaces mental health providers in its marketplace and drives patient discovery in ways that compete directly with practice websites.
The point is that this is not a four-company problem. It's a structural shift in how the market for mental health services is being intermediated, and practice owners need to understand the dynamics, not just the individual players.
What These Platforms Have in Common
Despite their differences, all four major platforms share structural characteristics that matter for private practice owners:
They are all venture-backed, which means they are optimized for growth, market share, and eventual return on investment, not for the long-term sustainability of individual therapeutic relationships. They all treat clinicians as independent contractors or members, not as employees with the support structure, supervision, and professional development that a well-run group practice provides. They all dominate digital search results through marketing budgets that no individual practice can match. And they all, to varying degrees, are reshaping what clinicians expect in terms of compensation, flexibility, and administrative support, expectations that private practices are then measured against, often unfairly.
The Real Threat, It's Recruitment, Not Patients
Here is the insight that reframes the entire platform conversation for group practice owners:
The most immediate competitive threat from these platforms is not that they're taking your patients. It's that they're destabilizing your ability to recruit and retain clinicians.
"These platforms are enticing a lot of clinicians to come work for them," Guidry explains. "And they generally pay more than what a private practice can pay a therapist to take patients. That creates a really uncomfortable market reality as an employer, as someone who is trying to recruit and retain clinicians."
The economics behind this are structural.
Venture-backed platforms operate with fundamentally different financial models than private practices. They have access to hundreds of millions of dollars in investment capital. They don't carry the fixed costs of brick-and-mortar offices. Many of them can afford to operate at a loss, or at razor-thin margins, for years while building market share. This means they can offer clinicians higher per-session compensation, at least in the short term, because they're subsidizing that compensation with investor capital rather than generating it through sustainable practice economics.
Private practices, by contrast, operate on fee-for-service economics with high fixed costs. In order for a group practice to competitively compensate its clinicians, those clinicians need to maintain a certain level of productivity to cover both their own compensation and their share of the practice's overhead, rent, administrative staff, technology, insurance, marketing, and the owner's ability to sustain the business. A practice with 15 clinicians can't absorb the same economics as a platform with 15,000 independent contractors operating from their own homes with no shared overhead.
The result is a compensation perception gap that creates real resentment. "Clinicians don't really know how to evaluate that," Guidry notes. "So they then just assume that private practices are undercutting or are not paying them what they deserve or what they should make as a clinician. And so they have resentment, and they feel like their practice owners are just in it for their own profit, which could almost never be further from the truth. Almost every private practice that I work with is barely scraping by from a profitability standpoint and cares tremendously about wanting to compensate their therapists at the highest level that they possibly can and still survive."
This dynamic puts practice owners in an impossible position. They can't match platform compensation without undermining the financial viability of their practice. But they also can't ignore the market reality that their clinicians are being presented with seemingly better offers from platforms that don't have the same cost structure or long-term obligations.
→ What Clinicians Discover When They Try Platforms
The saving grace, and it's a real one, is that the platform experience often doesn't live up to the recruiting pitch. Solomon Advising has observed a consistent pattern: clinicians who leave private practices for platforms frequently return, and the reasons are remarkably consistent.
They felt unsupported. Unlike a group practice environment where clinicians have access to supervision, collaboration, peer consultation, and administrative support, platform clinicians are largely on their own. There's no clinical director to consult with on a complex case. There's no front desk handling intake calls. There's no billing team resolving claim denials.
They experienced a bait-and-switch on compensation tied to productivity expectations. The headline rate looked attractive, but achieving it required maintaining caseloads that were unsustainable. On BetterHelp, therapists report needing to see 8 to 10 clients per day to make the economics work. Even on platforms with higher per-session rates, the pressure to maintain volume, combined with the lack of administrative support, creates a workload that leads directly to the third issue.
Burnout. The combination of high caseloads, lack of support, isolation from professional peers, and the inherent limitations of an all-telehealth model creates conditions that are fundamentally at odds with sustainable clinical practice. Clinicians who left group practices seeking higher pay and more flexibility often find themselves working harder, in greater isolation, with less professional fulfillment.
"Clinicians try these platforms, and many of them leave in droves," Guidry observes. "They feel very unsupported. They feel like these are just mills. They don't feel like they get the front office or the back office support that they need."
This doesn't mean platforms are going away. They will continue to evolve and improve. But it does mean that the competitive advantage of a well-run group practice, genuine clinical community, structured supervision, professional development, administrative infrastructure, and the ability to build a career rather than just fill a schedule, is real and durable. The challenge is communicating that advantage to clinicians who are being recruited with higher headline numbers and promises of flexibility.
The Clinician Moonlighting Problem, & the Policy Gap Most Practices Haven't Closed
There's a more immediate version of the recruitment threat that practice owners need to address: clinicians who are working for the practice while simultaneously maintaining active profiles on one or more platforms.
This is widespread.
Clinicians want the best of both worlds: the structure, community, and patient pipeline of a group practice, combined with the supplemental income and flexibility of a platform. From the clinician's perspective, this often feels harmless. Their practice is still building their caseload, or they want to work additional hours beyond what the practice needs, or they simply want a financial safety net.
From the practice's perspective, it's a direct threat, and one that most practices haven't addressed through a clear policy.
"Therapists often do this naively and don't see this as a threat," Guidry explains. "They feel like, 'okay, well, I'm working for this practice, and they're working to fill my schedule, but I want to work more or it's taking them a while to fill my caseload. So I'm gonna launch on some of these platforms and start taking some patients so that I can make some extra money.' They want the best of both worlds, but it absolutely is a threat to the group practice."
The threat operates on multiple levels. First, there's the direct competitive issue: a clinician seeing patients through Rula or Headway on the side is effectively competing with their own practice for the same insurance-based patient population. Second, there's the retention risk: a clinician who builds a side caseload on a platform has a lower switching cost when they decide to leave. Third, there's the brand erosion issue, and this is the one that practice owners often don't see until it's too late.
Guidry describes a specific scenario she's navigated: "In this instance, the staff member is a supervisor, and she's also a site lead, meaning she basically runs the branch office and is seen as the primary leader in that location. And if other therapists see that she's also promoting herself as a private practitioner and taking patients that way, what does that do to erode the brand, to erode the impression of leadership?"
When a practice's most visible clinicians are simultaneously marketing themselves on outside platforms, it sends a message to every other clinician on the team: this practice isn't enough. That message undermines culture, retention, and the practice's ability to position itself as a destination employer.
"We realized we needed clearer policies around outside employment and platform participation. It's not about being controlling; it's about protecting the brand and being upfront about expectations. Most clinicians respect that when it's handled professionally."
- Laura Slagle, Practice Owner of Olive Leaf Family Therapy
Closing the Policy Gap
Most group practices have policies prohibiting clinicians from operating their own private practice on the side or working for a competing practice. What most practices don't have is clear language that treats platform participation as equivalent to working for another practice, because when these policies were written, these platforms didn't exist.
The fix is straightforward but requires deliberate action. Practice owners should update their employment agreements and policies to specifically address participation on third-party therapy platforms. While specific requirements vary by state, and practice owners should work with employment counsel to ensure compliance, the general framework should include a requirement that clinicians disclose any outside clinical work, including platform participation, and a process for evaluating whether that work creates a conflict of interest.
Guidry is careful to note that being overly prohibitive can backfire. "Most states are very specific on what you can and can't prevent people from doing in terms of moonlighting or additional employment opportunities. It's not usually worth it to try to be prohibitive on that side." The goal isn't to control clinicians' lives; it's to ensure transparency and protect the practice's competitive position and brand integrity.
The broader lesson here is that the platform landscape has created a new category of employment risk that most practice policies haven't caught up to. Closing that gap isn't optional; it's a necessary operational update for any group practice operating in today's market.
The Review Imbalance: Why Platforms Play by Different Rules
There's a competitive dynamic that practice owners are right to be frustrated about, and it involves one of the most powerful signals in modern patient discovery: reviews.
Most licensing boards, at both the national level and state by state, have guidelines that generally consider direct solicitation of patient reviews to be an ethical violation.
The reasoning is sound: a therapeutic relationship creates a power dynamic that makes a review request inherently coercive, and patients should never feel pressured to publicly comment on their mental health treatment.
But there's a significant gap between how individual practice owners interpret and apply these guidelines and how large platforms approach them.
"What I'm seeing is these larger organizations are taking a look at the ethical guidelines, and they are interpreting them as broadly as they feel safe and legally able to do," Guidry explains. "They've got their attorneys that are interpreting, well, what does it mean to 'solicit'? And if you just provide access or if you indirectly ask, then that's not solicitation."
The structural separation is what makes this possible. When Alma or Headway, as an organization, not as an individual therapist, sends out a patient satisfaction survey or a review request, there's enough distance between the platform entity and the therapeutic relationship to create legal cover. These platforms have legal teams dedicated to finding the widest acceptable interpretation of "solicitation." Individual practice owners, whose personal licenses are on the line, understandably err on the side of caution.
The result is an uneven playing field. Platforms accumulate reviews at a pace that individual practices cannot match, and those reviews increasingly factor into how both traditional search engines and AI tools rank and recommend providers. Practice owners feel this imbalance acutely. "I don't know of any other industry where it is considered an ethical violation to solicit or ask for a review," Guidry notes, "but in mental health it is."
This doesn't mean practice owners are powerless. Solomon Advising works with practices on approaches that respect each owner's interpretation of the ethical guidelines while still creating opportunities for patient feedback. These include placing a QR code in the waiting room or checkout area that invites patients to share feedback on their experience, with the code linking to either a Google review page or a patient satisfaction survey. Similar invitations can appear in the footer of practice newsletters alongside social media links, positioned as an available option rather than a direct request. Patient satisfaction surveys themselves serve a dual purpose: they generate valuable feedback for quality improvement, and for patients who choose to share positive experiences, they can provide website testimonials with permission or a link for patients who wish to leave a public review on their own initiative.
The competitive concern is real, particularly as AI tools increasingly incorporate social proof into their recommendations. But the solution for practice owners isn't to match platforms in aggressiveness; it's to build a review strategy that's consistent, ethical, and integrated into the patient experience in a way that feels natural rather than forced.
The Pendulum Argument
Why the Right Way to Do Therapy Still Wins
It's easy to read the platform landscape and feel like the walls are closing in. The funding numbers are staggering. The growth rates are impressive. The partnerships, Amazon, major insurance carriers, and employer assistance programs, suggest a future where platforms control more and more of the patient discovery pipeline.
But there's a pattern that Guidry has watched play out over the past several years that should give practice owners genuine reassurance.
"We're already seeing that with everybody joining these platforms in droves in order to do telehealth, and that all happened through COVID. So many realized, actually, that telehealth is not really working as well for me. I really need to go to a space that is carved out and has that person-to-person interaction. And so we're now seeing this huge return in droves of people who are demanding and wanting in-person, largely because of their experience on these platforms."
We're seeing more patients specifically asking for in-person care after spending time on telehealth platforms. That trend has only reinforced our confidence in the group practice model. What we offer is fundamentally different, and patients are recognizing that."
- Christine Chae, Owner of Abundance Therapy Center
The pendulum has already swung once. The pandemic pushed millions of patients into telehealth, and platforms were the primary beneficiaries.
But as patients experienced the limitations, the lack of physical presence, the transactional feel, the difficulty of building a genuine therapeutic relationship through a screen, many began seeking what they'd had before, or what they'd always wanted: in-person care from a therapist they could build a real relationship with, in a practice that felt like a real place.
Guidry sees the same dynamic likely playing out with AI therapy tools. "I don't think there's anything inherently evil or wrong about it. I think it will, in some ways, drive adoption in a way that long-term funnels people back to in-person therapists. People who feel uncomfortable about going to therapy or are nervous, this is an easier barrier to entry. I think they'll experience it, realize that it's helpful in some ways, but now I realize that I really need legitimate support and help, and they're going to turn to where that help actually lives."
This isn't wishful thinking; it's grounded in what makes mental health treatment fundamentally different from other services that technology has disrupted. "The key to true, successful mental health treatment is still largely dependent on the relationship between patient and clinician," Guidry emphasizes. That relationship, built on trust, consistency, presence, and the kind of nuanced human connection that no algorithm can replicate, is what group practices offer at their best.
There's also a quality signal embedded in the group practice model itself that platforms can't easily replicate. "In order for a group practice to survive, to pay for a brick-and-mortar office and all of that, you actually have to be pretty good," Guidry argues. "You have to have built a reputation that can sustain itself in the market. If a patient doesn't really know how to assess whether a practice is any good or whether a therapist is any good, one easy metric is: do they have a business? Does it exist? Do they have a physical location? Are they surviving? Because if so, they're already a step ahead of everybody who's just listing their services as individuals."
This doesn't mean practice owners should be complacent. The platforms are real, the competition is real, and the need to adapt is real. But the argument for group practice, the argument for clinical community, for structured support, for in-person care, for the kind of institutional depth that only comes from building something sustainable, is not getting weaker. If anything, the limitations of the platform model are making it stronger.
The Honest Answer on Partnering
Practice owners inevitably ask: Should we just join one of these platforms to get more patients?
They're arriving in clinical workflows right now, and practice owners are being forced to make purchasing decisions with incomplete information.
Guidry's answer is clear: "My advice generally, almost universally, is to stay independent. There have just been too many instances where it has proved to be a negative experience to tie yourself to these entities."
There are practices that do partner with platforms, and there may be specific scenarios where the math works. But the fundamental issue is that participation blurs the line between independent practice and platform dependency. "The strength of being a private practice is your independence, your ability to build your reputation and your network and your community outside of this. If you blur it, then you diminish that which is inherently advantageous about your model in the first place."
This doesn't mean ignoring what platforms do well. Understanding how they acquire patients, how they position themselves in search results, and how they meet patient expectations around convenience and access can inform a practice's own strategy. But the response should be to strengthen your independent position, better digital presence, stronger referral networks, more intentional branding, and content that meets patients where they're actually searching, not to hand over your patient pipeline to an intermediary whose incentives may not align with yours.
→ How This Relates to Technology & AI in Mental Health Practices
The platform landscape is one dimension of a broader technology transformation impacting mental health practices. Understanding how platforms compete, and where their models fall short, connects directly to decisions about your digital presence, your content strategy, your recruitment approach, and your technology investments. This topic is part of our comprehensive Technology & AI Guide for Mental Health Practices, which provides practice owners with the full picture of what's changing and how to respond strategically.
key takeaways
1. The Biggest Platform Threat Is to Your Team, Not Your Patient Pipeline
While platforms do compete for patient attention in search results, the most immediate and destabilizing impact is on clinician recruitment and retention. Venture-backed platforms can offer higher per-session compensation because they operate with fundamentally different cost structures, but clinicians who try them frequently return to private practice after experiencing a lack of support, unsustainable productivity expectations, and burnout. The competitive advantage of a well-run group practice, genuine community, structured supervision, and sustainable careers is real and durable.
2. Your Employment Policies Probably Haven't Caught Up to the Platform Era
Clinicians maintaining active profiles on therapy platforms while working for your practice is a competitive, retention, and branding risk that most practices haven't addressed through a clear policy. Update your agreements to require disclosure of outside clinical work, including platform participation, and create a process for evaluating conflicts of interest. This isn't about being prohibitive; it's about transparency and protecting your practice's position.
3. Stay Independent, The Case for Private Practice Is Getting Stronger, Not Weaker
The pendulum is already swinging back. Patients who experienced telehealth-only platforms during COVID are returning to in-person care. Clinicians who left for platforms are coming back after experiencing the limitations firsthand. The fundamental value proposition of group practice, clinical community, professional development, institutional depth, and the kind of sustained therapeutic relationships that drive real outcomes is exactly what platforms struggle to deliver. Strengthen your independent position rather than blurring it through platform partnerships.
Related Articles & Resources
To further your understanding of the platform landscape and its impact on private
practices, we've curated a selection of related articles and resources. Back To Pillar Page.
frequently asked questions
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It depends on your practice type and market. Insurance-based practices are more likely to feel direct patient competition because platforms like Headway, Alma, and Rula operate in the same insurance networks and increasingly dominate search results for in-network providers. Private pay practices are less directly impacted on the patient side, though they face competition for visibility. But for most group practices, the more pressing concern is that platforms are reshaping clinician compensation expectations and making recruitment harder, which indirectly affects your ability to serve patients by making it harder to maintain a full, stable clinical team.
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You should be aware of it, but panic isn't productive. The pattern Solomon Advising observes consistently is that clinicians who leave for platforms often return after experiencing the reality: lack of clinical support, unsustainable productivity demands, professional isolation, and burnout. The best defense isn't trying to match platform compensation, it's building a practice environment that delivers what platforms can't: genuine clinical community, structured supervision, professional growth, and a sustainable career path. Make sure your employment policies are updated to address platform participation, and have honest conversations with your team about the trade-offs.
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Address it directly but constructively. Most clinicians don't see platform participation as competitive with their group practice role, they see it as supplemental income or a way to fill gaps in their schedule. Start with a conversation about why this creates a conflict of interest: they're effectively competing with your practice for the same patient population, it creates a retention risk, and if they're in a leadership role, it can erode the practice's brand and culture. Then update your policies. Require disclosure of outside clinical work, treat platform participation as equivalent to working for another practice, and create a clear process for evaluating whether outside work is compatible with the clinician's role at your practice. Work with employment counsel to ensure your approach is compliant with your state's labor laws.