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How to manage clinician performance in your group practice

Overseeing clinician performance through assessments and feedback ultimately improves the quality of care. Here’s where to start.

January 23, 2026

By Ryan DeCook, LCSW

8 min read

By Ryan DeCook, LCSW

Clinicians are the heartbeat of your practice. When they maintain full schedules and their clients are satisfied, your practice runs smoothly. When they struggle with client retention and utilization, the entire practice feels it. So how do we, as group practice managers, track the pulse of their clinical work and choose the right approach for our practices?

Below, we’ll cover a few different ideas for measuring and managing the performance of your group practice’s providers — whether you have two or two hundred employees.

Why managing performance matters

Keeping a view of performance with the right metrics gives you a picture of the overall health of your practice. It can reveal where things are running smoothly, where there may be gaps in processes, and which systems need improvement. 

Managing performance through assessing and providing feedback to clinicians is a part of ethical supervision, according to governing bodies such as The American Psychological Association and The National Association of Social Workers. For pre-licensed staff, regular feedback and assessment are required components of clinical supervision under most state licensing boards to achieve full licensure. For licensed clinicians, performance discussions support quality care and professional development.

Put simply, it improves the quality of care. It shows where there are breakdowns in delivery of care. If there are challenges that clinicians are facing, support can be put in place to help them navigate whatever they’re navigating or to improve their skill gaps if necessary. Monitoring care in this way helps to improve outcomes and overall experience for the clients.

Turnover and burnout can be reduced by staying connected to the team, having transparency, and providing effective supervision. When team members are connected and having ongoing dialogue, misunderstandings are reduced, clinicians feel supported, and feedback is delivered more readily. According to Kira Torre, chief clinical officer at Ever After Therapy, it’s supremely important to always engage your staff.

Performance starts with the hiring process

Reviewing a clinician’s performance starts in the interview room. As you and other team members get to know candidates, their ability to meet the performance standards of the practice must be a major topic of inquiry. Ask specific questions about past performance, expectations at previous jobs, schedule utilization, and client retention. Ask them how they kept track of their own performance standards. References from past supervisors and practice owners can provide valuable insight into their performance patterns. When you hire someone who is motivated, skilled, works autonomously, and achieves their goals, you’re already on the right track.

Note: This article discusses administrative performance management in group practices. Clinical supervision requirements vary by state and license type. Practice owners should consult their state licensing boards and obtain appropriate clinical supervision credentials before providing clinical supervision to pre-licensed staff.

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Empowering clinicians with measurement-based care

One way to monitor performance is to implement measurement-based care, though it should never be the only metric to measure performance. Measurement-based care enables your clinicians to utilize ongoing assessments to track client progress and feedback. This is often used with validated assessments such as the PHQ-9 for depression, GAD-7 for anxiety, PCL-5 for trauma, or Outcome Rating Scale (ORS). These can be offered before each session or on a different cadence that makes the most sense for each client. While not comprehensive, these assessments give clinicians insight into their own clinical effectiveness. Administrators can also access these results to inform performance conversations when needed. However, anchoring performance conversations primarily on symptom scores risks oversimplifying clinical care and can inadvertently strain the relationship with providers rather than support their growth. They should be used as one data point among many.

Monitor the metrics

Keeping in tune with your practice means listening to the right metrics for the business. Torre notes that in her practice, what she monitors the most are missed appointments, a clinician’s booking frequency, documentation completion times, and client retention. This helps her understand who’s growing, staying the same, or decreasing. 

Torre encourages practice owners and clinical directors to keep an eye on these metrics because they can give an overall sense of the business. You’ll want to monitor for low client retention, delays in documentation completion, low booking frequencies (Torre says to look out for rates below 70-80%), and high amounts of missed appointments. 

Choosing your approach

Structured supervision with pre-licensed clinicians

Structure is usually built in with pre-licensed clinicians, as many group practices have licensed supervisors on staff who provide the supervision required for licensure. When these supervisory meetings are already happening consistently and there are goals related to their licensure requirements, it can be fairly simple and expected to have conversations around their performance. Are they meeting their licensure requirements? How are they doing with the performance metrics of the practice? How are their clients doing? Are they needing support anywhere? These are all questions that can be openly discussed in the context of supervision. 

Torre says mutually agreed-upon goals are discussed and reviewed in weekly supervisory meetings in her practice. Note that when you serve as both clinical supervisor and employer, be mindful of the dual relationship. Some practices separate these roles — having one person provide clinical supervision while another handles administrative performance reviews. If your practice outsources your clinical supervision, you’ll have to find other ways to support and have these feedback conversations. 

Structured reviews with licensed clinicians

Carve out planned times to review clinical performance. These meetings could occur annually, more frequently as part of ongoing clinical meetings, or a combination of both. APA recommendations on supervision suggest having defined competencies (knowledge, skills, attitudes, values) that have observable evidence to them and can be discussed. They emphasize it’s important to measure what the clinician does, not who they are. The business metrics can be reviewed as well.

Some research shows that these conversations should balance performance accountability with professional development. Ideally, this shouldn’t just be a review of metrics — it should feel like a supportive conversation that discusses performance, but also highlights growth of the employee and ways the leadership team can support them. One major challenge with this structured approach includes making licensed, independent clinicians feel micro-managed and disrespected. Practice owners like Torre and others are keenly aware of this and shape the culture of their practice accordingly. 

Responsive approach to licensed clinicians

Torre emphasizes autonomy while providing as much support as possible. She monitors performance in the background by tracking clinical metrics and by staying relationally connected to the team in an ongoing way. 

“Stay plugged into your team,” she says, explaining she’ll have conversations about performance in response to seeing metrics slipping or clinicians struggling. She recommends framing this as a question about how the clinician is doing and if they need support. This approach can work well for licensed and independent clinicians. 

Other organizations take a less formalized and more responsive approach to reviewing performance. One risk of this approach is that important issues may slip through the cracks without regular check-ins.

Providing support for struggling clinicians

There are different ways to provide support if review discussions make it clear that a clinician needs it. Ongoing mentorship or connection points with clinical leaders can help open up more discussions and provide emotional and professional support to the clinician. These conversations should focus on developing their skills while respecting their professional independence. This can include picking skills or specialties for them to work on with their clients or through ongoing education. Frame these as collaborative conversations — you're partnering with them to support their growth, not managing them from above. 

Continuing education can be offered by the practice as support, too. If you’re unable to pay for CE programs for your employees, there are plenty of free resources. Headway providers, for instance, get free access to accredited continuing education from Violet, PESI, and more.

Opportunities to collaborate with peers through case consultation groups are another way to provide ongoing support to clinicians who are struggling. They can offer skills and suggestions to ‌clinicians without running the risk of feeling like they’re being corrected by a supervisor.

Expand your practice with Headway

Performance management doesn’t have to feel like surveillance or micromanagement. When approached thoughtfully, it becomes an ongoing conversation that helps your clinicians grow and develop. To implement these strategies effectively, you need the right systems in place. 

Headway can help your therapy group practice provide measurement-based care that is visible to clinicians and administrators, offer insight into practice level metrics, simplify documentation workflows, and provide free continuing education programs to clinicians. The combination of these features have never made it easier to run a practice, monitor performance, and support clinician success.

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This content is for general informational and educational purposes only and does not constitute clinical, legal, financial, or professional advice. All decisions should be made at the discretion of the individual or organization, in consultation with qualified clinical, legal, or other appropriate professionals.

© 2026 Therapymatch, Inc. dba Headway. All rights reserved. No part of this publication may be reproduced without permission.

Running a practice