Employee vs. Contractor: How to Make the Right Hiring Decision for Your Practice
Hiring support for your private practice is a BIG step—but as you grow your business, you usually need to get support in order to keep your private practice sustainable.
Who Should You Hire?
Deciding who to hire in your business starts with identifying what you truly need help with. Are you looking for someone to do simple tasks in your business, or do you need a specialized skill set to fill a gap? What do you enjoy doing in business, and what do you dread? What is important that’s just not getting done?
One of my favorite exercises for dietitian business owners is to do a “time audit” of a realistic week. Track your time and what you’re doing when you’re working! Think of this like a client’s food journal, but instead of tracking food, you’re tracking time. Just like we tell our clients, awareness without judgment is key. This exercise isn’t about shame—it’s about gaining insight into where your time is going and how it’s shaping your reality.
The real ah-ha moments come when you realize just how much of your workload could be delegated. That’s when it becomes clear what your business truly needs and what role you should hire for first (or next!).
Employee vs. Contractor
The decision between hiring an employee or an independent contractor isn’t always straightforward—it comes down to the level of control, financial arrangement, and the nature of the relationship between you and the worker. According to common law rules, businesses must consider three key factors:
1. Behavioral Control
Do you have the right to control how the worker performs their job? If you’re setting their schedule, providing training, and requiring specific methods for completing tasks, they are likely an employee. If they have autonomy over their work and decide how to get the job done, they are more likely a contractor.
2. Financial Control
Who controls the financial aspects of the job? Consider factors like how the worker is paid, whether expenses are reimbursed, and who provides tools and supplies. Employees typically receive a salary or hourly wage, may have expenses covered, and use company-provided equipment. Contractors, on the other hand, are often paid per project, use their own tools, and cover their own business expenses.
3. Type of Relationship
Is there an ongoing relationship, and is the work a key aspect of your business? Employees usually have written contracts, benefits (like insurance or vacation pay), and an expectation of long-term work. If the work being done is integral to your practice—like seeing clients regularly—it’s more likely an employee role. Contractors typically have short-term or project-based contracts and don’t receive benefits.
How Do You Decide?
Ask yourself:
✅ Do I need a long-term clinician who aligns with my business vision and wants to counsel clients under my supervision? (Employee)
✅ Do I just need specialized help for certain tasks like a marketing project? (Contractor)
✅ Do I want full control over their schedule, when and how they work? (Employee)
✅ Am I okay with being a client in their business? (Contractor)
✅ Am I ready to provide benefits? (Employee) *If you hire an employee, you will need to pay for payroll software, pay additional taxes, follow any HR laws according to your state (like sick time, PTO, etc), and also carry insurance for unemployment and disability (however, these are state-dependent).
✅ Am I ready to be a leader? (Both!) *You will step into leadership no matter what role you hire. You will have to set expectations, evolve boundaries, and work on communication skills.
Most dietitians will hire other dietitians who see clients in a group practice as employees and will hire other support team members like admin, marketing, and billing as contractors. This is not always 100% true though because it’s a subjective decision that business owners must make.
The Truth About Hiring
No matter which option you choose, hiring is about growing into your role as a CEO. It’s okay if it feels scary at first—this is new territory! But the right hire can help you avoid burnout, serve more clients, and build the business you actually want.
Want to work with me to build your private practice?
Business School is a comprehensive 6-month program designed to guide you through every stage of building a private practice: getting set up, seeing your first clients, growing until you’re fully booked, hiring a team, expanding your offers—and even learning how to coast when needed. Inside, you’ll follow a step-by-step curriculum with the flexibility to choose the path that fits your current stage of business and life. You’ll get access to advanced toolkits, templates, and systems for business topics like marketing and finances, but also for counseling skills and client support. Beyond the curriculum, you’re supported by personalized 1:1 coaching, weekly office hours, and monthly themes that address the real challenges of private practice. The program keeps you moving forward with built-in accountability that builds resilience and confidence so you feel like a legit business owner. Learn more and apply here!
