Most therapists spend more time evaluating a new EHR system than the terms of their employment contract. This guide is the checklist we walk every Saltlanding-placed therapist through before they accept an offer — the questions that reveal whether a practice is genuinely a good fit, or just looks like one in an interview.
About the Caseload & Schedule
- What is the expected weekly session count? Get a specific number. "Full-time" means different things at different practices — anywhere from 20 to 40 billable sessions per week. Know what you're agreeing to.
- Is administrative time built into my schedule, or is documentation expected after hours? This single question reveals more about a practice's culture than almost any other. If the answer is vague, assume the latter.
- What is the patient population and acuity level? High-acuity caseloads (trauma, crisis, severe mental illness) require lower session counts to be sustainable. Ask what the typical presenting concerns look like.
- What are the on-call expectations? Is there an after-hours rotation? Who handles crisis calls? Are you expected to respond to your own clients outside of session hours?
- What happens if I'm at capacity — can I close my caseload to new referrals? Practices that say "we'll cross that bridge when we come to it" often don't have a bridge.
About Compensation & Benefits
- Is this W-2 or 1099? If 1099, you'll owe self-employment tax (~15.3%), pay for your own malpractice, and receive no employer benefits. Factor this into your comparison with any W-2 offers.
- What is the productivity model? Is pay flat salary, per-session rate, or percentage of collections? Each has very different income stability implications.
- What happens to my pay if a session cancels or a client no-shows? In per-session or percentage models, you may not be compensated for cancellations. Know the policy before you accept.
- What does the benefits package actually cover? Health insurance deductible, employer retirement contribution percentage, PTO accrual rate, and whether CEU time is paid days or just reimbursed dollars — these details matter.
- Is there a sign-on bonus, and what are the repayment terms? Clawback periods of 12–24 months are standard. Know what you'd owe if you left before that window closes.
About Documentation & Systems
- What EHR system do you use? Outdated or poorly designed EHRs significantly increase documentation burden. Ask to see a sample note template before you accept — you'll be living in this system daily.
- What is the note-completion deadline? 24 hours? 48 hours? "Within the week"? And what happens if you miss it?
- Who handles prior authorizations and insurance appeals? At some practices, this falls to the clinician. This is a significant time burden that doesn't show up in the job description.
About the Contract
- Is there a non-compete clause, and what does it actually restrict? Read it carefully. Some non-competes apply only to direct competitors; others restrict you from seeing any former clients in private practice within a geographic radius for years after you leave.
- What does the termination clause look like? How much notice is required from either side? Can the practice terminate without cause? Can you?
- Who owns my caseload if I leave? This affects your ability to maintain relationships with clients who may want to follow you to a new setting. Know the policy — and your ethical obligations — in advance.
About Culture & Supervision
- What does clinical supervision or peer consultation look like here? Especially important for associate-licensed therapists, but relevant for fully licensed clinicians too. Practices that offer no peer support structure tend to have higher burnout and turnover.
- How long have the current therapists been here? This is the most honest proxy for culture you can get. High average tenure = good environment. If most clinicians are in their first year, ask why.
- What does a typical day look like for a therapist at this practice? Ask the hiring manager, then ask to speak with a current clinician. Compare the answers.
- How does leadership respond when a therapist raises a concern about caseload or workload? The response to this question — not just the content of the answer — tells you a great deal.
How Saltlanding Helps Therapists Navigate Job Offers
When Saltlanding places a therapist, we've already asked most of these questions on your behalf before we present the role. We only bring opportunities to candidates that we believe are genuinely well-structured — and we stay involved through offer negotiation to make sure the terms reflect what you're worth.
Our services are completely free for clinicians. Reach out if you're exploring your next position, or view our current open roles — many are exclusive to Saltlanding and never posted publicly.