Estimated Reading Time: 20-22 minutes
This comprehensive guide is based on an exclusive training session with Tamara, operations director and VA agency owner. The insights here come from real experience managing virtual teams and helping business owners successfully delegate and scale.
The Reality Check: Why Most Practitioners Wait Too Long to Hire
Here’s what usually happens: You know you need help. You’re drowning in admin tasks, spending hours on Canva designs, manually onboarding every single client, and watching your weekends disappear into inbox management.
But you tell yourself:
- “I’ll hire someone once I have more clients”
- “I need to figure out my systems first”
- “I can’t afford it yet”
- “What if I hire the wrong person?”
Meanwhile, you’re working 50+ hours per week, turning down clients because you’re at capacity, and missing opportunities to grow because you’re stuck in the weeds.
The truth: The online space may have been around for over a decade, but it’s still the wild west when it comes to hiring virtual support. Most practitioners make entirely preventable mistakes that cost them time, money, and sanity.
This guide exists so you don’t have to learn the hard way.
Before You Even Think About Hiring: Preparing Your Business for Outsourcing
1: Establish Your Budget (And Get Comfortable Financially)
General rule of thumb: You want 2-3 months of your team member’s salary in savings as a cushion.
Why this matters: You might have hot leads that won’t convert for 6-8 weeks. Having that financial runway means your VA can support you through those conversations without you panicking about cash flow.
2: Identify the Person You Want (Not Just the Skills You Need)
Before you write a job description, get clear on:
Personality and values:
- Do you want someone responsive? (Yes, obviously)
- Do you need someone whose values align with your business? (Also yes)
- What communication style works best with you?
Training level:
- Do you want them already trained in your platforms? (They’ll cost more but save you time)
- Are you willing to train someone new? (More affordable, you can shape them to your systems, but requires your time investment upfront)
Critical consideration: If you hire someone brand new, you avoid breaking them out of bad habits from other practitioners. If you hire someone experienced, they hit the ground running but might have their own way of doing things.
3: Record Everything (Starting Yesterday)
Create screen recordings of yourself:
- Onboarding clients
- Using the tech you use
- Sending emails
- Processing payments
- Managing your calendar
Don’t overthink this. A quick Loom video is perfect. Your VA can then create the formal standard operating procedures (SOPs) from your videos.
Example workflow:
- Send invoice
- Client pays
- Send welcome email
- Schedule first appointment
Critical rule: Don’t assume anything. Be super detailed. Virtual assistants aren’t mind readers, and this is YOUR business, YOUR brand, YOUR name on everything. The client experience should be crystal clear from day one.
4: Prepare Yourself for Leadership
You’re going from solo practitioner to team leader. That’s a mindset shift.
Key leadership principles:
High standards aren’t nitpicky – They’re necessary. You can expect what you accept. If you accept mediocre work, that’s what you’ll get.
Feedback is love – Make it clear from the start: “I’m going to give you feedback. It’s coming from a place of love, but I need you to meet me where I’m at because this is where my clients are at.”
The right person will appreciate this. They want to do excellent work and understand that your standards exist to serve your clients.
Realistic expectations – Your VA won’t be incredible on day one. They need time to learn your business, your systems, your clients. If you’re paying hourly, expect the first 1-2 months to be a bigger investment as they get up to speed. After that, efficiency should increase dramatically.
Set boundaries early:
- “I expect updates every Friday”
- “I need end-of-day reports”
- “Here’s how I want to be communicated with”
And boundaries for them too—when they should reach out, when they should problem-solve independently, what decisions they can make without you.
Allow them to be human – Things happen. Kids get sick. Life happens. Have clear expectations, but also flexibility. If they don’t deliver, the work falls back on you anyway, so building in buffer time protects you both.
Ready to build your team? Join our practitioner community →
The Automate, Delegate, Delete Exercise: Identifying What to Outsource First
This simple exercise will change everything.
How to do it:
1: Brain dump everything you do
Literally everything:
- Client calls
- Onboarding
- Creating contracts
- Invoicing
- Following up on invoices
- Social media engagement
- Creating Canva slides
- Email management
- Scheduling
- Content creation
- Admin tasks
Just dump it all onto paper.
2: Be brutally honest with yourself
Go through that list and categorize each task:
AUTOMATE: Can this be automated or semi-automated?
- Practice Better has tons of automation options
- Email templates for onboarding, offboarding, check-ins
- Pre-written templates save massive time
DELEGATE: Can someone else do this?
- Scheduling social media posts
- Turning podcast episodes into emails and social content
- Content repurposing
- Client onboarding communications
- Calendar management
DELETE: Is this actually moving the needle?
- A lot of “busy work” is just noise
- If it’s not getting you in front of ideal clients
- If it’s not part of your delivery process
- If it’s not fine-tuning your business operations
- It can probably be deleted
YOU TASKS: What only you can do
- Client calls
- Sales conversations
- Showing up on social media authentically
- Networking
- Discovery calls
The goal: Open up your calendar so you can do MORE of what generates revenue and serves clients. The more time you have to serve people, the more people you can serve.
What Your First Role Should Be
After the automate/delegate/delete exercise, you’ll have a list of “delegate” tasks. This informs your first hire.
For most practitioners starting out: You need a generalist administrative VA who can handle:
- Admin tasks
- Some social media work
- Basic tech support
- Client communications
As you grow: You’ll eventually want specialists:
- Copywriter
- Social media manager
- Marketing specialist
- Sales support
- Operations manager
But in the beginning? Generalist all the way.
The Plan for Your Reclaimed Time (This Is Critical)
Let’s say you hire a VA for 20 hours per month.
You’re probably getting back 35 hours because things you don’t want to do take you MUCH longer than someone who thrives in that support role.
What are you doing with those 35 hours?
This is not a rhetorical question. You need a plan.
Are you:
- Having more sales calls?
- Creating more content?
- Networking in your community?
- Serving existing clients more deeply?
- Finally taking that time off you’ve been promising yourself?
The ROI reality: Your VA doesn’t directly generate sales. They create the TIME for you to do revenue-generating activities.
Common pattern: Most practitioners spend the first month recovering from burnout. That’s okay. That’s actually perfect. You need to refill your cup before you can pour into your business and clients more effectively.
Growth comes from retention: For health practitioners, it’s easier to retain and re-sign existing clients than constantly finding new ones. Having time to show up deeper for current clients, optimize their protocols, dig into their cases—that’s where sustainable growth lives.
Where to Actually Find Virtual Assistants (The Good, The Bad, The Overseas)
Virtual assistants are everywhere. The question is where to find GOOD ones.
Option 1: Your Personal Circle (Often Overlooked)
Consider:
- Stay-at-home moms looking for flexible part-time work (10 hours/week)
- Students who need something flexible around their studies
- Past clients who know your work and values
- Friends of family looking for extra income
The advantage: They already trust you, you know their character, and there’s built-in accountability.
Option 2: Referrals (The Best Option)
Ask people in your network: “Who do you use as a virtual assistant?”
Why referrals are gold:
- They inform you about reliability
- Work ethic
- Responsiveness
- Attitude
- Quality of work
Important: Don’t just hire everyone who’s referred. Do a “vibe check” call. Just because they’re perfect for your friend doesn’t mean they’re right for your business and personality.
Option 3: Social Media and Job Boards
Platforms like:
- Facebook groups
- Upwork
The caution: You will get FLOODED with applicants. One recent job posting got 260 applicants in 48 hours. Out of those 260, only 16 were actually qualified.
You need a strong vetting process:
- Clear job description
- Application questions that filter out wrong fits
- Skills assessment
- Multiple interview rounds
Option 4: Agencies
The pros:
- If your VA goes on maternity leave or quits, the agency provides a replacement
- Often comes with some training
- Less individual relationship management
The cons:
- Not all agencies invest in training their contractors
- Some just match newbies with clients and call it a day
- Usually more expensive
- Less personal connection
Do your vetting on the agency itself: What training do they provide? What happens if your VA leaves? What’s the replacement guarantee?
Option 5: Overseas VAs
The reality: You can find excellent VAs overseas and terrible ones. Same as domestic hiring.
The advantage: Significantly lower rates (often $10-20/hour vs $25-40/hour domestically)
The considerations:
- Time zone differences
- Communication styles
- Cultural differences in business practices
- Varying levels of English proficiency
Bottom line: Don’t rule it out, but don’t assume it’s automatically cheaper if you factor in miscommunications and training time.
The Vetting Process: How to Actually Choose the Right Person
Must-Ask Interview Questions
About capacity:
- What are your current work hours?
- How many clients do you currently have?
- What’s your turnaround time for projects?
Red flag: If they have 13 clients as a solo VA, you are NOT a priority. In most cases, a VA can handle 4-5 clients max with a reasonable workload.
Skills:
- What’s your experience with [Practice Better/Canva/email platforms]?
- How do you handle learning new software?
- Can you show me examples of similar work?
Work style:
- How do you communicate when you’re stuck?
- What does your typical workday look like?
- How do you prioritize when multiple things are urgent?
Values:
- What’s important to you in a client relationship?
- Tell me about a time you went above and beyond
- How do you handle feedback?
The Vibe Check Is Real
Skills can be taught. Personality fit cannot.
You’ll be talking to this person potentially every single day. They can be amazing at their job and have a terrible personality that makes you dread opening Slack.
You’re building your business to LOVE your life and work. Don’t hire someone who ruins that.
Looking for the Right Traits
Resourcefulness: If they can find the answer on Google or YouTube, they should. You want someone who says “I figured it out” more than “Can you show me?”
Proactivity: They should anticipate needs, not just respond to requests.
Communication: Clear, consistent, professional communication is non-negotiable.
Ownership: They should take responsibility for mistakes and fix them, not make excuses.
Growth mindset: They should be eager to learn your systems and improve continuously.
Contractor vs. Employee: Know the Legal Difference
Critical legal distinction: Contractors and W-2 employees are different in the eyes of the law, and misclassifying someone can get you in serious trouble.
Contractors:
- You CANNOT tell them when to work
- You CAN give them deadlines (“I need this within 24-48 hours”)
- They set their own schedule
- They can work for multiple clients
- They handle their own taxes
- They can technically leave anytime (though good ones give notice)
Employees:
- You CAN set their schedule (“You’re available Monday-Friday, 9-5”)
- You control how, when, and where they work
- You withhold taxes
- You may need to provide benefits
- They work exclusively (or primarily) for you
The workaround: Many VA agencies hire their VAs as employees, then contract them out to clients. This lets the agency set standards and expectations while you benefit from consistency.
The variation: Laws vary slightly state by state and get complex with virtual/remote workers. Consult with an accountant or lawyer if you’re unsure.
What to Actually Pay Your Virtual Assistant
The range is WILD: $15/hour to $75/hour depending on experience, specialization, and location.
General Pricing Guidelines:
Beginner VA (little to no experience):
- Domestic: $20-28/hour
- Overseas: $8-15/hour
- They’ll need significant training and hand-holding
Intermediate VA (some experience, knows the platforms):
- Domestic: $30-40/hour
- Overseas: $15-25/hour
- They can hit the ground running with minimal training
Advanced VA/Specialist:
- Domestic: $40-50/hour
- Overseas: $25-35/hour
- They bring expertise in specific areas (copywriting, tech, marketing)
Operations Manager/Business Manager:
- Domestic: $50-75+/hour
- These are high-level strategic partners, not task executors
Where Most Practitioners Start:
The $25-35/hour range for 10-20 hours per month is the sweet spot for most health practitioners starting to delegate.
Minimum hours: 10 hours per month (about 2.5 hours per week). This is almost nothing but still makes a meaningful impact.
The Ethical Consideration
Remember that contractors pay for their own taxes, benefits, software subscriptions, and have no paid time off. Factor that into your pricing decisions. You want someone who’s fairly compensated and therefore motivated to do excellent work.
Learn from practitioners who’ve successfully hired VAs →
Onboarding Your VA: The First 90 Days
Setting Expectations from Day One
Have a kickoff call where you explicitly say:
“Here’s how we’re going to work together:
- I’ll be giving you feedback regularly—it’s how we both improve
- I need updates [frequency] so I can stay in the loop
- I want you to ask questions rather than guess
- We’ll have check-in calls [frequency]
- Here are my non-negotiables for client communication”
The Check-In System: Monday, Wednesday, Friday
Especially in the beginning, implement a structured update system:
Monday: “Here’s everything on the docket for this week”
Wednesday: “Here’s what’s been completed, what’s still pending, what I need from you”
Friday: “Here’s everything I completed this week. Next week I’m starting with X, Y, Z. Let me know if there’s anything priority.”
This keeps you in the loop without micromanaging.
Communication Hub: Pick ONE Platform
Don’t scatter communication across:
- Text
- Messenger
- Zoom calls
- Google Docs
Pick ONE primary communication hub (Slack, Asana, ClickUp, Practice Better messages—whatever works for YOUR brain) and use it consistently.
Why this matters: You need a clear paper trail. You need to be able to search conversations. You need to know where to look when you’re thinking “Did I ask them to do this?”
After-Call Recaps
After your check-in calls, have your VA send a recap:
- “This is everything delegated on the call”
- “These are the deadlines”
- “Here’s what I need clarification on”
This documents everything and prevents the “Wait, did we talk about this?” confusion.
Project Management Software
Your VA should use SOME kind of project management system where you can see:
- What’s open
- What’s in progress
- What’s completed
- What’s blocked
Popular options:
- Asana (great for structured project management)
- ClickUp (very robust, can be overwhelming)
- Notion (flexible, great for some brains, chaotic for others)
- Practice Better tasks (if you’re already using it)
Let your VA use what works for them, but make sure YOU have visibility.
The Performance Check-In Schedule
Schedule formal performance reviews at:
- 30 days: How’s it going? What’s working? What needs adjustment?
- 60 days: Are we hitting our rhythm? Any concerns?
- 90 days: Full evaluation. Is this the right fit long-term?
These shouldn’t just be about their performance—also ask what THEY need from YOU to perform better.
The Biggest Mistakes Practitioners Make (And How to Avoid Them)
#1: Giving Up Control Too Fast
You’ve been doing everything yourself for so long. Now you hand it off and… stop checking anything.
The problem: Things slip through cracks, clients have weird experiences, and you don’t catch it until there’s a problem.
The solution: Especially in the first 60-90 days, do spot checks. Pop into Practice Better. Read some client communications. Review a few deliverables. You’re not micromanaging—you’re quality controlling.
When to stop: Once they’ve proven consistent quality, you can step back. But build trust through verification first.
#2: Not Being Clear Enough About Client Experience Standards
Your VA might be great at admin work but not understand that YOUR clients expect:
- Responses within 4 hours
- A warm, personal tone
- Specific language around protocols
- Extra hand-holding during onboarding
The solution: Create a client communication framework. Literally write out:
- Tone and voice guidelines
- Response time expectations
- Templates for common scenarios
- What to escalate to you vs. handle themselves
Think Starbucks: Smile, Listen, Acknowledge, Fix. Create YOUR version of that.
#3: Not Having Consequences (Accountability)
If there’s no accountability for missing deadlines or making mistakes, performance drifts.
The solution: Natural consequences, not punitive ones. If deadlines are consistently missed, address it directly: “I’ve noticed this pattern. What’s going on? What support do you need? This is affecting our clients.”
If it continues, part ways. You’re not running a charity—you’re running a business.
#4: Building the Role Around the Person (Instead of Building the Person Into the Role)
When you get a unicorn VA who can do EVERYTHING, you start giving them all the things.
The problem: When they leave, you have to find another unicorn, which is nearly impossible.
The solution: Build out the role FIRST with clear responsibilities and expectations. Then find someone who fits into that role. If they leave, you just plug the next person into the existing system.
#5: Trying to Do It All at Once
You hire a VA and immediately want to delegate:
- All your admin
- Social media
- Content creation
- Client onboarding
- Email management
- Tech troubleshooting
The problem: You overwhelm them, overwhelm yourself with training, and nothing gets done well.
The solution: Phase it in. First month might just be calendar management and email. Month 2 you add client onboarding. Month 3 you add content scheduling. Build competence layer by layer.
Time Studies: The Secret to Knowing Exactly What to Delegate
Use a time tracking tool like Toggl for 1-2 weeks and track EVERYTHING you do down to the minute.
You’ll discover:
- “Holy shit, I’m spending 5 hours per week on Canva”
- “I’m spending 8 hours on admin tasks I hate”
- “90% of my social media time is just scheduling posts”
This data tells you:
- What to delegate
- How many hours you actually need from a VA
- What tasks are secretly eating your life
Advanced move: Even after you’ve hired and things are running smoothly, do time studies once or twice per year. Your business changes. What made sense to delegate 6 months ago might need to be re-evaluated.
The Long-Term Vision: Scaling Your Team
When to Hire Your Second Team Member
You know it’s time when:
- Your VA is at capacity (20-25 hours/week)
- You have a completely different skill need (you need a copywriter but your VA is admin-focused)
- Your revenue has grown enough to support another salary comfortably
Building Systems That Scale
Everything you create for your first VA becomes the foundation for your second, third, fourth hire:
- SOPs that anyone can follow
- Communication frameworks
- Client experience standards
- Project management systems
The compounding effect: The time you invest in documentation now saves exponential time later.
Moving from Generalist to Specialists
As you grow, you’ll transition from “My VA does everything” to specialized roles:
- Administrative VA (calendar, email, client onboarding)
- Content Manager (social media, blogs, newsletters)
- Copywriter (sales pages, emails, marketing materials)
- Tech Specialist (funnels, automations, integrations)
- Operations Manager (oversees everything, manages the team)
This is how you build a real business infrastructure.
Your Implementation Roadmap
Preparation
- Do the automate/delegate/delete exercise
- Document your current processes (screen recordings)
- Establish your budget
- Create job description
- Start sourcing candidates (ask for referrals first)
Hiring
- Interview top 3-5 candidates
- Do the vibe check
- Check references
- Make your offer
- Create onboarding materials
Onboarding
- Kickoff call with clear expectations
- Start with 1-2 simple tasks
- Implement Monday/Wednesday/Friday check-ins
- Provide loads of feedback
- Establish communication rhythms
Expansion
- Add more responsibilities gradually
- Fine-tune systems based on what’s working
- Address what’s not working immediately
- Start creating more SOPs from their work
Optimization
- 90-day performance review
- Optimize time allocation
- Build more autonomy
- Plan for what to delegate next
The Mindset Shift That Changes Everything
Hiring a VA isn’t about “getting help with tasks.”
It’s about:
- Protecting your energy for what only you can do
- Scaling your impact beyond your personal time
- Building a sustainable business model
- Creating space for strategic thinking
- Actually enjoying your business again
The practitioners who succeed with VAs understand this: Your VA’s value isn’t measured in tasks completed. It’s measured in the time, energy, and capacity they give back to you for revenue-generating and life-giving activities.
Red Flags to Watch For
In the hiring process:
- Can’t provide clear examples of past work
- Vague about availability or current workload
- Doesn’t ask questions about your business
- Promises they can do everything
- Prices seem too good to be true (usually are)
Once you’re working together:
- Consistently misses deadlines without communication
- Makes the same mistakes repeatedly
- Doesn’t ask questions when unclear
- Takes forever to respond
- Makes excuses instead of taking ownership
- You feel like you’re managing them more than they’re supporting you
When you see red flags: Address them immediately. If they don’t improve quickly, part ways. It’s not mean—it’s protecting your business and your sanity.
Green Flags: Signs You Hired Right
- They anticipate needs before you ask
- They send proactive updates
- They take feedback well and improve quickly
- They ask smart questions
- You feel MORE peaceful after delegating, not more anxious
- Clients comment on how smooth things are
- They care about your business like it’s theirs
- They make your life genuinely easier
The First 90 Days: What “Success” Actually Looks Like
Don’t expect:
- Perfection
- Mind-reading
- Instant efficiency
- Zero mistakes
Do expect:
- A learning curve
- Questions (lots of them—this is good!)
- Some inefficiency at first
- Investment of your time upfront
By day 90, you should see:
- Consistent quality
- Decreased need for hand-holding
- Proactive communication
- Measurable time saved for you
- Smooth client experiences
If you’re NOT seeing this by day 90, either your training needs work or you have the wrong person. Figure out which and address it.
The Question Everyone Asks: “But What If They Leave?”
This fear keeps practitioners from hiring. Here’s the truth:
People do leave. It’s not a matter of if, but when. And that’s okay.
How to protect yourself:
- Document everything
- Build systems, not dependencies
- Cross-train when possible
- Always have access to accounts
- Keep SOPs updated
The ultimate protection: Build your business around roles and systems, not around individuals. Then anyone leaving is an inconvenience, not a catastrophe.
Special Considerations for Health Practitioners
HIPAA and Client Confidentiality
If your VA will have access to client information:
- Have them sign a confidentiality agreement
- Use HIPAA-compliant platforms (Practice Better is)
- Train them on privacy standards
- Limit access to only what’s necessary
- Never share full medical histories unless absolutely required
Scope of Practice
Be extremely clear about what your VA can and cannot say to clients:
- They can schedule appointments
- They can send pre-written protocols
- They CANNOT give health advice
- They CANNOT interpret lab results
- They CANNOT make clinical decisions
Put this in writing. Protect your license and your clients.
The Client Relationship
Some practitioners worry: “Will my clients feel disconnected if someone else is handling communication?”
The solution:
- Have your VA use your email signature style
- Keep communication warm and personal
- You still show up for all clinical interactions
- Reserve some client touchpoints for yourself (welcome calls, check-ins, celebrations)
Most clients love the increased responsiveness and professionalism. They don’t need YOU to schedule their appointment—they need you to show up brilliantly when you’re together.
The Real ROI: What Practitioners Actually Experience
Within the first 3 months:
- 10-20 hours per week back in their calendar
- Ability to take on 2-3 more clients (if desired)
- Actually taking days off without chaos
- More consistent social media presence
- Smoother client onboarding experience
Within 6-12 months:
- Built out group programs they didn’t have time for before
- Launched that lead magnet that’s been on the list for months
- Consistent content creation without burnout
- Deeper relationships with existing clients
- Sustainable work-life boundaries
The intangible ROI:
- Feeling like a CEO, not a stressed solopreneur
- Coming back from vacation without 47 fires to put out
- Not working weekends
- Having mental space for strategic thinking
- Actually enjoying your business again
Your Next Steps
1: Make the decision
Stop waiting for the “perfect time.” Do the math. If you brought on 2 more clients because you had the capacity, would that cover your VA investment? Probably.
2: Do the exercise
Spend this week tracking everything you do. The automate/delegate/delete exercise is NON-NEGOTIABLE.
3: Start sourcing
Post in your community. Ask for referrals. Let people know you’re hiring. The best candidates often come from warm introductions.
4: Take imperfect action
You don’t need the perfect job description or flawless SOPs. You need to START and refine as you go.
5: Commit to the first 90 days
Give this a real shot. Not a half-hearted “let’s see if this works” energy. Commit to making it work, investing the training time, and solving problems as they arise.
The Bottom Line
The practitioners building sustainable, fulfilling, profitable practices aren’t doing it alone.
They’ve learned to:
- Protect their zone of genius (client care, sales, strategy)
- Delegate everything else
- Build teams that amplify their impact
- Create systems that run without them micromanaging
You’re not meant to do this solo. You’re meant to build something scalable, sustainable, and actually enjoyable.
The question isn’t whether you’re capable of hiring well—it’s whether you’re ready to stop being the bottleneck in your own business.
Ready to dive deeper? Join our free Self-Led Online Practitioners community of 800+ health professionals where you get exclusive access to training sessions like this one, monthly coaching calls, practitioner spotlights, and first access to new programs and discounts. Join the community here – it’s completely free for verified practitioners.
About the Author: Michelle Rogers, ND, MSAOM, FDN-P, is a clinical mentor and founder of The WELLthy Woman™ movement. A practicing clinician since 2012, she pivoted to mentoring fellow practitioners in 2019 after experiencing her own transformation from clinic burnout to online business success. She has since guided hundreds of health professionals to build profitable online practices using her unique integration of functional medicine expertise and scalable business strategies.
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