You Don't Have to Build an Empire (Tiny practices can change the world)
In this post:
- Why tiny doesn't mean "less than"
- The chronic disease crisis nobody's talking about (and your role in it)
- Why tiny practices are the finger in the dike
- The growth that actually matters (spoiler: size doesn't matter)
- How to become excellent at being tiny
Upfront honesty: I want you to know that I use AI to help me research and write my blog posts. I'm not going to pretend (like many) that I don't. It saves me time and means I can create more detailed, well-referenced content in much less time than just my dyslexic brain would allow me. The result? I believe higher quality content delivered more efficiently - I hope you agree 👍🏼
I'm guessing you've seen the posts. You know the ones.
LinkedIn celebrations of "We've just opened our fifth clinic!"
Instagram reels from practice owners sitting poolside while their team of 15 runs the business.
Podcast interviews with the practice owner who scaled from zero to high six or even seven figures in three years.
These achievements are wonderful. Genuinely amazing. But I'm curious - if you're honest, is there a part of you that wonders:
Should I want that too?
Is it wrong that I don't dream of owning a large practice?
I know many practice owners do. Maybe you've felt a twinge of guilt, or inadequacy even, when you realise that "empire building" doesn't excite you. That the thought of managing multiple clinics and hiring more staff makes you feel stressed rather than inspired. Sure some more free time would be great but you actually like treating patients and have no desire to step away from clinical work entirely.
Here's what I believe, and what nobody else seems to be saying:
You don't have to grow big to make a big difference, or to have a lucrative, rewarding, and fulfilling business and life.
There are thousands of health practitioners around the world running tiny practices who enjoy being, and want to stay, tiny. And in a world drowning in chronic disease, where most nations healthcare systems are buckling under the weight of largely preventable conditions, tiny, focused, robust, sustainable local practices might just be the most powerful force for change that we have.
Let me explain why.
What "Tiny" Actually Means (and why it's not a dirty word)
First, let's get clear on what we're talking about.
Many healthcare practice owners describe themselves as running a "small business." But in the UK, for example, a "small" business is defined as one with under £15 million turnover and up to 50 employees. Below that, a "micro" business has under £1 million turnover and fewer than 10 employees.
By those standards, a £500k turnover practice with five staff members is still technically "micro."
But your practice? It's possibly even smaller than that.
This is what I'm calling a Tiny practice: turning over £350k or less, with three or fewer clinicians (plus maybe some admin support). You might be flying solo. You might have one associate.
You're definitely not an empire AND the important bit, you might have very little desire to grow into one.
Here's what I want you to understand:
Tiny doesn't have to be a stepping stone for you and your practice.
It can be your destination.
It's easy to get swept along by the loud industry narrative that assumes everyone's idea of success is to scale from tiny to micro, to small to medium, to "I'm on a yacht while my practice runs itself."
But what if you don't want that?
What if tiny is exactly where you want to be - you just want it to work better for you?
What if you want a tiny practice that's profitable, efficient, sustainable, and gives you the life you actually want?
That's not settling.
That's strategic.
The Chronic Disease Crisis (that not enough people are talking about)
Right, let's talk about what's actually happening out there.
Globally, we're facing a healthcare crisis that's nothing to do with pandemics and everything to do with how we're living our individual lives.
Chronic diseases like diabetes, cardiovascular disease, autoimmune conditions, and obesity-related conditions now account for 70% of global deaths. These conditions cost the global economy trillions annually. In the UK alone, the NHS spends around 70% of its budget managing chronic conditions. In the US, that figure represents 90% of the nation's $4.1 trillion in healthcare expenditure.
But here's the best bit - and I mean this genuinely - much of this is preventable.
The research is clear: much of this morbidity is being driven by lack of movement, poor diet, and other poor lifestyle choices people are making every day.
In other words, much of this suffering is preventable and - excitingly - reversible if people can access good quality education, care, and support.
These aren't conditions that need more hospital stays, more surgeries, or more medication. These patients need rehabilitation, prevention, education, and regular, consistent care that helps them get and stay mobile, active, and positively engaged with their health.
This is where you and your tiny practice come in ❤️.
Your Tiny Practice: The finger in the dike
Remember the old Dutch folk story about the small boy who noticed a tiny leak in a dike wall holding the sea back from low-lying land?
He knew that if left unattended, that small hole would grow, the dike would break, and his entire village would flood and his friends and family would lose everything.
So he put his finger in the hole and stayed there all night until help arrived.
One small boy. One tiny finger. An entire village saved.
You are that boy. Your tiny practice is that finger in the dike.
Every patient you see who is returned to health, who learns how to move better, manage their pain, prevent injury, or understand their body - that's one less person heading towards costly chronic disease and a miserable middle or older age. One less person who'll need surgery, medication, or expensive emergency interventions. One less person lost to the preventable illness epidemic.
Multiply that by the 100, 200, or 300 patients you see each month. Then multiply that by the family members they influence, the colleagues they inspire, the years of healthy, active, productive life they gain.
This is not a tiny impact. This is massive. The ripples are almost never-ending.
And here's the bit I really want to emphasise: you don't need five locations to create that level of impact.
That's one practitioner in one location. You don't need a team of 20. You don't need to "scale" or "build a chain of practices" or work yourself into the ground pursuing someone else's definition of success.
You just need to do what you love doing - well, consistently, sustainably, with intention.
Being tiny doesn't mean settling for less
I'm absolutely not here to bash the empire builders. Building a huge practice can be amazing - if that's genuinely what you want. Hopping between locations, surrounded by a buzzing team of practitioners, supported by practice admin specialists 🤩 Amazing.
But for many practitioners, the pressure to scale comes from external messages about what success "should" look like, not from a genuine personal desire.
You probably trained for years specifically to help people, and you still love that about what you do. Maybe you chose private practice because you wanted autonomy - to deliver care your way. Maybe work-life balance and being present for your family matter more to you than building a business empire.
None of that is settling. That's choosing intentionally.
Tiny practices have advantages that large or multi-location practices simply can't replicate:
Personal relationships. You know your patients. They're not numbers in a system; they're Mrs. Johnson who's finally walking pain-free and David who's back playing football with his kids.
Agility. You can pivot quickly. Try new services. Adjust pricing. Change your schedule. You don't need board approval or complicated team restructuring.
Simplicity. Less complexity means less stress. Fewer moving parts mean fewer things that can go wrong. One location, a tiny team (or just you) - that's much more easily managed.
Sustainability. You're not on a hamster wheel of constant growth targets and juggling HR issues. You can build a practice that supports your life rather than consuming it.
Community impact. You're embedded in your local community. You're the practice people trust, recommend, and return to. That rootedness creates a sense of belonging and deep, lasting impact.
The practitioners making the biggest difference to their patients' lives aren't necessarily the ones with the biggest businesses. They're the ones doing excellent work, consistently, with genuine care.
That can be you. Right where you are. At the size you are.
The Growth That Actually Matters
Here's something a lot of practice owners haven't embraced: to succeed in business, growth is essential, but it doesn't have to relate to the size of your practice or your turnover.
If you want different results in your practice - more freedom, more income, more fulfilment - you absolutely need to grow. But not necessarily in the way everyone's shouting about.
The growth that transforms tiny practices isn't adding team members and locations. It's growing as a person, growing as a leader of your business, and growing how you deliver your service.
For years I have been saying "You can only grow your practice as much as you grow yourself" so hopefully it's clear that personal growth has to come first - yet it's often (like 99% of the time) the thing that practice owners are not working on at all.
Personal growth might look like:
- Developing the confidence to charge what you're worth
- Building the mindset to market yourself without feeling sleazy
- Learning to set boundaries so you're not working 60-hour weeks
- Overcoming the limiting beliefs that keep you playing small (even when tiny is your choice)
- Taking time to learn new business skills - who knows you might just be great at them
Service delivery growth might look like:
- Creating systems so you're not reinventing the wheel every day
- Streamlining your admin so you spend more time with patients
- Improving your patient experience so retention skyrockets
- Developing signature services that attract your ideal patients
- Building processes that free up headspace and time
- Improving profitability to enable reinvestment, not to scale up but to step up.
This kind of growth doesn't require more staff, more space, or more complexity. It requires you doing things differently to get different results.
It means being strategic, not just busy. Building a practice that's profitable, efficient, and sustainable - whether you're going solo or have a small team.
This is how tiny practices become mighty.
The ripple effect: Tiny practices - massive impact
Imagine if every solo and tiny practice owner decided to:
- Stop feeling inadequate for staying tiny
- Focus on doing excellent work consistently
- Intentionally build effective, profitable practices that support richer lives
- Stay embedded in their communities for decades
- Educate and empower their patients toward better health
What would happen?
We'd have thousands of practitioners across the country (across the world 🌍) acting as those fingers in the dike. Improving and preventing chronic disease one patient at a time. Keeping people mobile, active, and out of crisis.
We'd reduce the strain on overstretched national healthcare systems. We'd keep more people working longer, contributing to the economy. We'd help more families stay active together. We'd create healthier, happier communities.
Tiny practices, collectively, are a powerful force - I'm talking to you - Do you hear me? 👂🏼
BUT this only happens if you stop believing the lie that tiny equals less-than. If you give yourself permission to build the practice you actually want, not the one you're "supposed" to want.
Become excellent at being tiny
I've got some questions for you to ponder:
What if you stopped comparing yourself to the empire builders?
What if you gave yourself full permission to stay tiny - and instead focused all that time and energy on becoming excellent at being tiny? What would that feel like?
What if you grew as a practitioner, as a person, as a business owner, without growing your team or your clinic size?
What if you built a tiny practice that was wildly profitable, efficiently run, and genuinely sustainable? One that gave you the income you want, the time you need, and the fulfilment you deserve? How would that feel?
What if you let yourself be proud of that?
Because here's what I know after working with hundreds of practice owners since 2010:
The happiest practitioners aren't necessarily the ones with the biggest practices. They're the ones whose practices align with their values, support their lives, and allow them to do the work they love in a way that feels right to them.
Sometimes that's big. Often, it's tiny.
And both are valuable. Both create impact. Both matter.
The beauty is you get to choose
So what do you want to build?
Just because others are doing it - doesn't mean you have to - You don't owe anyone an empire.
You don't have to justify staying tiny, or wanting to work three days a week, or loving hands-on clinical work.
Your practice, your rules. Your definition of success.
But if you're going to stay tiny (or tinyish), then let's make sure you're doing it brilliantly. Let's make sure your practice is profitable, efficient, and sustainable. Let's make sure you're growing as a person and in your service delivery, even if you're not growing in size.
I get that it's a massive cliché BUT -Your patients need you.Your community needs you. The world needs you.
And they need what you build to be sustainable for you so you are not burning out. So you are confident, not guilt-ridden. Thriving, not just surviving.
Tiny practices have the power to change the trajectory of healthcare.
But only if you're still standing. Only if you've built something that lasts.
So let's stop apologising for being tiny. And let's start celebrating the mighty impact you're making, one patient at a time.
Want to connect with other tiny practice owners who get it?
Join our free Practice Momentum Academy a community of solo and small practice owners building thriving practices and richer lives without the pressure to scale.
👉 Join the Practice Momentum Academy
Because you don't have to do this alone. And you definitely don't have to grow big to make a big difference.
Thank you soooo much for taking the time to stop by my healthcare marketing blog today. I really hope you found value in spending some time here today.
I’d be so grateful if you could spare me just another 5 minutes to share your thoughts or questions in the box at the end of this page. What are you going to do differently now in your private practice?
Oh, and please use the social share buttons if you think other people you know might benefit from seeing this.
Until next time.
Thank you
Jill Woods
Healthcare Marketing Specialist
Founder of Practice Momentum
