Why I Don't Want You to Scale Your Practice
By Jill Woods | Healthcare Marketing Specialist | Practice Momentum
In this post:
- Why a business coach is telling you not to grow (and means it)
- The book that proves staying small can be a deliberate, brilliant strategy
- The difference between growing bigger and growing better
- Five honest questions to help you decide what you're actually building
- Why permission and significance aren't quite enough on their own
Upfront honesty: I use AI to help me research and write my blog posts and I'm not going to pretend otherwise. It saves me time, helps me find and reference evidence I might otherwise have missed, and means my dyslexic brain can produce more detailed, well structured content far more efficiently than it could alone. The result, I hope, is higher quality thinking delivered more consistently. I'll let you be the judge. 👍🏼
There's a sentence you're not supposed to hear from someone in my line of work.
Ready?
I don't want you to scale your practice 😱
Not "scale it carefully" or "scale it when you're ready." I genuinely, do not want most of the practitioners I work with to try building the empire the rest of the industry keeps telling them they should be building.
That probably sounds like an odd thing for a business coach to say. Growth is the whole game right? More locations, more clinicians, more turnover, just more. It's a mantra repeated so often in our industry that it's starting to sound like the only version of success out there.
But I've been doing this since 2010, and I've watched what actually happens to a lot of practitioners who chase that version. Not all of them, but a lot. They get bigger and they get further away from the very thing they loved in the first place. The patients, the clinical work, and the reason they trained for all those years, to help people and feel good about the impact they have every day.
So no, I don't necessarily want for you to grow a big practice. And I've got a bit more than a gut feeling to back me up.
Permission, significance, and the thing that was still missing
I've written about this before, from two different angles.
A while back I wrote You Don't Have to Build an Empire, which was really about giving you permission. Permission to stop feeling guilty for not wanting fifteen staff in 5 locations. Permission to want what you actually want.
Then I wrote The Cavalry Isn't Coming, which was about significance. About your tiny practice being a very significant part of an overlooked healthcare resource that quietly holds communities together, one patient at a time.
Having permission and feeling significant both matter, but there's a third element your still missing, because you can feel "allowed" to stay small, and you can believe it matters, and still have a nagging little voice that whispers "yes, but is it actually a good business decision? Or am I just settling for less and dressing it up nicely?"
That's the bit I want to address today.
The book that changed how I see this
Last week I finished "reading" (in commas because I Audibled it 😁) a book called Small Giants: Companies That Choose to Be Great Instead of Big, by Bo Burlingham. If you've not come across it, it's worth a read.
Burlingham went looking for a particular kind of company. Not the startups scrambling to get big, in fact the opposite. Companies that had every opportunity to scale, investors circling, easy growth sitting right there for the taking, and who looked at all of that and still deliberately said no to growth. They chose to stay a size they felt they could be brilliant at, rather than chasing a size that would make them bigger but ordinary.
And here's the part that stuck with me. Staying small didn't make them less successful, it made them more profitable, more resilient, more loved by their customers and their communities. They didn't given up on success, they just chose a different kind of it, on purpose.
Burlingham reckons the thing these companies share is a sort of soul. A closeness to their customers and their community that bigger businesses simply can't manufacture, no matter how hard they try - Doesn't that sound like a great tiny healthcare practice.
You already have the things the giants spend fortunes trying to fake. You know your patients by name, you know their stories, and you're rooted in a community that trusts you. That's not the consolation prize for staying small, in a lot of ways, it's the whole prize. The prize big corps are chasing, trying to artificially manufacture.
Here's the distinction I really want to emphasise.
Scaling is about getting bigger - more of everything. It's a perfectly great and legitimate goal if it's genuinely yours. But there's another kind of growth that almost nobody talks about, and it's about getting better.
Imagine:
- Deeper relationships with your patients.
- Deeper expertise.
- Deeper roots in your community.
- A practice that runs beautifully, earns well, and gives you your evenings and weekends back.
You don't need a second location for any of that, you just need the intention to build your practice differently.
A small giant doesn't accidentally stay small. It chooses its size on purpose, then pours everything into being exceptional at it. That's the shift. Not "how big can I get," but "how good can I be at exactly this size."
Five honest questions
So rather than sending you off with a warm glow and nothing to do with it, here are five questions worth pondering. Borrowed loosely from what Burlingham found, and translated for a healthcare practice.
- Am I choosing my size, or just defaulting to it? Big or small, is this a decision you've actually made, or one that's happening to you?
- Am I still close to the work I love? The owners of these companies stayed connected to the actual thing. If your "dream" growth plan quietly removes you from patients, is that really the dream?
- Am I growing deeper, or just busier? Better relationships and better skills, or simply more of everything until you're stretched too thinly?
- Am I using my rootedness, or ignoring it? That community trust you've built is a genuine advantage. Are you leaning into it, or treating it like it doesn't count?
- Whose definition of success am I actually chasing? Yours, or one you absorbed from LinkedIn without ever actually choosing it?
You don't have to answer all five today. But even one honest answer might shift something for you - if indeed it needs sifting. You might be wildly excited by a steep and fast growth trajectory and that is amazing. But equally it might feel like that's so far removed from what you really want to build.
I don't want you to scale your practice on autopilot.
I want you to choose it - Deliberately, decisively, and on your own terms. To build something small and genuinely mighty, that run so well it gives you a life, rather than swallowing the one you've got.
There are thousands of practitioners that could be making exactly that choice. And I've been thinking for a while now that they ought to be able to find each other more easily, because a choice like this is far easier to hold onto when you're not making it alone - More on that very soon 🤔 🎉.
For now, if any of this made something click, come and find your people in the free Practice Momentum Academy. It's full of tiny practice owners building thriving practices and richer lives, with no pressure whatsoever to scale.
Because you don't have to grow big to be great. You just have to choose, and then whatever you choose be brilliant at it.
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.
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
Jill Woods
Healthcare Marketing Specialist | Founder, Practice Momentum | Author of ELEVATE
I started Practice Momentum in 2010 after watching too many brilliant clinicians quietly burning out — not because they were bad at their jobs, but because nobody had ever taught them how to run or market a small business. Since then, I've helped hundreds of tiny practice owners around the world build practices that are professionally exciting, personally fulfilling, and financially rewarding. I'm the author of ELEVATE: Mindset, Marketing and Happiness Strategies for Allied Health Practice Owners, a podiatrist turned healthcare marketing specialist, a speaker, a nomadic military wife, and a self-confessed happiness junky. I believe tiny practices have the power to change healthcare globally - and I'm on a mission to help as many of them as possible thrive.
