There's a quiet assumption that a practice should always be growing — more patients, more practitioners, more rooms, more locations. But growth isn't automatically good. The right question isn't "how do we grow?" — it's "what kind of practice, and what kind of working life, do we actually want, and does growing serve that?" For some owners the answer is a bigger practice; for others it's a better, not bigger, one. Both are legitimate.
When growth does make sense, the discipline is to choose it deliberately rather than drift into it: does this expansion improve care or just add scale? Can our systems and team genuinely support it (growing past your foundations erodes quality, as we've seen)? Does it move us toward the life and purpose we want, or just toward "more"? Growth chosen on purpose, at a pace you can hold, strengthens a practice. Growth chased reflexively often strains everything that made it good.
And sometimes the wisest, most confident choice is not to grow — to run an excellent, sustainable practice at a size that serves your patients and your life beautifully. That's not a lack of ambition. It's clarity about what you actually want.
Choose your growth — including the choice not to. The best practice is the one that fits the life you're trying to build.
Making deliberate decisions about growth and direction is part of the [Practice Management course].
Explore the Practice Management course
Free first step: the practice systems starter.
Annie
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