Determining Your Private Practice Growth Trajectory

Episode 2

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Growth is exciting , until it isn't. In this episode, Brandon Seigel challenges practice owners to slow down and measure before they leap, explaining that unplanned or poorly evaluated growth can actually cost you more than it earns. The question isn't whether to grow; it's whether the juice is worth the squeeze.

Brandon opens with a critical distinction: slow, deliberate growth almost always outperforms rapid expansion when it comes to long-term sustainability. A $1 million practice with a 25% margin generating $250,000 in profit can quickly find itself losing money if it jumps to $5 million without the infrastructure, team, and systems to support it.

When evaluating a growth opportunity , whether acquiring another practice, adding a new location, or expanding services, Brandon urges owners to look beyond the revenue number and ask: what are the liability exposure, the operational demands, and the margin impact? In a recent example, a $2.5 million acquisition opportunity fell apart once Brandon analyzed the insurance contracts and patient demographics. The restructuring required would have eliminated the margin entirely.

Goal setting for growth requires clarity on three things: what you're trying to accomplish year-over-year, what patient volume and revenue targets support that trajectory, and what resources you genuinely have available to invest. Vague ambitions don't scale, quantified milestones do.

Brandon recommends building a growth risk matrix: for every growth action you're considering, map out the revenue upside, the cost to achieve it, the timeline to break even, and the worst-case scenario. If the worst-case scenario puts your current profitability at risk, that's your answer.

One of the most overlooked aspects of practice growth is the people component. Before any growth move, ask whether your current team, clinical and administrative, can absorb the demand. Hiring ahead of growth is expensive; hiring reactively during growth is chaotic. Planning the people side of your trajectory is just as critical as the financial side.

Key Takeaways

• Slow, planned growth creates more sustainable outcomes than rapid expansion
• Always evaluate liability, margin impact, and infrastructure before pursuing growth
• Build a growth risk matrix to stress-test every major opportunity
• Revenue alone is not a growth goal, net profit sustainability is the target
• The people capacity of your team must be factored into any growth plan