Practicing Independence
Chapter 5
Growth & Strategy
Grow on purpose, not by accident
2 hours with your leadership team
Growth is not automatically good. Added volume in a low-margin service line with a stretched staff makes the practice more fragile, not more independent.
This chapter forces a choice: which patients, which services, and which referral relationships you are building the next three years around — and what you will stop doing to make room.
Tests for any growth move
- Does it improve margin per encounter, not just volume?
- Can current operations absorb it without new rework?
- Does it strengthen a referral relationship you control?
- Is the payer mix acceptable at scale?
- What are you stopping to fund it?
Ancillary revenue
Ancillaries are the most common growth lever for independent practices and the easiest to get wrong. Model the staffing and space cost before the revenue.