How to Scale a Private Medical or Dental Practice from One to 100 Locations

Paul Vigario, CEO and Founder, SurfCT

For many private practitioners, getting one brick-and-mortar medical or dental office up and running is hard enough. The thought of going from zero to one location — let alone scaling your practice from one to 100 — is hard to fathom. Yet the path from one to 100 isn’t as arduous as it might seem. 

Well-run practices that have the personnel and ability to scale might not do so simply because they lack important knowledge — and leave millions of dollars on the table as a result. The secret? Making sure the first practice is running flawlessly from a business standpoint. Building the perfect first practice at the start offers a blueprint for building the next 99.

Too often, however, the journey from one to 100 is sidetracked by perfectionism, myths about the importance of the clinician’s skill, or being distracted by capital equipment upgrades. 

Common myths

Medical school has a habit of attracting perfectionists. Research shows that perfectionism isn’t just a trope — it’s been measured and analyzed in medical student populations. One study of undergraduate medical students in Germany found that students who were selected for medical school based on their high school degree showed high scores for adaptive perfectionism, compared to those with lower grade-point averages.

Some degree of perfectionism can be an asset when it comes to acing a test. But the same trait can be a hindrance when it comes to establishing a private practice. Not everything has to be perfect in order to open the first office. There’s a time to go back and perfect every process, piece of furniture, and tertiary detail that makes your clinic shine. It shouldn’t be on or before Day 1. 

Consider the amateur runner who decides he needs to get in shape before training for a marathon. At that stage, putting one foot in front of the other is more important than running fast. Putting perfection first positions the runner to lose valuable time.

High achievers often believe the secret to growing their practice lies in becoming a more skilled clinician. Doctors and dentists sign up for a lifetime of learning, but growing a business and growing one’s clinical skills are separate and unrelated — an idea many are slow to grasp. The world’s best doctors and dentists might only have one office; the practices whose brands extend from coast-to-coast grew by virtue of their business acumen, not their clinical skill.

This is a direct contradiction to the messages often peddled at industry conference events, where capital equipment upgrades and digital healthtech platforms are marketed as the secret to business growth. Many private practitioners spend excessively as a result. Yet the ability to scale does not rest on having the newest equipment. 

Getting the house in order

The basics of getting your practice in order might strike a highly trained doctor or dentist as boring. Is your marketing clearly communicating your brand? Under the hood, do all your IT systems function as well as they can? Are you leveraging AI tools to complete all the tasks they can manage?

The answers to these questions — not if your skills are up to par, or if your equipment is the latest and greatest — will determine whether or not you’re ready to scale. It’s all easier said than done; if not, every doctor or dentist would operate multiple clinics. But compared to completing medical or dental school and opening the first clinic, scaling is relatively easy. The hard work is done. Most medical and dental professionals simply aren’t trained to complete the easier tasks on their own.

Getting ready to open a second clinic will require making difficult choices for many private practitioners. When a new patient walks through the door, most will choose to care for the patient rather than perfecting the business of their practice.

Fortunately, there’s no downside to getting your existing practice working more efficiently from a business standpoint. Eventually, a better-functioning business gives the doctor more freedom to focus on other things, like personal time or patient care. The private practitioner looking to expand their business is a lot like the aspiring marathon runner. Not everything has to be perfect in order to take the first step.

For most, that will mean partnering with professionals who are experts at branding, technology, IT, marketing, AI implementation, and the other necessary ingredients that gets a business ready to expand. For the private practitioner, this doesn’t mean more work. It merely means working smarter, and surrounding yourself with a team that knows how to scale and grow your practice so it works for you — more than merely building a practice to work in.

Pursuing scalability has wonderful side effects and gives you a sense of purpose to get your existing machine running as efficiently as possible. Whether you go from 1 to 100, or even just 1 to 2, the process of making your business efficient enough to scale is rewarding. Winning a marathon is amazing, but for most finishing it is the more realistic goal. Doing both has the potential to get a runner in the best shape of their life.

Setting scalability as a goal has the effect of pulling your current practice in the right direction — a powerful force doing the pulling, rather than trying to push through it yourself with will power. If you’re trying to use will power to grow, you’re going to run out. You’ll have bad days. You’ll get the flu. But if you create a compelling enough story, and a compelling enough vision to serve as a target, it will have a gravitational pull for you, your patients, and your team. 

At best, your vision will come to fruition. At worst, your existing practice will function more smoothly, giving you more freedom and improving your quality of life. There is no downside to scaling with the right team.

About Paul Vigario

Paul Vigario is the founder and CEO of SurfCT, a leading authority in healthcare practice strategy, design, and technology for private healthcare practices, known for its integrated approach to improving and modernizing operations. Over the past 25 years, he has helped more than 12,000 practices worldwide generate more than $36 billion in healthcare revenue, redefining how providers automate, scale, and grow. Widely recognized as a visionary leader and pioneer in healthcare innovation, Mr. Vigario has spent his career advancing the integration of technology, brand, and patient experience in modern healthcare through clarity of vision, purposeful design, and systems that create freedom for providers.