Seven Figure Practice Series: How to build a Seven Figure Practice without Specializing and Standing out with a Model T with Dr. Elizabeth Carr | POP 932

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Is it possible to build a successful private practice without niching? How can you massively boost your SEO with ethical Google reviews? What should you do to move from six to seven figures?

In this Seven Figure Practice series podcast episode, Joe Sanok speaks about how to build a seven-figure practice without specializing and still stand out with Dr. Elizabeth Carr.

Podcast Sponsor: Therapy Notes

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Meet Dr. Elizabeth Carr

A photo of Dr. Elizabeth Carr is captured. She is the founder of Kentlands Psychotherapy. Dr. Carr is featured on the Practice of the Practice, a therapist podcast.


Dr. Elizabeth Carr is the founder of Kentlands Psychotherapy. She started the practice in 2005 after six years as a Navy Clinical Psychologist. She is married with an only child who’s a freshman at Georgia Tech. Her practice now includes 21 clinicians, 2 admins, and two therapy dogs.

Visit Kentlands Psychotherapy and connect on Facebook, Instagram, LinkedIn, and YouTube.

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In this Podcast

  • What to do to move from six to seven figures
  • How to create success without a niche
  • Stepping up as the leader
  • Sponsorships and ethical Google reviews
  • Finding a community with other CEOs
  • Dr. Carr’s advice to private practitioners

What to do to move from six to seven figures

I started thinking in terms of commoditizing my time. You know, unfortunately the downside of that is now saying; “Oh, I could bake a loaf of bread, but that’s a $400 loaf of bread now!” Similarly, I realized [that] I should not be doing accounting [or] bookkeeping … I don’t need to do those things. I could pay someone else to do it and see another patient and easily pay for it. (Dr. Carr)

The first shift that took Dr. Carr from running a six-figure practice to one that annually makes seven figures was to realize that her time was valuable both financially and strategically. As the CEO, she had to remove some hats and delegate tasks so that she could have the time and mental capacity to focus on what only she could do for the business, which was to grow it and maintain its path toward success.

That’s one of the first things that we realize, is [that] we need some office assistance because it makes it scalable. Until you do that, you’re always going to be stuck under a shelf or a ceiling. (Dr. Carr)

How to create success without a niche

Dr. Carr’s private practice has over 20+ clinicians who see a range of clients, all in one building, and without taking insurance.

As there are pros and cons to specializing, there are also pros and cons to not niching down. It would depend on your practice, the vision that you see for the future of your business, and the values you want to base your work on. Dr. Carr wanted her therapists to come and work in her private practice and have the freedom to work with whom they wanted and with whom they had experience, without feeling cloistered up or stuck with only that niche group of people.

I want therapists to come and love it and stay for the rest of their career, and to be able to change your specialty, to not see the same people all the time, [and] to also not feel like you’re competing in-house with other therapists … If you’re the only one doing internal-family systems [for example] then you’re going to have a sense of security in your caseload. (Dr. Carr)

Stepping up as the leader

Dr. Carr had experience in the Navy for six years and there she learned some of the tenets of what it means to be a true leader. One of these was that a leader takes care of the needs of their people.

My responsibility is to make sure that all of my clinicians are full and also that they’re not burning out, so I’m hustling to make sure we have enough referrals coming in so that everyone has economic security but I’m also saying, “Hey, I see that you have eight people in a row on a Saturday … maybe we should block one of those hours in the day so that you can have a breather.” – Dr. Carr

The responsibility of being the CEO and leader of a successful and large group practice is to not just handle the direction of the business but to care for and be in touch with the people that are working for and with you. They cannot be the ones to call the shots – you have to keep your eyes and ears on the ground to notice when you can step in, step up, and make decisions that place their needs and the business of the business at their center.

Sponsorships and ethical Google reviews

Dr. Carr and her practice often invest in swimming teams or neighborhood competitions to get their logo on the backs of T-shirts and other clothing. It shows their commitment to their community and gets their name out in the community organically and invitingly, showing their approachability and connection with their immediate city and its events.

From these sponsorships or from giving talks, since it’s unethical to ask clients to review your practice on Google reviews, Dr. Carr asks the organizers to send in some reviews that massively boost her practice’s rank on Google.

Those Google reviews are extremely valuable and they don’t cost you anything. This is a controversial topic because you can’t ask clients for reviews, but you can speak to a mom’s group and ask the organizer, “Hey, can you thank me by giving a review about the quality of the talk I did today?” … I lean into that heavily because I know how incredibly important for our business those Google reviews are. (Dr. Carr)

Finding a community with other CEOs

Dr. Carr knows that some business owners and therapists often get stuck in a scarcity mindset and try to protect their clients and don’t want to openly give or send referrals, and this type of behavior closes off private practice owners from one another even more.

However, if you can connect with other business owners on a national scale, you can both appreciate your work, support one another, and boost the business and the professional relationship in other ways too.

These national opportunities to connect with other people are really solid … And you know that generally speaking the more homogenous a group is, the more beneficial it’s going to be for you and so when you go to a national scale you can say, “Oh, I really want to find a group [of business owners] that it’s in the one to two million dollar branch”. (Dr. Carr)

Dr. Carr’s advice to private practitioners

Don’t be afraid to stumble into success because you won’t have everything figured out. Remember, you can’t drive a parked car, so get out there and try something new because that’s only when you can start to make changes for the better.

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Check out these additional resources:

Seven Figure Practice Series: Christy Pennison on how to Position Yourself for a Seven-figure Practice | POP 931

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Meet Joe Sanok

A photo of Joe Sanok is displayed. Joe, private practice consultant, offers helpful advice for group practice owners to grow their private practice. His therapist podcast, Practice of the Practice, offers this advice.

Joe Sanok helps counselors to create thriving practices that are the envy of other counselors. He has helped counselors to grow their businesses by 50-500% and is proud of all the private practice owners who are growing their income, influence, and impact on the world. Click here to explore consulting with Joe.

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