What Does It Really Take to Scale from 2 to 120+ Employees?

If you are a private practice owner, you already know that scaling a business is one of the hardest but most rewarding things you will ever do. We all want to make a massive impact, but as I always say: you can run fast alone, but to go far, you need a team.

On a recent episode of the WillPower Podcast, I sat down with Brian McQuilkin. Brian helped grow his organization from just two people to over 120. Back in 2008, when his partner Joan pitched the idea of opening a practice in Rochester, Minnesota, Brian actually told her it was a “bad idea”! Fast forward to today, and their team includes 17 different locations serving 12 different communities.

How do you survive that kind of explosive growth without burning out or losing your culture? Brian dropped some pure gold on how high-performing leaders build teams. Here are the biggest takeaways.

1. Hire (and Fire) By Your Core Values A lot of clinics have a nice mission statement slapped on the wall in the breakroom. But for Brian’s team, core values are the ultimate operational filter. They use their six core values to decide exactly who they hire, fire, review, recognize, and reward. When you interview with them, they draw out those core values to see if you are a true fit. It’s not just lip service; they revisit these values at 30, 60, and 90 days, as well as during annual reviews. If you want to scale, your culture cannot be an accident. It has to be a living, breathing system.
2. Personality Tests Are Your Secret Weapon Brian admits he loves personality tests. And honestly, so do I! His team uses assessments like Myers-Briggs, Enneagram, Kolbe, and even Love Languages. Why? Because understanding how your team thinks and how they prefer to be appreciated changes the game. If you know a team member’s love language is words of affirmation, your feedback is going to hit differently than if they value quality time. Brian pointed out that if an extroverted front desk coordinator is talking endlessly to an introverted coworker between patients, the introvert might just be trying to recharge but without self-awareness, it breeds unnecessary conflict.
3. Seek Out the “Curiosity Quotient” We often focus on IQ or EQ, but Brian’s team looks heavily at the “Curiosity Quotient”. Brian shared an incredible story about a team member named Lex. She asked how she could support him, and he handed her a task he didn’t even have time to explain. Instead of handing the problem back to him, she took full ownership of it and simply asked, “I have no clue how to do that for you, but how would you start it if you were going to do it?”. That sheer curiosity and willingness to figure things out makes a team member absolutely invaluable.
4. Put the Team Before the Patient This one rattles people, but it’s the truth. Brian unapologetically states that their team comes first, not the patient. The philosophy is simple: a healthy team and healthy team members will always out-serve and care for people. If your clinicians are burnt out or feel undervalued, your patients are going to feel it. Build your team up, and patient care takes care of itself.
5. Work-Life Balance is a Swear Word I loved this perspective. Brian believes “work-life balance” is a swear word because life simply doesn’t work in perfect balance. Instead, he advocates for having 5 to 8 passions in your life. They might not always get equal time, but as long as you are making a little space for your faith, fitness, family, or whatever drives you, you stay aligned.

Ready to Build Your Rockstar Team?

Listening to Brian’s journey from 2 to 120+ team members is a massive reminder that you don’t have to wear all the hats forever. The key to freedom, income, and leadership is empowering the right people to help carry the ball. If you are a private practice owner drowning in administrative tasks, billing, or patient scheduling, it’s time to build your own scalable team.

At Virtual Rockstar, we provide elite, highly-trained virtual assistants explicitly tailored for outpatient private practices. Our VAs are packed with that “Curiosity Quotient” Brian talked about. They aren’t just remote workers; they become dedicated allies invested in your success, saving our clients an average of $20,000 in profit per hire while simultaneously changing a family’s life across the globe. Stop running alone.

Head over to Virtual Rockstar today and book a discovery call. Let’s get you back to the clinical and visionary work you love.

Lead with love. Never give up.

Want to build a practice that runs smoother and scales smarter? Visit VirtualRockstar.com to learn how we help medical entrepreneurs thrive.