Stop Doing It All: The Case for Choosing Your Niche with Keisha Nolan

Nov 8

Stop doing it all.

That’s easy to nod along to, and hard to live out when you’re the one holding the caseload, running the schedule, answering emails, and trying to make your practice “work” in the middle of real life. A lot of private practice owners start the same way: wide open, saying yes to whoever walks in, taking any referral you can get, and trying to be helpful to everyone.

And for a while, that approach might even keep the lights on.

But eventually, it starts to cost you. Your systems feel messy because every case looks different. Your marketing feels scattered because you’re trying to speak to too many people at once. You get good results, but you also wonder why some clients need so much more time, why progress feels slower than it should, and why you still feel like you’re working so hard to be “fully booked.”

In this episode of The ScaleSmart Podcast, I sat down with Keisha Nolan, a speech-language pathologist and certified myofunctional therapist, to make the case for choosing your niche. Not as a branding exercise. Not as a trend. As a way to build a practice that actually supports your life and helps your clients more deeply.

Keisha’s story is the kind that makes you pause, because she didn’t niche down after fifteen years of running herself into the ground. She niched down early. She started as a generalist, like most of us do, and within a year she realized there was a whole layer of what she was seeing that she didn’t fully understand yet.

And once she saw it, she couldn’t unsee it.

The moment that changed everything

Keisha shared a story from her school SLP days that still sticks with her.

She ran into the mom of a student she had already discharged. The student sounded good. The tongue thrust had been addressed. Keisha had done her job well.

But the mom told her the orthodontist wasn’t going to move forward with braces because of the tongue thrust. And then she said something that surprised Keisha.

She was driving an hour away to see an orofacial myofunctional therapist.

Keisha had never heard the term.

So she did what a great clinician does. She got curious. She asked questions. She signed a consent form so she could talk to the provider. She watched a session. And she realized how much she didn’t know.

That’s the thing about growth in private practice. There’s often a moment where you realize your current skill set is not the ceiling. It’s the starting line. And if you’re willing to go deeper, your entire practice can change.

Keisha started learning, investing in continuing education, and shifting her focus toward the root causes behind what she was seeing in speech therapy.

Within that first year of owning her practice, she began niching down.

Why niching down isn’t “leaving money on the table”

This is usually where fear shows up.

If I niche down, what if I don’t get enough referrals?
What if people stop calling?
What if I make it too narrow and regret it?

Keisha named that fear directly, and she also shared what has been true in her experience: niching brought more clarity, more referrals, and more sustainability, not less.

She described five ways a niche supports a private practice:

It creates clarity in how you’re positioned, so you become the go-to person for something specific.
It increases your value and income, because people pay differently for a specialist than a generalist.
It brings more fulfillment, because you’re working in the area you care about most.
It builds trust and reputation, which fuels steady referrals year after year.
It makes marketing easier, because you’re not trying to speak to everyone.

That last point matters more than people think.

When you’re a generalist, your marketing becomes a constant game of explaining. You have to stretch your message to fit ten different kinds of clients. You end up posting “we help with everything” content, and it blends into the noise.

When you’re known for one thing, your marketing becomes a clear signal. People know where to send their clients. Referrers know what you do. Families know why they’re coming to you.

And that isn’t limiting. It’s relieving.

Your niche can be personal, even if your clinic is broad

One of my favorite parts of this conversation was how practical Keisha is about this.

She has a niche. She is the specialist. But her practice doesn’t have to be “one single thing” to the point where no one else can be served.

Keisha explained it like this: you can be the expert in a specific area, and still build a practice that offers other services through team members and collaboration.

She shared how she hired and partnered based on complementary expertise. One example was bringing in a therapist who specialized in reflex integration. That expertise supported the work Keisha was already doing, and it gave the clinic a stronger ability to identify what was really going on for certain clients.

She also talked about getting training, like becoming a certified lactation consultant, not because she planned to do everything herself, but because she wanted the knowledge to make better referrals and understand the full picture.

That’s a key distinction for practice owners.

You do not have to become the provider who does all the things.

You can build a team and a network where clients get what they need, and you stay focused on what you do best.

The collaboration model that makes the “one stop shop” possible

Keisha’s practice is also unique because of how she built collaboration into the structure.

Because of Michigan’s learned professions law, she can’t legally own a business with a chiropractor. So instead, she and her business partner each run their own practice under separate LLCs, and they share space, staff, and overhead.

They share the rent. They share trained front office support. They share the experience of being in the same building with aligned providers.

That setup created a multidisciplinary environment without needing to merge businesses. It’s collaborative, practical, and it supports the kind of care their community was looking for.

It also reinforces something that many private practice owners need to hear:

You don’t have to scale by doing more alone.
Sometimes scaling looks like building smarter partnerships.

Values first, business second

This conversation also went deeper than niche strategy.

Keisha talked openly about her faith, and how values alignment was the reason she left her school job in the first place. She described a meeting where she realized what was being asked of her no longer matched her values, even though the job was stable and well-paying.

So she walked away and opened her practice.

And she built the practice around a core commitment: giving people hope.

She referenced Jeremiah 29:11 as the foundation of her business, not as a slogan, but as a lived value. Her goal is that anyone who walks through the door, a patient, a parent, a referral source, leaves with hope for a future.

Whether you share her faith or not, the takeaway is powerful.

A practice that isn’t aligned with your values becomes a runaway train.
A practice that is aligned gives you something to build on, especially when it gets hard.

We also talked about abundance, and Keisha made a point I appreciate: abundance is not just money. It can be time, health, relationships, energy, impact, and the ability to build a boutique practice that feels sustainable.

That’s why this matters. Niching down is not only a business decision. It can be a values decision.

If you care about family time, your health, or having space to breathe, your niche can support that. It can help you create clearer systems, better referrals, stronger outcomes, and a schedule that doesn’t feel like it’s eating you alive.

The role of coaching when you’re trying to grow

Keisha also shared how much coaching has shaped her journey. She talked about the clarity it brings, especially when you’re too emotionally connected to a situation to see it clearly.

She also said something that I fully agree with: crowdsourcing advice in Facebook groups can only take you so far.

You might get good tips.
You might get bad tips.
You will almost always get advice that isn’t tailored to your actual practice, your market, your goals, or your values.

Coaching brings objectivity, perspective, and accountability. It helps you avoid mistakes you don’t need to make the hard way.

We also talked about how important it is to choose a coach who has sustained what they’re teaching. Private practice is a long game, and the skills required to start are different than the skills required to grow, stabilize, and lead.

That’s exactly why Keisha created her coaching program, SLP Biz Boost. It’s designed to help SLPs niche down, gain referrals, and sustain them, with support that’s individualized instead of cookie cutter.

If you feel like you’re doing too much, this is your sign

Here’s what I hope you take from this episode.

If you’re exhausted from trying to serve everyone, it might not mean you need to work harder. It might mean you need clarity. It might mean you need a lane.

Your niche doesn’t have to be chosen perfectly the first time.
It does have to be chosen intentionally.

Because when you stop doing it all, you finally get to do what you do best. And that’s where your clients win too.