Big City or Small City Therapist Marketing: Pros and Cons

Even with PsychFusion, I still manage what I humbly consider to be a successful private practice. Not only do I typically operate a full schedule of largely cash paying clients, but I am also a psychotherapy partner of several national sports organizations.

You wouldn’t know it, but I’ve been able to grow this practice despite my office being located in Chandler, AZ, a town of about 280,000 people located 30 miles from Phoenix. While Chandler isn’t exactly the smallest city in the world (it’s actually the 4th largest, ahead of Scottsdale), it’s not the city that probably comes to mind when you hear about what I’m involved in.

You can build a successful practice no matter where you’re located. Some of the most successful therapists I know are located in townships of 30,000 people, or in unincorporated communities in counties you’ve probably never heard of before – and this was before remote therapy was taking off.

Still, when it comes to marketing and advertising on the internet, where you choose to market matters. We’ll create a post someday detailing how advertising and marketing works, but in the world of search engine optimization and Google Maps listings, you have to decide where you’re located if you’re going to try to market to that community.

For example, while I can probably get away with marketing to Phoenix, it’s much more difficult for me to market to, say, San Francisco, California. I’m licensed in California, and I have clients there, but I’m not located there, and if I’m talking about my physical location being in Chandler, I’m not exactly going to show up in “therapist near me” searches 750 miles away no matter what I do.

So, therapists are typically faced with a choice:

  • Focus on your local area, no matter how small it may be, because you’re located there.
  • Focus on the biggest city/town nearby because there are likely to be more clients.

Let’s talk about the pros and cons of each approach, starting with choosing the biggest city nearby.

Benefits of Choosing a Big City

The benefits of choosing a big city are obvious. The bigger the city, the more potential clients will be available. Phoenix, which is close to me, has 1.6 million people compared to Chandler’s ~250,000. There’s more people there, which means more opportunities for growth.

But that’s not the only benefit:

  • Even those in small towns often search for services in big cities. When I’m looking for someone to help me with a task, I sometimes search for “near me” or “in Chandler,” but many other times I search in Phoenix, because I don’t exactly need someone immediately local as long as they serve my area and Phoenix has more options.
  • Although this is not true in all big cities, many times the big cities are where the money is. Some affluent suburbs are an obvious exception, but if the big city is where the tech jobs are, or the jobs with the better health insurance policies, then those cities are more likely not only to have more clients, but to have more clients that can pay for a therapist.

Also, and this just tends to be anecdotal, those in big cities tend to be more open to therapy in a way that some smaller areas may not be. There are culture differences that matter.

Weaknesses of Choosing a Big City

It should, then, be a “no brainer” to target a big city. But that’s not necessarily the case.

  • Big cities are going to be more competitive, and marketing is hard – arguably harder now, than ever. That means that, while a big city might be a great idea in the long term, it can be difficult as you’re starting out. On the other hand, ranking in a smaller city tends to be easier depending on the competition.
  • If you’re not physically located in the city, search engine algorithms may not reward you the way you expect. For better or worse, search engines prioritize local addresses. You can get around this fairly easily, but it is still a barrier at a time when you’re already competing with more businesses.
  • Your callers may be disappointed when they find out your real location. When a client in Phoenix does call me, if they only want in-person, they may find the distance too difficult to overcome. I do offer remote therapy, but as I’ve talked about before, not everyone wants it. Those that only want local may find your distance from them too much.

So, while a big city offers more opportunities, it comes with downsides that do need to be acknowledged before taking this approach.

Benefits and Weaknesses of Local Marketing

Locally, in your small town or region, marketing your therapy practice is (usually) less competitive and thus ranking in search engines is easier. It is also where you are physically located, which is something Google wants and is also slightly more effective at converting callers. But of course, you’re limiting your client pool, and that can mean that if your goal is to grow to a multi-therapist practice, you may eventually find that you’re running out of clients for your team.

What’s the Best Choice?

There is no right or wrong choice. It depends on your specific circumstances. Though PsychFusion doesn’t provide marketing, we are happy to guide you in your decisions as part of our consultations, and help you determine what the best options are for your practice and location. Are you ready to launch your practice? Reach out to PsychFusion today to get started.

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