Dr. Rachel Millner vividly remembers the moment she realized something had to change. She was working in a large healthcare system, helping people navigate some of their hardest battles. She truly believed in the mission and loved the work, but the system itself kept getting in the way.
That realization pushed her to take a risk. Dr. Millner, a renowned clinical psychologist and certified eating disorder specialist, left behind the safety of the system and stepped into the unknown to open her own private practice.
This move wasn’t about freedom for Dr. Millner, it was about impact. She wanted to offer the kind of care she knew worked best, the care that wasn’t tied to red tape or corporate policies. And it worked. One step turned into many and her solo practice grew. Soon, she was hiring other therapists. Today, her private psychotherapy practice is thriving in Philadelphia, helping more people than she ever could have inside the old system.
Dr. Millner is now known not only for her clinical work, but also for her voice in the field of eating disorders, body image, Body Trust specialist, and Health at Every Size care. Her work challenges norms, while her journey proves that meaningful change often begins outside the system.
In this interview, we speak with Dr. Millner about the obstacles she faced and how she overcame them, her advice for avoiding burnout, the mission behind what she’s building now, and the lessons she’s learned along the way.
1. You specialize in eating disorder recovery, body liberation, and Health at Every Size. How did you shape your business to reflect these values beyond just the services you offer?
It’s important to me that every aspect of my business reflects these values. Our website explicitly states our values and the type of services we offer. All marketing material reflects it. When I give lectures or teach, I am very clear about the values that I hold and that the business holds. Any social media posts reflect our values as well. Before hiring a new clinician, I always make sure that their values are aligned with the business’s values so that clients are getting consistent and ethical care.
2. What were some early obstacles you faced in building your practice as a scalable business, and how did you navigate them?
I think the main obstacle was that I had never been taught how to run a business. In graduate school, I learned about how to be a therapist and how to help people, and I have had a lot of years of training and experience in that area, but nowhere in my training was I required to take business classes. I had to learn as I went, which meant making a lot of mistakes along the way. I tried to seek out help and advice from people I trust and who ran businesses that I trusted and felt comfortable learning from.
I think the main thing was seeking out support whenever possible and then trusting my instincts. Even though someone may have knowledge about running a business that you don’t have, they don’t have knowledge of your business or services, so you still need to trust your instincts and don’t compromise on what you know.
3. Many entrepreneurs struggle with burnout, especially in the mental health space. You are a single mom by choice to 12-year-old twins, how do you balance showing up fully for your family, your clients, and yourself — all while running a values-driven business?
It’s a good question and an important one. It definitely helps that the values that I bring to my business are the same values I show up in my life with. It’s not like I have one set of values at work and a different set at home, so that consistency is really helpful in how I show up. I don’t think there’s any perfect way to balance it all. Sometimes I am giving more attention to one thing than another, but I still try to be as present as possible with whatever I’m doing at a given moment. I find that I’m actually more prone to burn out if I am not showing up fully.
I also think a key part of the question is that you included “yourself” in who you need to show up for. I think so many of us, especially those of us socialized female, have learned that it’s not important for us to show up for ourselves, when it’s actually critically important.
4. What advice would you give to therapists or clinicians who want to expand into entrepreneurship but feel overwhelmed by the business side?
As I said previously, I think getting guidance is so important. But you need to be careful who you ask for guidance from. Only go to those who have shared values and who you trust. There may be someone out there who does an amazing job running their business, but if you don’t have shared values then you won’t be comfortable running your business in the same way they are.
There are also plenty of training and courses you can take on entrepreneurship and business. Also, don’t talk yourself out of it. It’s so easy to convince ourselves that our ideas aren’t “good enough” or that no one will be interested in what we are doing, but that often comes from that critical part of us that has learned to shut new things down by saying we won’t be able to do it. If you have an idea or want to start a business, don’t immediately talk yourself out of it. Take time with it and trust yourself and your instincts.
Starting a business is overwhelming so being overwhelmed is part of the process. It’s okay to let yourself feel overwhelmed and remind yourself that it’s normal to feel that way and then to keep moving forward anyway.
5. Looking ahead, what’s next for your business, and how do you see your impact evolving in the next 5 years?
I am currently focused on broadening my impact and trying to get hired by Peloton as a plus-size instructor. So much of my work has been one-on-one with clients for the past twenty years, which is great and something I love doing. And, I want to expand to shifting the fitness field and increasing representation in that space.
The fitness industry has been so toxic for a long time, and I want to work on changing that. The impact of representation is significant. I know how much it has impacted me to see other plus-size people challenge stereotypes and be visible and take up space. It’s my turn to do the same. I think my private therapy practice will continue to grow and evolve to meet the needs of our clients and new challenges that will come up as time goes on.
