"Factors that you may never recognize
about your medical practice business,
any of which can sink your flagship"
If you one day find yourself and your disintegrating medical practice in deep financial trouble, you need to quickly analyze the meaning to you of, “You don’t know what you don’t know.” That single thought prevents almost all medical doctors from considering the extreme importance that medical practice business management and medical practice marketing education contributes to your medical practice.
That thought, when disregarded because of your arrogance about thinking you know business already, clamps a ball and chain around your strongest efforts to make the income you expected your private medical practice career to provide you with. Reaching the end of your medical practice career without ever understanding how much of your medical practice capabilities you involuntarily gave up, dishonors your goals, intentions, and expectations.
It’s because of your attitude or belief about what you thought you knew, and didn’t! What’s
worse, you probably never gave yourself the option of investigating what a sound business education would offer you over time in your medical career.
Can you stand the overwhelming truth?
Anytime during your medical practice career, it’s enormously profitable for you to dig into your medical practice business deficiency and do something about it. But first, you need to have a clear picture of what happens to you and your practice while you zigzag along in your private medical practice wondering what it is that’s fowling up your expected path to affluence.
The following examples of what you miss out on should embarrass you to the core, but hopefully you will forget the embarrassment and take action that can exponentially enable you to reach the visualized goals and lifestyle you had at the very beginning.
You may find this series of "Why Doctors Fail" article a critical and hand slapping rant intended to criticize your career, put-you-down, or to show you that you are not as smart as you think you are--or to show you how smart I am. My passion and intent is exactly the opposite. You might want to
ask yourself who is the best person to ask about breast cancer? And you know that it's the person who has had breast cancer.
In that same sense you are actually reading these seemingly intrusive descriptions from a person, another physician, who discovered the reasons why his own practice failed, was destroyed by factors that he never knew were coming, and who would love to reveal to you what you need to know to avoid the same failure in your own practice.
What I tell you is the honest truth about how to protect your medical practice from what will happen to you if you disregard what I see as being the cure for financial failure of medical practice today...October 2021.
Also understand that I don't expect any thanks, or publicity, and I am not engaged in a pity-party as Pastor Joel Osteen often speaks of. But what is real, is that I am donating the hours of my life to what I believe will undoubtedly benefit everyone in our profession tomorrow... and it makes me
feel good inside.
1. Proven requirements for business success (including medical practice business) are lacking...
Essentially all highly regarded business experts are in agreement that there are foundational elements required for maximal business income, growth, and stability. Most medical practices are small businesses and lack all of them.
These are a few foundational elements for business that are missing...
A. Failure to recognize common basic business principles
When you never take the time to learn and manage your medical practice business as a real business should be managed, you're playing a losing game.
The time you spend correcting the problems and errors made in your office daily, or whenever the blunders come to light, wastes employee productive time and the money you are paying them, let alone the number of patients you could have treated during that time period.
Those problems arise because of your lack of management knowledge and what I call “floating employees.” You have not set the rules and standards you expect from them in their job duties, never reinforced those requirements verbally or often enough, and you never have shared your goals for your practice with your employees--called medical practice management.
They have no idea what you want done, nor how you want it done. You must instruct employees in a detailed fashion what you expect from them. It pertains to each job that you hired each one to do. You can create a list of those instructions that they keep handy to check on or you can remind each person often about what you expect them to be doing and accomplishing.
Be aware that 99% of medical office employees are kept in the dark by the medical doctor who employed them because of the medical doctor’s neglect to enlighten them. If you believe it’s none of their business, then you obviously won’t get the help you need to become highly profitable in your practice.
They do the job you hired them for, as best they can, because they have no professional office procedures manual to follow or to refresh their memories. You may think you told them everything, but neither you nor the employees remember what it was that you told them when they were hired months or years ago.
Commonly you will never repeat those instructions again during their employment. If you don't, each employee will slowly create their own way of doing their job which may slow down the
office functions.
Employees simply fall back to what they may have learned while working in other doctor’s offices or elsewhere. The only way you will find out whether they are doing their jobs as you want them done is to take the time to supervise each employee on a weekly or monthly basis.
When you don’t know or never learned the successful basic business principles, let alone implemented them, then you will never recognize the common business conflicts and problems that originate from your lack of using profitable medical practice business principles.
They’ll happen, but even if you are aware of the problem, you will either think they’ll resolve themselves or someone on your staff will get it corrected somehow. Foolish thinking.
Employees that are inspired to do more than is expected of them are rare to find. Over 90% of your present employees do only enough to get by. If they do anything else, it only happens when they are told specifically to do something.
So, get it in your head that the management, supervision, and instruction job belongs to you…the doctor employer. If not, then you are settling for a mediocre practice and income…and the problems continue. And maybe, you simply don't care where you're headed.
B. Integration and implementation of basic medical practice business principles
The second step beyond knowing medical practice business principles, is that of implementing them into your medical practice. You’re lucky if you have a solid knowledge about good business principles and strategies because 95% of medical doctors don’t. And another 3% are lying or think they know, but don’t.
It’s quite common in today’s world that even the physicians with great business knowledge still won’t implement the business basics into their practice. Every business expert is confounded by
this question.
That attitude derives from the fact that no one told them they would need to know business to run a successful medical practice business, meaning in this case that any level of their practice income is big enough to fulfill all of any physician’s goals.
Neglecting to implement business basics is also the result of two other factors.
One---No one in the medical school community thought business
was important enough to stress to the students that the
knowledge was necessary.
Two---By traditional belief in medicine circles, a separate level
of business knowledge is unnecessary for medical practice success.
A hundred years ago that may well have been true… but not today.
This kind of outdated garbage is still in existence today. The tragedy is that most medical educators and medical doctors continue to believe this fairy tale.
Implementation of business knowledge into private medical practice ideally should be done at the time medical practice is started. This implies that a medical doctor needs to get the business education before, during, or right after medical training is completed.
This could very well be accomplished I believe at a low cost and in addition to the medical school’s curriculum without interfering with the medical education process. Another topic for another day.
C. What are some of the business issues most all medical doctor’s rarely consider?
o Requirement for private medical practice marketing strategies being used persistently
o Medical practice business plans
o Organized 3 ring manuals for employee job functions and office procedures
o Use of employee teams to organize and perform business projects
o Medical practice business management tactics to enable optimal profitability
o Delegation of medical practice business functions
o Complete transparency between doctor and employees regarding your practice goals
2. In-Office business resources are lacking...
Every medical practice business needs to have in-house medical practice educational and business resources that add to the growth and development of your business.
Use of the Internet with computers, books, videos, educational CDs and DVDs, reports on specific medical issues and updates to the medical profession, and many more are important to how much benefit you receive from your medical practice business.
If you walk into any private practice medical office today, you are quite likely to find NO...
- Written/printed medical practice business plans
- Manuals for duties of employees, functions of medical practice business
job responsibilities
- Educational materials for the office staff
- Medical Educational materials for the patients
- Supervision of jobs being done by employees
- Team organized efforts on projects... like medical practice marketing,
marketing for physicians, practice marketing, and medical practice management - Physicians who have no interest in profitable and productive
management... or they'd be doing it already - Doctors who resent being told they should do things differently...so no one tells them,
and the ignorance persists and the profits fall. - Reference books on medical practice business management or medical practice marketing
The greatest risks from having no office manuals are conflicts over job duties, suits by disgruntled employees you fired, and employees who forget what duties they were hired for… and you won’t remember those either.
Because healthcare is getting much more complicated, faster, and less satisfactory to your patients, the need for medical practice staff business education and improved customer service management is much greater. Patient visits need to be more than an "event". Office visits should be an “experience”…but only if you want to keep loyal patients coming back again.
By providing educational materials, preferably written by the physician or office staff for patients, you save time on hundreds of patient phone calls over time that could easily have answered
with a printed handout.
Another good reason is that patients won’t remember what you told them 3 days later. The same is true for post-op instructions at the time of hospital discharge. Hours of office time are saved by doing these things whether you believe it or not. Do you honestly know how many phone calls are made back to your office, that could be avoided, by using handouts for post-operative patients?
- Handouts are an easy way for the doctor to avoid spending a lot of extra time answering patient questions about certain problems.
- Handouts are a free marketing method for your practice. Patients often take handouts home to read, give to someone who could use good advice, visitors notice them laying around and pick them up to read.
The absence of a medical practice written business plan leads to what David Ogilvy's brother calls, “The slippery surface of irrelevant brilliance”=(chaos).
A medical practice business plan is an ongoing reminder used to keep you focused on your primary objectives in your medical practice. Over time you will forget what it was. When you review it every 6 to 12 months, you have the option to alter the plan and refocus it on new and better business strategies. All business plans must be revised and updated annually.
Providing medical practice business training for your employees is a powerful magnet for reducing employee turnover in your office. Most medical doctors don’t do this--which is a very good reason for you to do it. You can pay for them to go to medical meetings, to medical office courses, and to get training skills to run tests and perform office medical procedures...like sonography.
Having an office library of medical books for the medical staff and yourself, is of great value. Those resources that are readily available to medical doctors and medical staff and offer almost instant answers and ideas about diagnosis and treatment, including tough patient questions. Office management resources are important as references for managing your medical office and resolving issues that come up often. I see...you don't have any of that... right?
Most physicians laugh when you ask them if they have regular office staff meetings to iron out office problems. However, it reflects on the fact that, if they have no meetings, they are not going to discover problems that need to be resolved. And that there is no intention of doing anything in your medical practice to improve efficiency, productivity, and profitability. That is called a slowly dying medical practice.
Any physician, who is not asking his staff for ideas about improving the medical practice business processes or patient management processes, is telling his employees that they are too dumb to come up with anything useful... without saying it.
Asking your employees for ideas, and accepting them gracefully, makes them feel valuable, needed, and motivated to run the extra mile for you. Make it a point to compliment every staff member about something they have done at least once a week. You’d be surprised what it does
for your practice.
3. How to improve your customer services...
The most common reason patients leave a medical practice is because of the way they are treated while in the office by the staff and the doctor.
Such issues arise most commonly when a staff member is upset with a patient and it shows in their voice pattern and gestures without ever saying anything verbally that’s offensive. Patients pick up on it instantly.
In each case, when recognized, an apology from the staff member or/and the doctor given promptly will usually resolve the patient’s anger or frustration—even if the staff member or doctor did not originate the problem—one should pretend that it was their fault.
Office visit/appointments are another source of problems regarding customer service.
There are at least three instances when patient’s reach their tolerance level, and you need to be aware of them if you aren’t already.
1. When patients are not notified that their appointment was cancelled and travel all the way to the office only to discover they have no appointment.
2. When patients are waiting beyond the time of their scheduled appointment time and no one tells them the reason why.
A “because” answer and response to the patient is an instant defusing of the patient’s frustration. The patient will remain calm if someone tells them how much longer it will be every 5 minutes after they are told something like, “… because the doctor is running late on appointments.”
Actually, Robert Cialdini, PhD, in his book, “The Psychology of Persuasion—Influence” has shown by studies that just the speaking of the word “because” followed by almost any simple or weak excuse will accomplish the same result repeatedly.
The same is true if the physician is called out of the office for an emergency patient problem and a patient’s appointment has to be rescheduled.
3. When patients are left alone in the exam room for a prolonged period of time (like over 10 to 15 minutes) before the physician sees them, without being informed promptly about the reason
for the delay.
Any common reason will do. But it’s necessary for someone to pop open the exam room door at least every 5 minutes to give them follow-up guesstimations of time left.
Customer service, although often not very important to many physicians, is simply a process of being nice to a patient while they are there—plain and clear. But, it goes much deeper than smiles and greetings.
The deeper levels of customer services that are far more satisfactory to patients have to do with such things as showing respect to patients, recognizing their presence, saying their name, saying a greeting, making them feel important, remembering things about them that they told you at the last visit and bringing that up for discussion again, reacting and responding to their needs promptly, among others.
The ideal level of customer service offered by wealthy physicians and dentists is to provide an “experience” for the patient.
Multiple enjoyable services and treatments are available beyond that of the doctor visit—like a massage, nails done, hair done, or even a spa treatment--by providing additional non-medical businesses for patients to use while at the physician's office(s).
For medical doctors who can’t afford such luxury items, examples like patient activities boards, patient of the month with photo taken, and promotion of a patient’s recent awards or accomplishments, work well. Recognition is an important issue for all of us.
Sending patients holiday cards, birthday cards, and keeping in touch with them gains loyalty of patients... recognition is a powerful patient pleaser.
Physicians who have no idea about the value of marketing to their practice business, don’t know what it takes to grow and expand their practice, except for recruiting more patients... so it
doesn’t happen.
Great customer service is an inexpensive means of marketing your medical practice and drawing patients to your practice.
4. Doctors don’t see the early signs that their medical practice business is
failing financially...
The great majority of medical practices that eventually fail for financial reasons can be brought back to life, if only it is recognized early enough.
The primary problem is that by the time physicians see that they are not able to pay the office overhead and stop paying their withholding taxes to the IRS to temporarily bolster up their bank account, the medical practice business financial problems are often beyond fixing.
The only way that a medical practice is salvageable financially is if the physician has enough self-discipline, business knowledge, and aggressiveness concerning their medical practice business to have these factors in place long before the practice is on life-support measures.
There's not a single acceptable excuse for any physician to permit their medical practice to fail. Why does your practice financially fail?
Doctors don’t know how to establish ways to measure how their medical practice is doing from month to month. There are very reliable and easy ways to do it. Best to keep a list of new patients and list of one's that leave the practice (patient records transferred to the other doctors).
Unfortunately, most doctors depend on advice from their CPA, accountant, or practice attorney to alert them of trouble coming down the pike. Rarely will any of them tell you about it.
Actually, these advisors don’t give a damn about you or your practice, and it’s not their belief that it’s their job to do so. That’s a sad fact throughout the medical advisory kingdom.
If and when a physician happens to have ways of measuring how their practice is doing, it’s a start on the right path. Almost all of the situations where the physician notices that their practice productivity and profits are steadily decreasing, the physician faces the issue of what to do about it. Then does nothing!
Is there one physician in a thousand that knows what to do next? NO.
Hiring a business expert to get your medical practice business back on track is very difficult at
this point because often you lack the significant funds to hire one.
One option is to quickly get advice from everyone you know, put it all together, and see how
it goes with what you can do yourself. When you consider that you have never had a business education, how would you know if the advice you received was reliable or not?
How would you know that what you choose to do will fix the financial problem or even fast
enough? Beyond that question is another. What will it take to maintain the progress you may
have accomplished by then?
Any reasonable person would understand that fixes are only temporary. After that, you drift
right back to the original circumstances that caused your problem in the first place. You’ve just
dug yourself another hole.
Another option that most physicians in financial distress face with their medical practice businesses is often the most common option today. They’re being forced into participating in their worst nightmare. They saddle their horse and head for the hills… and hope that their
destiny has a much better place for them. RUN!!
Of course, this second option need never happen...EVER!
Any doctor with a good business foundation and education already has all the tools to fix everything on their own if they choose.
Physicians quit because they don’t have those business tools, never thought about getting those tools, and probably will never get those business tools because no one has ever told them that the business tools would be of exceptional value later in their medical practice.
5. Almost all doctors fail to recognize the most effective practice building strategies, as well as fail to know how to use them when they find out what they are...
The infamous method for building a medical practice business touted by medical practice tradition for the last century is little more than opening a medical office and waiting for the tsunami of patients fighting to get in the door first. Logically, if that happened to be true, there would not be the attrition of medical doctors today quitting private medical practice.
If your load of patients drops off and are not replaced with new patients, your income drops proportionately and you will be forced to close your office. Accepting the rush of new patients most new medical doctors starting in private practice locally notice in the first year or so of practice doesn’t continue forever, as some mistakenly believe.
There’s a reason why that happens. Like any business starting out, patients for one reason or another are curious to discover if your medical practice business has more to offer them than the previous one. So they are willing to search for a physician that offers them something that others can’t or don’t. What ever that reason is, if you have the ability to respond to their needs better or faster, they are hooked.
If you have knowledge of the magnetic marketing factors that entice customers or patients into your medical practice, you will often maintain a loyal group of patients far longer than those who don’t know how to make it happen.
Your practice will remain financially stable for a few years longer, or at least long enough for you to create the next level of attraction or persuasion necessary. You may have heard some famous individuals mention that they had to keep reinventing themselves to maintain their
position and status.
Successful businesses must constantly be reinventing itself to remain viable and attractive to its customers. Do you have any idea what that means? It’s not only important, but essential, for medical doctors to understand and employ.
What does a business that sells products such as toys do when it becomes obvious that the numbers of customers returning is decreasing annually. It’s always the same old store selling the same old products and toys and loses its attraction for customers.
The store then, if they are smart, has to be bringing in more exciting and new products continually to keep their customers coming back.
Your medical practice business is no different!
Instead of products like toys to sell, you are in a services business. What do you sell to keep your patients coming back forever?
What do you sell to keep your herd of patients loyal to your medical business business and even maintain a flow of incoming new patients. Remember what I said above about the beginning initial flood of new patients when you start medical practice? Then in a few years that flood becomes a trickle and the doctor wonders what the hell happened?
Well, those who remain business and marketing ignorant will never know what hit them. Even worse, they have no idea what reinventing their business services would mean or how it would help, or even it would work, if they actually knew.
It’s no wonder that the stress, disappointment, and burnout are so frequent in medical practice. Face facts, you are responsible for putting yourself in that position.
You are also responsible for getting yourself out of that quicksand. It’s where the medical practice graveyards are found. However, there is a positive side to all this.
Every physician, including you, can tap into business and marketing education and learn some essential things that can dramatically reduce your stress and increase your income.
How do doctors reinvent themselves and their medical services?
1. You improve your surgical skills, expand your skills into treating new health problems patients are looking for...if you have the income to afford it.
2. You improve your medical practice management of your office and staff, make it more efficient, hire employees who demonstrate a work ethic and willingness to help improve your practice. If you can afford it.
Read my article #20 titled, "How a Business System Prevents You From Being
Incarcerated At The Poor Farm"
3. You repeatedly promote to your patients and to other medical doctors who refer patients to you, what new skills you have learned and can now do safely. You promote any new bit of knowledge you learn to them. They will never know these things unless you spread the word. If you can afford it.
4. You dramatically increase your customer services for patients to the point of being outrageous about what you do for your patients. Other physicians wallowing in the mud hole of stagnation certainly won’t be doing this. If you can afford to do it.
5. You may purposely avoid overextending your practice load and number of patients. Your feeling is that you are working hard enough in your medical practice. It’s not difficult to grow your practice, increase your patient load, and accomplish much more when and if you discover the well documented ways to work less and earn more.
That’s done much easier when you understand what marketing your medical practice business will do for your practice growth, income and career. If you can afford it. Marketing costs run from $500 to $5000 a month for the average physician--depends on the strategy being used and how long you intend to use it.
At first it may seem you are doing double duty and are increasing your load doing both marketing and running your practice. Becoming much more efficient in how you manage your medical practice business, however, creates shortcuts and automation using business systems. These are free because you do that yourself.
That, profoundly reduces your workload time running your business and allows you to work less and accomplish more.
Remember...
Did you happen to notice the "if you can afford it" at the bottom of some of the medical services listed above? I did that to reinforce the fact that in order to do most anything in medical practice you need enough money/income to do so.
To make money, you need a steady flow of new patients.
To get more patients and keep your practice growing, you need to know how to do it persistently.
To do recruiting of patients continually, it requires medical practice business knowledge and especially physician marketing knowledge. Your new patients otherwise get to you by referrals from someone. Studies show that 60% of those referrals usually come from other referral doctors.
Those who have a grasp of business and marketing know how to triple their new patient load and income. You might want to "sweet-talk" a bunch of doctors in your area to refer patients to you. It's your primary resource for patients.
6. Your inability to step out of your comfort zone once you’re in practice is probably the most serious conflict hindering your career, progress, and income...
This is the primary reason that over 95% of doctors end up with a mediocre private medical practice with sloppy ineffective practice business functions. It’s what I call “medical education burnout.” You're not willing to continue your strong passion for any more education of any type.
By the time that the majority of medical doctors leave medical school and specialty training, they have used up most of their educational energy and ambition to persist beyond where they are at that junction.
If I’m right, it’s easy to understand why physicians are so predestined for medical practice burnout later. And, it also is the reason why physicians are so quick to avoid the idea that for the rest of their career in their medical practice, it will require even more education on top of just remaining medically current in their skills and knowledge. Swallowing all this would choke an elephant.
As an old white haired medical practitioner viewing the medical profession now, I am astonished that any person would choose to become a medical doctor in light of what I have just
written here.
I am certain that keeping all of these factors secret from college students, medical students, and new medical doctors is the only reason we still have medical doctors available today looking around for someone to hire them. But, there’s always another way to paint that picture.
The definition of an entrepreneur matches the personality pattern of virtually every physician I have ever known. Entrepreneurs are people who are entirely comfortable with stepping out of their comfort zone and willing to take the calculated risks involved with doing so.
Physicians see and treat symptoms, diseases, findings, and medical issues almost every day that they have never heard of, never seen before, have never been taught about, never found in a medical book, and don’t fit into any recognizable pattern that points to an exact diagnosis
and treatment.
Your willingness to wander into a profession that requires this clearly makes you an entrepreneur. Have you ever thought of that effect on your capabilities?
One could also surmise that physicians have minds that search out answers, solutions, and undiscovered steps to successful medical practice. Wouldn’t you also have a mind that understands why a business education is mandatory for extracting from medical practice everything you need to reach a level of affluence, practice income, and meeting financial obligations you
never dreamed of?
Making a business education a necessary essential part of a productive and profitable medical practice should be a non-issue in your mind.
The enigma is that it is an issue in the minds of almost all physicians for some reason. Tackling and changing one’s belief and thought patterns isn’t easy, but it can be done if diligence and self-discipline are aroused.
What's the secret about your “comfort zone” management that you may have
never heard of?
1. When you make the decision to go beyond the ordinary, acceptable and less than optimal medical practice management life, remarkable changes occur in your mind that commonly
go unrecognized.
Your unconscious mind becomes intent on finding everything buried and forgotten in your
memory banks that could possibly help you reach that new goal. Thoughts arrive consciously
that you would never have considered otherwise. This magic continues with every new step
you launch into.
It’s not easy to accept, but it is the documented occurrence that happens to those with self-confidence and faith in their own capabilities. Self-confidence originates with expanded
knowledge and belief in yourself.
2. There is in every physician the tendency to stretch their skills beyond what they thought they could handle. Some do and some don’t need to keep pushing the edge of what they are
already doing.
The combination of all the life long factors that have accumulated in your mind about yourself
and your capabilities is almost always highly underestimated. It depends on the number of self-limitations you have stored up in your brain and how they can be unleashed.
Believe it or not, you have the built-in capabilities to do astoundingly more in your profession and life than you ever thought possible. So why don’t most doctors understand and accept that fact? Yeh… another enigma.
3. “Normalcy bias”, fatigue, stress, depression, burnout, lack of ambition and motivation, goals that disappear or are unattainable, are a few distractions that will leave you feeling helpless, like finding yourself in an alligator pond.
I love how Henry Ford explained this kind of dilemma, "Thinking is the hardest work there is, which is probably the reason so few engage in it."
Taking the quiet undisturbed time thinking to set up your priorities for your career and then the attainable steps it will take you to get there will eliminate most distractions and make you maintain focus on your path to success in your medical career.
“Only those who risk going too far
can possibly know how far to go."
---T. S. Elliot
“If we did all the things in life we are
capable of doing, we would literally
astound ourselves.”
---Thomas Edison
----Professional Probe----
"This is my workshop where
I do my brain editing at the
back of my home"
Articles © 2013-2022/CGG INVESTMENTS LLC. All rights reserved. #47, 3-16-22
