The 5 Stages of Success: How to Realize the Full Potential of Your Practice

What’s the first step to growing your medical practice, no matter what size it is now?

Imagine you’ve decided to climb a mountain, say something challenging but doable like Mt. Washington in New Hampshire or Mt. Whitney in California. You’re at the base of the mountain and it’s a foggy or even snowy day. You’ve got no trail map to guide you.

What the heck? If you can’t plan where you are going, summiting is going to be challenging and risky at best.

The same is true with growing your medical practice. The first step is to find a map so you can visualize where you are going.

Can you actually grow your practice from startup to profitable, to multi-location and set yourself up for an enviable retirement?

The answer is YES!

Here’s how it worked for one ambitious practice owner. Jennifer came to us hoping to grow her single location audiology practice. She had recently started her practice but wasn’t seeing the kind of growth she’d hoped for.

Jennifer’s goals:

  • Be profitable by year 3
  • Buy another practice by year 5
  • Build up for retirement – she was excited about her goals here

Our team started by setting her up with several of our proven patient-attraction services, adding more as her profits grew. So how did she do?

Jennifer’s results:

  • Profitable in year one
  • In year two, she was making enough to buy a second location
  • By year three, both locations were profitable and revenue was continuing to grow

Pretty impressive results and it took just two things; an ambitious practice owner and proven new patient lead generation systems. Put the two together and it equals success.

How can you be as or even more successful than Jennifer?

We’ve mapped out ideas for growth for each stage, to help you climb the mountain of success with your medical practice and in turn reap a mountain of rewards.

5 Stages of Success

  1. Startup
  2. Growth
  3. Expansion
  4. Maturity
  5. Exit

 

Stage 1. Startup

Happy colo practice owner growing his practice.

In the startup phase, you personally do everything! That includes answering the phone, scheduling appointments, seeing patients, and even licking envelopes. Yes, it takes a lot of work to start a medical practice, but the biggest mistake most startup practice owners make is the following.

All too often we talk to practice owners in the startup phase who’ve spent their last dime setting up their office and are ready to help patients but forgot three essential elements of their growth plan.

  • They don’t have defined or written goals – ones that take into account your competition.
  • They don’t have a written growth and marketing plan.
  • They don’t have a budget to grow their practice.

When we talk to practices, the first thing we help them do, whether they want to work with us or not, is to help them set goals and use a proven marketing plan.

Once you have a few patients, it’s important to hire support staff as soon as possible. Even a virtual assistant or part-time front desk staff person can free up your time to see more patients and grow your practice.

It’s true, it can be hard to let go of administrative tasks and no one else can lick envelopes the way you do, but bringing on support staff is essential to get to stage 2.

Sure, we hear lots of excuses like:

  • It’s hard finding good help (we can help)
  • I’m not making enough to hire someone right now
  • I can handle all that stuff…I don’t need help.

But until you hire someone, you won’t be able to tackle some of the other big things that get in your way like:

  • Finding a patient attraction firm (one you can rely on)
  • Dealing with the insurance companies (which can be a nightmare)

It’s easy to give up and blame the competition for stalled growth, But in truth, the only limits for your practice are ones you set yourself. Of course, in order to afford to hire even part-time help, you’ll need at least a modest flow of patients. (And if you need a little help with that, Online Review Builder is a great way to get new patients coming in with minimal investment.)

The key at this stage is to clarify what business you are in. Sure you’re a medical expert, but in your messaging, in your marketing are you focused on you or on your patient?

If you focus on the problem you solve for your patients,
you’ll attract a lot more.

 

Stage 2. Growth

You spent years in training to become the medical expert you are. Now it’s time to move beyond your title. This involves moving from working in the practice to being a business owner and working on your practice, at least to some degree.

Once you’ve got even a small flow of new patients coming in and you’re covering your basic costs and even starting to pay yourself a salary, it’s time to revisit your growth goals. Here’s what we see when we ask practices owners at this stage, what their goals are:

  • Some practice owners say they want to increase new patient visits and private pay hearing aid sales by a few a month or grow by 5-10%.
  • Others want to increase new patient visits and sales by 100%, without spending more than a few dollars on marketing.

Obviously, setting realistic goals that are too low can be just as great an impediment as setting unrealistic goals. Assuming your practice is in a solid market, there is a good chance you can grow your practice by at least 15% if not 30% or more with a proven marketing plan and staffing plan.

As in Stage 1, it’s essential to have defined goals, a proven marketing plan, and a staffing plan to follow. For the solo practitioner, staffing up is a huge hurdle. And the biggest obstacle is your mindset, going from scrimping and saving to get by, to spending large on the type of qualified staff who will help you grow your practice – is a big leap to take.

Hiring and managing new staff members can feel like you’re jumping out of a plane without a parachute. With each new team member you add, you’re increasing your monthly overhead and it’s true if you’re not careful you could be spending more than you’re making.

A couple of hard-earned lessons:

  • Before you hire anyone, clarify your values and management principles. If you don’t, you stand a good chance of putting someone in the job who isn’t a fit. Those people can sink your practice. We spent years coming up with our “Un-Management Principles”, which work for us.
  • Hire self-motivated people, give them the training and tools to succeed, and they will.
  • Hire slow, fire fast.

The tendency at this stage is to micromanage everything when the real goal is to teach your growing team to think for themselves and avoid trying to be anyone’s boss. Of course, it helps if you hire people who can manage themselves to take your practice to the next stage.

The more team members you add, the higher the cost, which is why you’ll need to keep a focus on marketing (attracting new patients). Identify what makes your practice stand out and come up with a marketing plan. At MedPB we’ve helped hundreds of practices grow and we can help you write and review your marketing plan. Just talk to us.

 

Stage 3. Expansion

group of doctors that build on their success

Once you have a successful practice, there are two ways to continue to build on your success. Which you choose depends on your market and your competition. If your practice is in a small town, and you’re selling 20-50 hearing aids a month and you have a handful of smart competitors – it could be you’ve tapped the potential for that market. This is why it makes sense to take your winning strategy, your core values, management strategy, systems, and processes and clone it in another market. The first step is to scout out other underserved markets and the next to plan to set up a practice there.

Imagine instead of owning an individual practice with a single location, you now own a healthcare company with ten or twenty locations or more. Instead of being focused on day-to-day patient care, you’re focused on managing a growing portfolio of practice locations. This could be 20+ audiology locations or a multi-discipline practice with offices in adjoining towns.

On the other hand, if your practice is in a larger city or in close proximity to multiple markets, the simple solution is to just expand at your current location. Whether you’re planning on expanding your practice at your existing location or adding more locations, your focus will be on filling out your team, hiring a full complement of front desk staff, and adding assistants and another provider or two. At the same time, you’ll be fine-tuning your business model and your marketing model to maximize your return on investment.

Develop your brand

Regardless of your business model, this is when you get to build your brand and how you do so will determine its trajectory. Ask your management team the questions below.

What do we want patients to associate our brand with?

  • Empathy?
  • Arrogance?
  • Personal communications?
  • Excessive and duplicate paperwork?
  • Simplicity of online access?
  • Treating patients like cogs in the system?
  • Responsiveness?
  • Talking, or listening?
  • A superlative patient experience?
  • Medical expertise?
  • Results?
  • Red tape?
  • An impenetrable voicemail system?
  • A used-car sales strategy (yes, we’ve seen this in Google reviews for a surgeon).

This stage is where your practice is making between $400,000 a year and a million, so it can be easy to start patting yourself on the back and become complacent. The truth is until you’ve worked out all the kinks in the system, your actual profits could vaporize in thin air and you could be out of business.

What can go wrong?

We’ve seen it happen over and over; practices generating almost a million a year in revenue going bankrupt! A practice has solid revenue, but their expenses are more than they are making, so they’re losing money. That’s right! It happens all too often to practices due to:

  • Lack of financial management — simply making sure they are earning more than they are spending.
  • Not reviewing every single expenditure every month.
  • Excess staffing. (Every staff member should be able to define their role or it will take 7 people to do the work of 2.)
  • Overpaying for services. (We knew a single location practice paying thousands a month in copier-leasing fees!)
  • Tying up tens of thousands of dollars in inventory that was collecting dust on the shelves.
  • Giving away services for free or charging fees that earn them next to nothing.
  • Lack of billing or follow-up on unpaid bills.

Every practice will have growing pains. But there is a big difference between practices that succeed and the ones that don’t. The practices like Jennifer’s that continue to grow are always looking for ways to improve. These practice owners and their staff continually strive to take what’s working and make it better.

Once you have your practice running smoothly, the next step (if you want to take it to the next level) is to scale the business. You’ve already done the hardest part of the job by creating it and getting it running. The next step is to leverage all that hard work to scale it.

It’s a big decision, whether to stay in the business and focus on treating patients, or to step outside of the business to run it and grow it. Either choice is the right one, depending on what you enjoy. For some, the fun comes from talking with patients and helping them return to good health. For others, it’s the challenge of growing a team and running a business. Up to you.

Think about it. You’ve built a practice that’s making good money. Why not use all this hard-earned knowledge to open one or two more locations and double your income?

Over the years, we’ve asked practitioners what their biggest fear is, whether it’s fear of success or fear of failure. We’re always amazed at how many people’s biggest concern isn’t going out of business or having too few patients, but having too many.

How about you?

What’s your biggest fear?

Either way, talk to us. We can help.

Review your systems and processes

Once you’ve dialed into what you want to be known for, the next step is to regularly review each of your systems and processes to make sure they support your goals and your brand.

Some questions to ask each month or quarter include:

  • Does your marketing accurately portray who you are, whether you want to be known as personable local providers or regional experts?
  • Do your website and phone system motivate patients to contact your offices?
  • Do you have a proven follow-up system to nurture each patient inquiry, to make sure questions are answered and patients scheduled? Or do patients have to repeatedly call to get on the schedule?
  • Have you mapped out the patient experience, from scheduling an appointment to your reminder systems, to how they are greeted to the paperwork you ask them to complete? Have you asked patients what improvements they would like to see?
  • Is your billing system timely and effective?

Back when your practice was bringing in under a million a year, you the practice owner were in charge of day-to-day operations. As your healthcare company grows from three to ten million, you are still in charge. Successful business owners are those who can let go of being in charge of the day-to-day operations and instead focus on the key task of growing the company.

A clear focus on goals, people, and systems solutions are what works. One simple solution to stay humble and focus on reviewing everything you do each week and or month to identify:

    • What’s working? What should they keep doing?
    • What’s not working? What should they stop doing?
    • How can they improve? What should they start doing?

 

Stage 4. Maturity

Practice owner managing employees and growing practice.

 

Growing your practice over 5-10 years is a lot of hard work and with each new stage, your goals and your revenue grow. The growth can be addictive. With increases of 20-30% a year, it’s easy to expect it to continue indefinitely. But, doing so can be fatal to your practice.

We’ve seen it all too many times, with some of our fastest-growing practices. Each year they see their numbers go up and then when they start to plateau, they assume something is wrong and they jump ship. They dump the tried and true marketing strategy that got them to their present level of success, to chase the next flavor of the month idea.

Almost 100% of the time, they see their new patient leads drop off a cliff and their market share and profits decline. Why?

We’ve never met any successful business owner, who didn’t want to earn 30% more, including us. But in every market, there is a limit to growth for a practice based on the simple demographics and number of competitors.

Once you’ve reached that limit, the key is to be realistic and shift your goal from growth to maintenance, which sounds boring but there actually is a lot you can do to continue to fine-tune your practice and increase profits.

The primary focus at this stage is fine-tuning and documenting your systems for:

  • Billing
  • Hiring
  • Management
  • Marketing
  • Monthly Financial Review
  • Onboarding
  • Continuous Improvement

 

Stage 5. Exit

Medical practice growing by developing brand.

Whether you’ve owned your practice for 10 years or more, at some point it will be time for a change and or time to retire. At that point, you’ll want to maximize your return on all the hard work you put into growing your practice.

What determines the price you’ll get for your practice?

Some variables are obvious like the size of your revenue, your profits. But any smart buyer will also be evaluating your systems and processes to determine the future viability of your practice. They’ll be looking at everything from your growth plan to your marketing plan to your management systems.

Remember, back in the maturity stage, we talked about the need to fine-tune and document your systems. It’s this clear documentation that will position your practice as one for continued growth.

Looking to sell? Consider this first.

Questions on growing your health care company? Talk to us.