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When Your Business Needs a Kick in the Rear


At some stage in its "business life cycle," every medical practice or physician-owned business starts to spin its wheels, either because the patients or clients are showing dissatisfaction, or there's way too much business and things are bogging down. Here's how get back on track.

At some stage in its "business life cycle," every medical practice or physician-owned business starts to spin its wheels, either because there isn't enough business, or the patients or clients are showing dissatisfaction, or there’s way too much business and things are bogging down.

Ideally, we the business owners can spot this coming and have a plan in place for taking action. More often than not, we're caught unawares, and we find ourselves frantically trying to put things right with disgruntled clients, patients, colleagues and/or employees. Or coping with a feeling of pressure in the chest or the base of the skull (or other even more dramatic somatic symptoms)!

The biggest clue I had that I was running into a problem of this kind was realizing late last year that I was hopelessly out of touch with my intended consistent marketing plan.

What clues should you be on the lookout for, to help predict upcoming stormy weather, and to perhaps avoid problems entirely?

• You're running so hard on the job that You. Can't. Catch. Your. Breath. Anymore… puff, pant! For most of us, there just aren't enough hours in the day to get our major tasks tackled. However, when things are mostly going well, we still manage to breathe, and occasionally sigh, as we plod our way through the day. In the situation I'm talking about, you feel a rising sense of panic and keep asking yourself how you'll ever manage to tackle even part of your horrendous to-do list.

• You're irritable and lashing out at the cat, or the spouse, or the office manager. Everyone glances away as you walk by in case they catch your eye and suffer the consequences.

• Patient or client complaints flood your inbox, or tie up your manager’s valuable time for hours in a month.

• You're way behind on your billing, and cash flow is suffering.

• Your email Inbox is stuffed with 300+ emails and you can’t get below 200 no matter how hard you try.

• You are days behind in your charting and when you get to it, you’ve forgotten much of the visit or meeting details.

• The phone is either ringing off the hook and most of the calls are going to voice message, or the office is uncannily quiet due to the absence of anyone calling to interact with your business.

• You're staying up late at night to complete rushed projects, you're constantly fighting against deadlines -- and it takes three cups of heavily leaded coffee to get you going in the morning.

• You waste at least an hour a day looking for misplaced stuff that you know is somewhere on your desk/in your office/on your computer/at home.

• You hardly ever hear from friends anymore, mainly because they've given up trying.

What's a physician business owner to do in these rough seas? These are a few of my thoughts:

1. Call an Emergency Meeting with Yourself. Schedule it right away on your calendar and cancel everything else. Make it at least two hours long -- a half-day retreat away from the office in the local coffee shop is even better.

2. Ask Hard Questions. Be prepared to answer the following questions in this meeting with yourself (you may include your office or business manager if you prefer):

  • What is your desired/preferred lifestyle? (For me, my decision to go nannyless has been a huge kick in the tush.)
  • What are your business’s vision and mission? Feel this out, as much as you think it out. Be authentic.
  • What support structures do you need in order to fulfill your vision and mission? For me, it was a business manager!
  • What do you have in place that you are under-utilizing?
  • What’s missing that you need to put in place? A Systems Manual filled with my business processes is now hiding in a cyber-cloud and can be accessed by my support team anytime, anywhere.
  • What tasks are you performing that a less highly paid or similarly skilled person should be doing?
  • What are your top 3 priorities for the next 30 days?
  • What are the top action steps that you must take, and are willing to take, to accomplish your priorities?

3. Ask yourself: “What is your shortest path to money over the next 90 days?” Is it to complete your charts and get the billing in order? Is it to address those patient visit denials? Is it to land another couple of clients by following up on prior conversations? Is it to network furiously and with great conviction, now that you are clear on your business vision and mission?

4. Create an Action Plan Calendar. Use pencil and paper, or your computer if you’re a whizz, and give it timelines, due dates, and daily or weekly tasks.

5. Decide What to Delegate. Be realistic -- some of this will take training time. It’s a pain, but a hugely worthwhile investment of time and energy.

6. Find Someone to Hold You Accountable. Of all the suggestions, this has been the most valuable one for me. Whether it’s my coach, or now my wonderful business manager, just knowing that I have gone public with my plan is enough to get me into action.

7. For Bed-Time Reading. Get Tim Ferriss’s “The 4-Hour Work Week,” or Michael Gerber’s “The E-Myth Revisited.”

8. Get Going. Your revamped business and enhanced personal life await!

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Victor J. Dzau, MD, gives expert advice
Victor J. Dzau, MD, gives expert advice