¶ Thriving in Private Practice
You can get A players people who are A players somewhere else and they can come into your practice and they can be C and D players , not because they don't know what to do . It's because we haven't created an enabling environment for them to thrive .
Hi dogs , welcome to the EntryMD podcast , where it's all about helping amazing physicians just like you and race entrepreneurship so you can have the freedom to live life and practice medicine on your terms . I'm your host , dr Imna . In 2021 , 11,000 private practices either went out of business or sold out their companies to private equity .
That is one stat that makes me really rethink what I do as a private practice owner . The second stat is that , out of every 10 businesses that are started , 9 of them will go out of business after the first 10 years . Now , if you know me , you know I'm a very positive person . So am I saying this to say doom and gloom ?
Well is , everybody know , but this is just to point out how seriously we have to take our businesses if we're going to thrive . Can we thrive ? Absolutely , are we going to thrive by default ? Absolutely not . So today we're going to talk about three questions you should ask yourself before you decide to quit on your private practice .
Now I want to talk about this because I've seen in a lot of Facebook groups , in conversation with physicians , doctors are like somebody went to one event . I met three doctors who told her I am shutting down my private practice . I'm like , oh my goodness , I give them the podcast , tell them to come to the business school .
I say that because there are things that we can do to thrive . Okay , so I'm creating this episode . You may be thriving in private practice . This episode is still for you .
It's three questions I want you asking regardless , because these are the questions that are going to stop you from getting to a point where you're like I think I should shut down my private practice . Okay , and if you're not in private practice , I want to listen as well , because the principles are universal . Now , you guys know that .
You know I've talked about it a lot on the podcast that I started . You know this whole journey of strength training because I want to be super strong on my 90th birthday . I want to be dancing , picking up grandbabies , doing all of those things , and I am at week 17 .
You can believe it , and in the beginning I noticed that I was getting results faster and as I got closer to week 15 , week 16 , week 17, . It seemed like it kind of stalled and I started investigating like what is going on ?
And I have learned that I will put in the effort , even if I don't see the result , Like it's not a reason to quit , but at the same time , I want to make sure I'm optimizing you know the time and you know the project , if you will and so I started looking at it . Was I working out ?
Yeah , so I was still going to the gym four days a week , working with my trainer , who we call the torture , by the way , because he does a really good job . However , there were other parts of my fitness journey that I had kind of stalled on . So I was not sleeping as well as I used to sleep .
I was not eating as clean as I used to eat , because I had quite a bit of travel that I was doing . I was not drinking as much water . So there's all these things like strength training is not enough . There are other things I need to do if I want to be successful and , in the same way , right .
There may be things you're doing well in your practice but or your business . But doing one thing does not remove the need for all the other things that you need to do . So in coaching hundreds and hundreds of physicians , these are three of the areas that I find are almost always lacking .
When there's a private practice that's struggling and when people start thriving , these are also the areas that people start slacking on , which inevitably gets them to a place where they start having challenges . So three questions . The first question , the very first question , is am I holding my team accountable for profits ?
Now , when you hear that , that may go like well , I'm the business owner , that's my responsibility . They shouldn't need to deal with that and it may seem almost like , wow , all I care about is the money . Right , I'm holding my team accountable for making me profits and all . So I just want you to Take a deep breath and go with me .
Okay , this is the deal . I want you to think about your business as a whole entity . So don't worry about like I go in the office . This is this person does this task . I do this task . I forget about all of that . Think about your business . Chances are . When you started , you started .
You know , like by yourself , like this is , before you started , even hiring people , you had this dream . I'm gonna build this practice . These are the kind of people who are gonna serve . These are the kinds of you know like outcomes they're going to have . This is the kind of revenue we're going to bring in .
This is gonna be our position in the community , and all of that it was you . Everything came out of you right . The whole business was you .
Now , after you were done with that , you decided to recruit a team , and Sometimes we think of the team as I recruit these people who can help me do some stuff , or I recruit these people because that's what people do like .
When you started private practice , you should recruit a front desk person , you should recruit a medical assistant , you should recruit a referral coordinator , like things like that . But the truth of the matter is you had a vision and you brought on the team to help you with your vision .
Now , your vision includes profitability , because if there is no profit , you have to shut it down Right , and so one of the best things you can do for your practice is Remember why you brought the team on in the first place . It is to help you , and part of what you do is you make sure the practice is profitable so that you can continue to serve .
Okay , now I want us to look at it . I want us to look at it this way when you bring them on , you can get a players who people were a player somewhere else and they can come into your practice and they can be C and D players , not because they don't know what to do is because we haven't created an enabling environment For them to thrive .
What is required for that , but enabling environment , one you have to be very clear like this is their role . This is this is their role , because sometimes you have offices where it's everybody's responsibility . But the thing is this anything that is everybody's responsibility is nobody's responsibility and nothing gets done right . So very clear on what the role is .
Very clear to the path to profitability . For instance , my medical assistant , right , would come in and work up the patients so that I can see more patients . That's one way they create revenue . My medical assistant make sure that Everybody who leaves leaves with a follow-up appointment .
So that means if I saw 20 patients , let's say you know there are few who you want to schedule , no matter what she did , but let's say 80% of them schedule , that is , 16 appointments . She created that day , right , and I can go on and on . So it's very clear . This is my medical assistant . These are the things they do .
This is how they contribute to the bottom line . Your front desk person may be the number of calls that they're converting to appointments and all of those things , the percentage of the co-pays that they make sure they collect , because we don't get paid because we saw patients .
We get paid because we got paid right , and so I did collecting the money and all of that . So , if you look at every role , the question is how is this role contributing to the bottom line ?
Okay , because the number one reason why private practices will go out of business , or any business actually , is cash flow problems , right , and so if that's the , if that's the biggest quote-unquote risk , then we want to make sure our team is on board helping us mitigate that risk . That's not just you , the business owner .
That's quite a bit of a way to carry , okay . So if you think of it in that way , it's not sleazy , sleazy or slimy . You just need to define the role , define how it's profitable , and then when you meet with them , it's not , it's not just about the task , but you're reviewing the outcome , right ?
So 80% of the people who came in yesterday left with appointments . Really good . Only two co-pays were collected and there should have been 20 co-pays collected . Let's work on that , right . Like , don't be afraid to do that because , listen , your , your private practice shutting down doesn't serve anybody , it doesn't serve .
It doesn't serve you , it doesn't serve your team , it doesn't serve your community , doesn't serve your patients , right . So we want to pay attention to this . So that's the first question . The second question you want to ask is did I abdicate the management of my revenue generation , my revenue cycle ? Okay , and I'll tell you what I mean by this .
Now , there is delegation , which means I have somebody else Doing a task for me , but I've defined what the task is , how the task needs to be carried out . I have checks and balances , I have ways of evaluating was it done or was it not done ? That's delegation .
Abdication , which I see happen a lot with billers who manage the revenue cycle , is oh my goodness , I have a biller , may the force be with them . And a lot of times doctors won't want to meet with the billers . They won't want to dig into the numbers , they don't really want to know what is happening .
All they know is there's cash in the bank , but that is not the way a savvy entrepreneur is going to lead . And if we have numbers like thousands of practices going out of business and nine out of 10 businesses fail in the first 10 years , we don't have the luxury of doing that . Your revenue cycle in your business is like your aorta in your body .
If you nick it you bleed out Like that's , that's just the way it is , and so we don't want , we want to delegate that , but we don't want to abdicate that .
And sometimes you may not intentionally want to do that , but you get so much kickback you try to meet with the bill and then like , oh , everything is fine , okay , your billing department , your revenue cycle , is data driven , it has numbers , so there's nothing . Like everything is fine , right , like everything is fine , great , I'm happy .
You think that now let's look at the reports . Don't be afraid to look at the reports . Don't be afraid to question things , don't be afraid to look into that point . That is your aorta . Chances are , if that department doesn't work , your practice doesn't
¶ Revenue Cycle Management and Practice Growth
work , period Right . And so don't abdicate and don't be intimidated If someone tells you oh , it's okay . I don't know why asking these questions Like I had a client who's biller was like I don't understand . Nobody's ever asked me all these questions before . I don't understand why you want to know these things . I've told you that these things are okay .
I don't know why that's not enough . It's not enough because the box stops with me and it is my responsibility to know what my numbers look like . Right , like hello . Like you don't want me to say yeah , you know , we're going to pay you someday . You want to be paid . You want to be paid on a schedule . You want to be paid some specific dollars .
In the same way , I expect specific results , like reports , right , okay , so that's the second question . The second question that you want to ask did I abdicate ? Because this is the deal , if , if we're not holding our team accountable to to profits and we start , we can start generating profits almost right away , almost right away .
Right , you tell them Okay , here's a list of all the people who are overdue for appointments . Go , schedule these Right . Like , these are all the people whose co-pays you forgot to collect yesterday . Hit the phone , get them like . Do you see ? Like you can start generating profits right away . You can start looking to your building department .
You can start shifting things right away so you can make a big difference in your private practice right away . The third question you want to ask is this Am I making sure that new people find my practice every single day ? Am I making sure that I am doing things to make sure that new people find my private practice every day ? Why is this important ?
And this is especially important if you're busy , because when we get busy , we're like oh , we're so busy , we can't see any more patients . So , oh , we're not talking to referrals or sources anymore , we're not posting on social media anymore , we're not sending emails anymore . We're not doing that because we're so busy . But guess what usually happens ?
That busyness lasts for a season . It only lasts for a season , and after that it's like I don't know where . Our schedule is not full anymore and at this time , referral sources have forgotten about you . They're patients who have forgotten about you . The momentum you built was gone . So this applies to you , even if you're bursting at the seams . Okay .
Why is it important for new people to find you ? Because people are going to leave your practice . It doesn't matter how good you are . People are going to need to move , people are going to age out , people are going to die . There's so many reasons why , right , people are going to leave , no matter how good your practice is .
So think about a population where they're like , oh my goodness , you know , there's so many of us , there's 120 million of us , and then they stop having babies . It's only a matter of time .
Right , it's only a matter of time , and the longer it lasts , the more of a snowball in the wrong directions being created , right , where it's going to be even harder to recover . Now , when I say harder , I do not mean you cannot recover , because of course you can't recover .
Okay , now , so there's the mechanics of it , right , like , how do I put myself in front of new people ? So that's you talking to referral sources . That's you speaking out events . That's you networking out events . That is you . When I say referral sources , it's other doctors who could refer to you as patients , who could refer to you as the whole nine yards .
It's all of that . So that's the mechanics . But the other part is the mindset piece , right , because a lot of times people feel if I practice good medicine , they'll come . It's not true , right , like , yeah , if you practice good medicine they'll stay , but practicing good medicine does not attract them right , like the other things that attract them .
Some people feel like I shouldn't have to do this and I think that's the most damaging mindset . I shouldn't have to do this . I shouldn't have to mark it right Because , you know , because what I do is good , because I'm a good doctor . It's not fair . I'm a professional , whatever it is , but I shouldn't have to .
There's a doctor in the on-term new business school . Her name is Dr Karen Kuffman . I've interviewed her , I think twice on the podcast and you know she made a statement that I just love and I filed it somewhere in my brain and I pull it out anytime I need it , like now , and she said this is what she said . She said marketing , that's part of my job .
That's part of my job . Now . She's been in private practice for three years . She just hit three years and she just hit patient 5,000 . She's an allergist , right , but she has this understanding that , yes , it's my responsibility to build my team , it's my responsibility to provide great medical care . It is my responsibility to market my practice .
If you can have that thought , it is so liberating , it is so empowering . It puts you in control , it makes you the driver in your practice . You know that you can create results . You don't have to just wait and wish things will happen right . That can be your experience .
But in order for that to be your experience , you have to come to terms with the fact that marketing your practice , putting yourself in front of new people , is your job . Okay Now you might say but Dr Una , I have a team who's doing that . If you have empowered a team and a team is doing a good job , that's great .
You know what we say in the entrepreneur world . We say it needs to be done . Right , it does not all need to be done by you , but it needs to be done . So as long as they're doing it and they're getting results , we're good .
Sometimes , on the other end , what I see is people will hire a marketing company and they're like you fix it , you fix all my marketing problems , right , but then they don't give them the information they need . They're not doing any of the supporting activities , like maybe you know also going out to events and all of those things , because they all work together .
Nobody's going to make this go away . We need to do this and especially if , especially if you're in a place where you're struggling with your private practice Own this , because this alone can turn your practice around .
I have seen it time happen time and time and time again with the clients that I've worked with , okay , and with the doctors in the on-tranquility business school . So maybe your practice is struggling . I want you to hear me . Maybe at a point where you're like , forget it , I'm gonna shut my doors . Before you do , I want you to hear me .
Maybe you're here , you're thriving . I want you to run an audit to make sure that , yes , I'm thriving , but I am also setting the stage to continue to thrive , because not just about thriving is about continue to thrive . Ask yourself these questions .
If you have an office manager or practice administrator or anything like this , you can make this a team question and you guys can sit at workshop this , but this is a practice . These are three questions that have the potential to save your practice , to get you back to thriving , to bring in millions and millions of dollars Into your practice . This is serious .
So , number one am I holding my team accountable for profits ? Number two did I abdicate my revenue generation cycle ? Number three am I making sure new people find my practice every single day ? Okay , and as you ask these questions and you answer them truthfully . I want you to pick the 180 for the ones that you're like yeah , I'm not .
This is not the way to be doing it . Right ? I want you to pick the 180 and I want you to start right away and we just start holding your team accountable . This is not a bad word . They will actually love you for it . Right , it would be a much better round practice . I went to . I went to start holding them accountable .
I want to have those difficult conversations with your billers and I want you to do it to , to go like you know what , before everyday runs out , new people are gonna find about pride out about my practice today . Right , and if you make this a habit , everything will change for you . Okay , everything will change for you . So I want you to imagine this .
I know that , yes , there's all these things going on . You know decreasing reimbursements and all of those kind of things , but this is the truth . You can still thrive . You can still thrive in private practice and you can still build a practice where your thriving is sustainable .
It's not something that happens for a year or two years or three years , but ten years later , 20 years later , 30 years later , if you still decide to hang on to the practice right , like it's still working . It's still working . So I want to invite you to do that . I want you to create a dream practice .
I want you to thrive as a physician entrepreneur , because it is within reach for you . The second thing I want you to do is I want you to take this episode , grab the link and I want you to share it with every doctor you know who's in private practice . Why do I want you to do this ?
Because the more private practices thrive , the more private practices will thrive . The more private practices thrive , the more examples of what is possible we have , and this is going to be a situation where some get better . Because of that , all of us get better .
So you'll be a part of the Calvary , bringing change to medicine , changing the narrative for physician communities , and all you have to do is share this episode . So , grab a link , share it with the doctors in your world who are in private practice , and I will see you on the next episode of the untramby podcast .