I coach doctors seeing 2-3 people/day barely staying afloat. I also coach doctors seeing over 100 people/day and those collecting around $200,000/month. What’s the difference between the two? ZERO’s! That’s right, zeros. At the end of the year the doctors seeing more people and making more money have more zeros at the end of all their stats and in their bank accounts.
The point here is both of the doctors and their offices have the exact same issues to deal with when it comes to breaking through their glass ceiling and successfully growing their practice.
The basic premise is, make space for patients, fill that space with patients, make more space, and fill that space with more patients. Make sure there are no “bottle necks” along the road. Simple, but not easy!
Most of us have experienced the roller coaster ride of building our practice only to see it plummet back to where it was. It is almost like there is a governor on our practice, like there is an invisible glass ceiling that no matter how hard we try or what we do, our practice settles back down at its comfort zone.
The reason for the rollercoaster ride and the ensuing comfort zone is very simple. Every practice has very specific areas that I call growth potential units or GPU’s. Another name people use is capacity blocks or bottlenecks. These GPU’s are similar to links in a chain, and every practice no matter how many zero’s they have at the end of their stats is only as strong as their weakest link!
So what are these GPU’s?
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Staff and Teamwork
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Treatment Time
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Scheduling
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Practice Systems
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Space and Equipment
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Marketing
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Pricing
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Self
Let’s say you have been collecting 20k/month and no matter what you do you cannot break that level. Oh, you may do a big marketing ploy to get a bunch of new patients in and you may go up to 24k for a month or two, but in the end your practice settles back down to its comfort zone of 20k. Sound familiar?
Why does this happen? How does this happen? It’s simple. Let’s look at some examples. Let’s assume of the 7 GPU’s you have 6 of them that have the potential or the ability to support a 30k/month practice. But you have one of the GPU’s at 20k. You can continue to work on all 6 of the 30k issues and no matter what you do, the practice will settle back down to 20k. Remember, it is the weakest link, and you are only as strong as your weakest link!
If, on the other hand you spent time and energy upgrading your 20k growth potential, or your weakest link, as soon as you fixed the problem and brought it up to the 30k level, your practice would instantly jump to the 30k level and that would be your new comfort zone. In other words the previous glass ceiling becomes the new floor!
This is why you will rarely see a practice crawl from 20k to 21k to 22k etc. Practices always jump a level or two, and this is the reason why.
We’ve all seen or heard of experiences where we go to a seminar and hear a great idea. We go home and make the appropriate changes to our practice and so does our best friend. Within a month our best friends practice jumps up to the next level, and even though we did the exact same thing our practice doesn’t budge. Why does this happen? Again it is simple; it comes back to the weakest link. In this case your friend’s weakest link was addressed and of course the practice jumped. But in your case it either wasn’t your weakest link or more often it was only one of your weakest links. The fact is for many of us we have two or three of our GPU’s at 30k, but we have the rest of the GPU’s at 20k. So although we do address one of the big GPU’s, we still have a few more that are still weak links at the 20k level.
Before we touch on the seven GPU’s it is worth mentioning that from my perspective there are only two real problems. One I call procedural and the other is headspace. Procedural means you need a procedure or a form or a script. You need more data or information or a better way of doing something. These are usually pretty easy to deal with. Headspace on the other hand can be a little trickier. Headspace issues keep the doctor from trying new things. More often than not the doctor has tried something in the past and has had a bad experience. Those of you familiar with Dr. Scott Walker’s N.E.T. technique might call these issues N.E.C.’s or neuro-emotional complexes. The point is, for some reason we have a limiting belief system; I like to call B.S. for short, which does not allow us to see the truth and move to the next level in our practice and our life. One of the classic ones is, “Anyone spending less time with patients than I do is not giving quality care.” That is one of my favorites. I used to say that all the time. I started off spending an hour/patient when I was in the clinic. Finally I got it down to 30 minutes/patient. Clearly anyone spending less than 30 minutes was a thief. Then I got it down to 15 minutes, of course anyone spending less time than that was a thief. Eventually I got it down to less than two minutes/patient, and of course I was doing the best possible quality of care possible, but anyone less than that was a crook! Sound familiar?
Another category is, “I tried that once and it didn’t work!” Again, it may not have been done exactly right, or it may not have been your weakest link. There are lots of reasons why something works one time and not another. The point is we don’t want to be shackled by our past. Headspace issues can be very tricky, they almost always need a third party like a coach to help you out of it, and once you are on the other side life gets a whole lot easier!
Let’s take a cursory look at the seven GPU’s:
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Staff and Teamwork- There is no question that you can take a hot doctor with a mediocre staff and they will rarely reach their growth potential. Conversely, you can take a mediocre doctor and a highly trained, super motivated, highly trained, inspired staff that is working as a team, and this practice will reach their growth potential. There are so many highly effective and inexpensive things that you can do to create the perfect dream team, and if it is not one of your main focuses you will keep banging your head against the glass ceiling until you are dizzy and bloodied.
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Treatment time- Treatment Time/Special Appointment Time- The fact is if it takes you 30 minutes to see a patient, you can only see two patients per hour. Sounds ridiculous I know, but you’d be amazed how many doctors may get that in theory, but in practice… If you spend an hour with a new patient or on the R.O.F. it is a major block in your day! The point is if treatment time/special appointment times are your blockages, there are many things that can be done to help you get in the flow, stay in the flow, hit the bull’s-eye every adjustment, quit socializing, and learn to give better quality care in less time as well as reduce your special appointments to a fraction of the time and get better patient compliance!
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Scheduling- Procedures can set you free! That’s right, if you set up your schedule the right way; there is plenty of time for new patients, ROF’s, re-evals, re-reports and adjustments. If you do not have it set up the right way there is just not enough time in the day to do all of the things that need to be done in a day. The appointment book must be set up so that you are available to adjust your patients when they want to see you. If your staff is telling patients that there is no room during the peak demand times you are driving down the street holding your wallet wide open while flapping it out the window. There is no perfect schedule for everyone, but there are some basic concepts that are easy to personalize to you and your behavioral style.
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Practice Systems- This is a catch all phrase. Here we look at every system that you may or may not have in your office. The office and all that you do should be as automated as possible, you should not spend much time on your reports, and you should never be behind on them. There is no need to reinvent the wheel every time you write a report, or when you or your staff communicates with a patient or someone on the phone. This is where making sure that your consultation/examination, ROF, daily interactions, re-exams and re-reports are so important. You may want to consider taking my L.A.A.S.R. course or D.I.S.C. behavioral analysis course. Anyway about it you want to make sure that you have studied every possible interaction you or your staff may have with another human being, you want to make sure that your staff is saying what you want them to say, and you want to make sure that everything that is done in your office is as automated as possible.
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Space and Equipment- Of course if you have a bottleneck in your office because you do not have enough tables, therapy equipment, treatment rooms, computers etc. you cannot grow past this particular GPU. Again I realize that it sounds so simple, but you would be amazed at how many doctors tell me they will add another table, or break out that wall etc. as soon as they fill up the rest of their schedule, and the reality is they will never fill up the rest of their schedule until they add the table or break out the wall.
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Marketing- I recommend having a marketing calendar for the year with internal and external marketing. If you would like more information about this go to my website, rosencoaching.com; go to “information” in the navigation bar; go to “articles” and read, “New Patients and a Marketing Calendar.” This article will address the importance of a marketing calendar and the difference between internal and external marketing.
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Pricing- Your prices must be comparable to the rest of the industry in your area or you must have something that no one else offers, people must recognize that, and of course want what it is you offer! Your first visit must be very reasonable, remember, this is not where you make your money; it is in the regular office visits. You must also have several options for your patients to choose from to help them pay their entire case.
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Self- And of course, last but not least is your SELF! If you are going to run an attraction practice vs. a coercion practice. You must be healthy, balanced and attractive (and I don’t mean your looks.) In other words if you are not going to use the manipulative fear based patient scare tactics to get people to comply, and instead you are going to use the empowering and honoring patient care tactics, you must come from a place of balance and passion. You must lead and inspire others to be all they can be. They have to feel better about themselves just by being in your presence and they must experience in their being that there is another and better way. For this to occur you must have balance and passion in your own life. You must be healthy and strong physically, mentally, emotionally, and spiritually. Most of us need slight tune-ups to complete overhauls when it comes to this particular GPU and I know of no better way than to work on this one with your personal coach.
From my perspective it is imperative that we continually have our fingers on the pulse of your GPU’s. That is why every two months I have my clients fill out an “outcome assessment questionnaire” where together we review all seven of these GPU categories, we access the weakest links and prioritize a course of action to upgrade these problems and issues so that they are taken care of and fixed once and for all. We don’t move on until we have completely corrected the problems. Only then do we move on to the next weakest link, until we have helped you to not only attain your goals but maintain them as well.
Russ Rosen, D.C. – May 31, 2003
