
Don’t stretch yourself too thin before you are ready to open another office, and consider these options before scaling a business
My 30 years of consulting doctors with multiple clinics and other doctors with the desire to expand and open new locations has allowed me to learn about the numerous issues one will run into if one does not follow a certain sequence of stable achievements before a business expansion.
There can be great difficulties if scaling a business s done out of sequence or incompletely.
Over the years I have seen many doctors who expanded before they were ready, and in almost every case they had double the overhead but maintained the same level of income and production. In most cases where the doctor was the solo adjuster in the practice, his or her time was split between the locations, and the total sum of adjustments between the two locations was what the total was for the original one. That can cause a lot less profit and a lot more stress.
Before opening a new location
One has heard many times that the success of a practice, or any business for that matter, is dependent on location, location, location. Location is important, but no matter how great that location is, that business can quickly fail if not operated correctly. The first major overall step to accomplish before opening a second, or more, locations is to get the current practice running so smoothly that the owner or doctor is not required to be there on a full-time basis.
This is vital, as the owner will need to focus a lot of time and attention on opening and getting the new location up, running and stable.
Leadership and team training
To accomplish this feat — and it is a feat — it is strongly suggested that the owner get training as an executive and on how to select and lead a team. This is a special skill set for success. The owner has to set the pace, set the purpose and lead the employees. Sequential planning must be done, such as in the areas of hiring, marketing, sales and more.
Please note that the success of any practice is directly related to that owner’s ability to control it; lower control levels equal lower results and lower income. And inversely, the higher the level of control, the better the results and the higher the income.
The owner should have the ability to hire good team members and then, as part of a team working together, should see statistics rising and the office becoming more profitable. At this point the right office manager would need to be established, if not done already. Recruiting from within is the best way to find an office manager; however, if the staff are not up to that task then hiring from outside the practice has to be done.
Once the office manager is trained and fully functional, the demand for the owner should be decreasing rapidly. At this point an associate doctor should be hired and trained. Once all these staff are in place and functioning well, there should be much more freedom and profit for the new expansion.
There is a formula and theory of building an organization or scaling a business that goes like this:
- Hire well
- Apprentice well
- Turn it over
- Keep an eye on it
If these steps are violated or not done well, it will, in all cases, result in the owner back adjusting patients or pulled back into the practice once again.
Hire and apprentice well
Hiring well means just that. Unfortunately, our education system is not what it once was, so the competence of our work force has decreased over the years. But that does not mean one cannot find good, hard-working, intelligent help when scaling a business. If the owner has deficiencies in the area of hiring good staff, that can be learned as well. Putting the wrong staff member in a vital position can decimate a section of the practice or even the whole practice — so hire well.
Apprentice well means to train one’s staff. Get out the manuals and policy binders and get them trained, trained, and trained some more. Incompetent or under-trained staff can set you up for failure and definitely make it more stressful to work in the practice.
Once you get a staff member trained on any action, and they are doing it correctly, then give it to them to do. Any actions they are doing in the office should result in a “thing” produced, such as an appointment made, a fee collected, a new patient arrived, etc. These products can be measured and watched.
Be data-driven
The best way to keep an eye on things is to use statistical graphs. They show so much more than just numbers on a page. The use of statistical management is a management art form in itself.
With these points in place, the owner/operator after scaling a business will be free to open additional practices and manage from outside the office.
ED SHARP founded Sharp Management & Consulting, which has been helping business owners and doctors since 1993. He can be reached at thesharpmanagement.com.