Second time’s a charm: creating your next practice

How to avoid déjà vu when creating your next practice.

You’ve played the options out in your head many times: double your patient volume, expand your business, or start over fresh. On several occasions, you’ve driven by the empty building where you envision your practice logo fitting perfectly. Indeed, it feels like the time has come to build another practice, but this time around you’ll be smarter.
Several reasons might prompt a doctor of chiropractic to start a practice for the second time. You might be:

• Moving from one location to another
• Opening a satellite office
• A retired doctor who misses taking care of patients and decides to reopen (like I did)
• Looking to recover your first practice due to incorrect demographics, psychographics, or lack of profitability
• Wanting to move to a different climate or be closer to relatives
• Tired of associateship and wanting to open your own successful practice
• An independent contractor hoping to open your own practice

Before starting your second or third practice, do some soul searching. If your first business didn’t do as well as you wanted it to, what could you have done better? What would you never do again? What would you focus on more? What would you change? To flesh out these ideas, make the following lists:

• Things you liked about your first practice
• Things you didn’t like about your first practice
• Productive and profitable activities
• Unsuccessful activities

Then, after you have made your lists, drop those items you didn’t like and develop a plan to accentuate your successes. Sounds like a lot of work? You bet—but it’s worth it.

The keep pile

• Effective techniques. If your clinical techniques resulted in solid patient outcomes, then reimplement them and take a review course if necessary. If not, enroll in a different technique course.
• Strategic hours. When patients have no trouble booking an appointment that fits their schedule, you know you’ve set accommodating hours. You’ve likely done some experimenting with various blocks of opening and closing times, so follow what worked in the past for your second practice. If not, now is the time to schedule hours that match the needs of your community.
• A loyal location. Perhaps you are enthralled by city life or can’t get enough of the small-town celebrity feeling. Stick to the environment that suits you, and don’t fix what isn’t broken. But if your mind (and wallet) could benefit from a change of scenery, don’t be afraid to try out a different size of town or move to the suburbs, for example.
• Successful social endeavors. In a past practice life you surely did some outreach that proved worthwhile. Did attending civic club meetings produce new patients? Keep at it. Whatever you do, it has to be fun for you and not a source of dread. Networking should be productive, but you’ll find ways to avoid it if you aren’t enjoying yourself. Did you hate doing health talks and screenings? If so, don’t do them. There are hundreds of other patient-attracting activities you can try.

The throw-away pile

• Marketing failures. You might have struggled to attract new patients in the past. A marketing or startup consultant can help you start fresh and teach you original strategies for healthcare promotion and education. Did it take you too long to reach profitability? A startup consultant can fix that, too.
• Money woes. If you feel like your practice was short of money from the get-go, you were likely underfinanced on the original investment. Being underfinanced is the No. 1 cause of new-practice failure. Save enough funds to finance your new practice. Save up at least six months of practice and living expenses.
• The wrong demographics. A demographic and psychographic study of prospective new towns can ensure you’re picking a tactical location.
• Too much paperwork. Working with insurance companies means committing to a significant amount of documentation. A startup consultant can simplify your paperwork. Or, skip the big hassles and start a cash practice.
• Unprofitable discounts. Your “family plans” and other discounts have to work for patients and your practice. If they were killing your bottom line, don’t offer them again.
• A chaotic scheduling system. Digital programs abound that offer to ease the workload of patient scheduling. No need to pull your hair out over a disorganized front desk.
• Undervaluing your authority. When your first practice failed, was it because you were deceiving yourself? Here’s a newsflash: techniques don’t make doctors successful. Doctors make doctors successful. It’s all about how patients perceive and trust you.
• Your “winging-it” attitude. Were you flying by the seat of your pants when starting your first practice? That’s the worst mindset to have because it leads to making too many mistakes—and mistakes cost money.
• Playing up your personality. Don’t depend on your personality to build a practice. Unguided, enthusiastic, and effervescent people fail faster. You need a plan to succeed, not enthusiasm alone.
• Fancy trimmings. Did you over-equip or excessively decorate your first office? This causes higher overhead, and high overhead results in failure. Keep expenses down.

Get with the times

Times change; practices change. The insurance reimbursements you received in your first practice won’t be the same today. Insurance plans that paid well yesterday are now misers. And filing insurance has been complicated by pre-certifications and restrictions.

Therefore, learn up-to-date procedures to deal with insurance companies, or become insurance independent. If you want to build a practice like you did yesteryear, think again.

Don’t skip the business plan

The best way to avoid problems with your second practice is to develop a bulletproof business and marketing plan. If you don’t know how to make a plan, mimic someone else’s that has been proven, tested, and reproduced many times. This will give you a better chance of succeeding in today’s tougher-than-ever marketplace.

Dianne M. Fernandez, DC, was in a successful practice for nearly 25 years and is now a startup practice consultant. She has written numerous articles on starting a practice, and has consulted with many new DCs. She can be contacted at 800-882-4476, drdianne1@gmail.com, or through practicestarters.com.