The Executive Suite: Intentional growth plans can avoid loss of revenue, talent, and patients

Running a successful medical practice is no small feat. The complexities of insurance, HIPAA compliance, technology solutions, and other needs grow exponentially year over year—and if you’re not keeping up, you’re falling behind.

Without focus and intentionality in your growth plan, you may find yourself in a situation where you lose revenue, talent, and patients. Today, I want to help you learn how to mitigate risk in your healthcare practice’s growth plan.

Your Practice is a Business, First and Foremost

I’ve spent the last 20+ years of my career working to grow a successful ophthalmology practice called Eye Centers of Tennessee (ECOTN). What started as a single-physician office with a handful of staff members has grown to 13 physicians and more than 125 employees seeing patients in nine locations and an ambulatory surgery center, all across the Upper Cumberland region of Tennessee. I’m not a physician, so my contributions to the exponential growth of ECOTN over the years are focused on the business of the practice.

Regardless of the size of your practice, regardless of the makeup of your staff, you have to see the practice that you are running as a business, first and foremost. Sure, at your business, you practice medicine. But by viewing your practice in business terms, you’ll be able to improve processes, see more patients, and ultimately grow profits.

With so many moving parts, medical practices are ripe for errors that lead to lost revenue. But in my experience, the following are six mistakes you can address now to prevent challenges down the road.

Mistake #1: Not taking time to work on your business instead of in your business.

As a doctor, every minute of your time is important. We only have so many hours in a day and physicians are the people who have to deliver the service people are paying for.

If you don’t take at least an hour each week to step away and get back up to the 30,000-foot view, you’ll never get a real picture of how things are working. During this time, you’ll uncover real opportunities and real problems to solve.

Mistake #2: Not laying the appropriate groundwork before making changes.

Let’s say you’ve realized you have time in your day to see four more patients—that’s a lot of potential revenue. But there’s more to bringing additional patients into your practice than the time you spend with them. There are implications for insurance, billing, scheduling, etc. Do you have the staff to manage the additional effort and paperwork that comes with 20 more patients per week?

If you don’t take proper steps in preparation for adding new patients or service lines, you run the risk of losing staff members, losing patients, and ultimately, losing money.

Mistake #3: Not staying ahead of the friction coefficient.

I’m a former Marine Corps Officer, and the things I learned during my time in the service are still my guiding principles in essentially everything that I do. There’s no way I could get through this piece without providing some advice I learned as a Marine.

The friction coefficient essentially states that the difficulty of a task is the square of the number of people involved. If you decide you’d like to go grab a coffee before heading to the office, your friction coefficient is 1. If you decide to take your spouse and two children to grab a coffee on the weekend, your friction coefficient is 4^2 (16).

I remember when we first opened our surgery center, we set our first appointment at 7:30 a.m. Seems simple enough, right? But if you asked six people, “What does 7:30 mean?” you got six different answers. Is 7:30 when the patient’s name is called? Is it when their surgery begins?

Even the simplest pieces of your business become more and more complicated the more people you add. As you grow your business, it’s critical to establish standard operating procedures and to make sure everybody understands them. Failing to do so will lead to inefficiencies that leave dollars on the table.

Mistake #4: Not monitoring cash flow.

In our industry, costs are astronomical. Every piece of equipment is ridiculously expensive, and it can feel like the money is flying out the door faster than it comes in. This means it’s critical for the practice owner to understand cash flow, revenue projections, and the ways cash flow impacts your business operations.

As you plan to scale, you may have a target number of additional patients you’d like to see. But do you know if you’re getting paid for the ones you’re seeing now? Can the person doing processing, posting, etc., handle the additional work involved, or is your accounts receivable going to keep growing and growing because you don’t have the logistical support in place to manage it? If you can’t answer these questions, you’ll never be able to properly implement a revenue growth strategy.

I every day—literally seven days a week—by reviewing our cash balance and accounts receivable. Once you get in the habit, projecting your cash flow and making informed decisions based on what you know can become second nature.

Mistake #5: Not staying on top of legal.

Every time you add an employee, you add a potential legal complication to your practice—and legal complications can be costly.

You don’t know what you don’t know, and if you only have a couple of employees, you may not run into any issues. But as you grow, a good employment lawyer should become an important part of your team.

When it comes to employment laws, each state is different, and there are additional rules at the federal level. If you run into a legal problem, saying “I didn’t know” is irrelevant. It’s incumbent upon practice owners and executives to do the work to educate themselves and call on an attorney to clarify anything you don’t understand.

Mistake #6: Not knowing what success looks like.

I’ve worked with doctors for so long, I feel like I can say that they’re a very competitive bunch. They want to get straight A’s, they want to be at the top of their class. It’s how they’re wired—they’re always thinking “I could do a little bit more.” But at what cost?

If you don’t know where you’re going and why, you may find yourself working 18 hours a day, a slave to this thing you created yourself. I believe this is one of the top causes of physician burnout—the consequences of which can negatively impact morale at your practice, patient experience, and even safety. All these issues can lead to lost profits and even potential legal complications.

Ask yourself: What do I want my practice to do for me? I worked with a doctor at one point who wanted to have her last appointment each day finished by 3:30 in the afternoon so she could watch her kids play sports. She knew how much money she needed to make and when she needed to end her day, and we built her practice by working backward from there.

Your answer to this question may even evolve over time. Perhaps you had an answer at one point, but it’s changed since then. Spend the time to find your answer, and then write it down. Put it in a place where you can see it every day. If you find yourself slipping from your picture of success, it’s a good reminder to reevaluate.