You have been in practice for many years. You have been successful in building and maintaining your practice. The career goals you set upon graduation have been far exceeded. Now you have ten, fifteen or twenty years before completing your degree. What are your options to grow personally and professionally?
Turning one practice into multiple practices would define the growth of many chiropractors in their mid-career. To be able to serve more of the community and in turn increase your passive income, decrease doctor/patient time and increase equity in the practice would further broaden the definition of your success.
As a co-owner of six chiropractic practices, my experiences may clarify whether expanding multiple practices is a viable option for you to achieve greater career satisfaction. If asked, most chiropractors would say that they would love to own multiple practices and reap the rewards, but most chiropractors who try to expand fail.
A common business plan is to open a second office and work in it on days off. Build a small patient base and then an associate can take over the existing patent base. What invariably happens is that the existing practice declines in profitability, a small practice is built in the satellite practice, overhead costs nearly double, and the physician works an additional two days in addition to the regular workweek with no financial ability to hire one. associated. The doctor is now bleeding until he has a hemorrhage. The reality is that every hour you spend in the satellite office you are losing money and enthusiasm.
This failed plan is reproduced over and over again. I have profited by buying many of my satellite practices from hemorrhaging doctors. All physicians felt that selling their practices at an undervalued price is better than continuing to waste money and energy. For them, it was to sell or close the office completely.
The fundamental error that these doctors have made is that they have worked in their practice, not in their practice. This statement by Michael Gerber in E-Myth must be fully understood before attempting any expansion.
Doctors tell me all the time that they are working harder than ever, spending time traveling from office to office, training new staff, and seeing more people. They are not achieving their goal of multiple practices; they are simply doing more than they are already doing with much more overhead. They are working on their practice.
The chiropractor whose goal is multiple practices must work less as a chiropractor and more as a visionary, manager, and staff motivator. A transformation from the practice of chiropractic to the business of chiropractic must occur. A shift in thinking from “This is what I do, I’ll do it myself more” to “I must delegate responsibilities to grow” is a must for growth. Your interest will grow in other related areas, such as information technology for greater efficiency, human resources for quality hiring and training, and improvements in basic business modus operandi. His responsibilities will include researching the best buying opportunity for printing, telephone, x-ray sales and service, commercial liability and malpractice insurance, and durable chiropractic supplies. The physician who puts his energy into implementing specific systems that can assess productivity and efficiency within his practice is working in his practice.
There are three interdependent traits that I have found define success in any project, but definitely in multi-office expansion; vision, motivation and implementation of the system. The vision you create will be the motivating force that develops quality systems that can be highly executed.
You, the Chiropractor, must be the visionary; the leader who has a burning desire to climb this mountain. His employees must understand, accept and follow this vision. Ideally, the chiropractor, staff, and patients should all be aligned on the mission of the practices.
This vision must encompass the satisfaction of all involved. Each person who works with you must have a community and personal interest in reaching the goal. By serving the community, the practice, and oneself professionally and financially, it solidifies the entire organization with the vision.
No one person can perform all the tasks necessary to build and maintain multiple practices; it is a true team effort. Acknowledging this statement exemplifies the need to motivate your team. Not all employees are motivated by the same compensation or management style. My experience has shown that evolving towards a well-defined corporate culture allows the leader to anticipate the needs of the team. High employee diversity leads to greater difficulty in motivating and managing. Similar personalities are motivated by similar and predictable ethics, expectations, and rewards.
As the organization grows, the talent needed to manage and motivate must also grow. My basic theory for managing staff successfully is to clearly define what is expected of the employee, get them to accept that level of competence, and then motivate and manage them to achieve that expected level.
“Success is in the system” and “the system is in the solution” are common phrases in my offices. We live for them and grow for them. The most famous illustration of the concept is McDonalds. With 300 percent staff turnover, they rely on systems to achieve a predictable standard of quality and service. Once the system was established, replicating the service to over 25,000 locations worldwide was history.
In many multi-employee physician practices, the chiropractor has the least knowledge about the systems within his practice; the office manager runs “the show”. This doctor is binding that person to the point of being held hostage. The physician who eliminates every major task within his practice and develops a system for others to complete that task will be able to grow into multiple practices. That doctor must first master the task, document the process or system, and then set it in stone for everyone to use. Every system should have a component that evaluates and monitors the effectiveness of that specific system for constant improvement. This allows the clinician to delegate with the ability to monitor. The result of this process is growth; growth by organization, not by individual.
The most difficult challenge is committing to multiple practices, financially and emotionally. Make a real commitment, don’t go into the plan saying, “I’ll open a second office and see how it goes.” Once engaged, you become the architect and design the business plan with your talents. Based on your past experiences, you will transition from concept to reality.
Personally, going from one internship to six has been one of my most challenging and satisfying professional experiences. I can relate it to mastering a video game. In a video game, at first every move you make hits a landmine that brings you closer to death. As you begin to understand this new environment, you develop a plan or vision to win. It soon becomes apparent that a motivated workforce with a plan or system will conquer their opponent. The additional repetition of necessary tasks increases your ability to perform at a level of excellence. With all these forces behind you to gain intellectual strength, political influence, and financial independence, you crush the opposition. Unfortunately, life doesn’t exactly mimic video games.
