In dealing with problems that can develop in a practice, there are six basic maxims:
What you don’t or can’t control loses income. To the degree you are in control of these seven key areas of your practice, you will have a lower-stress, higher-income practice. To the degree you are out of control of these seven key areas of your practice you will have a higher-stress, lower-income practice.
Even a poorly run practice can earn enough money to get by on. This is true, but unfortunately it is more of a curse than a blessing as “just getting by” often takes so much of your time and energy that doctors wind up on a “work-a-day” treadmill with problematic and stressful practices. This adversely affects their quality of life and personal relationships and often causes production plateaus well below what their actual production levels would be were they better organized.
The real and only reason a practice stops growing or becomes stressful is because the practice owner has reached his or her level of management skill. There is no other reason. Socioeconomic and demographic factors (income per capita, population, number of competing doctors, local economy, etc.) are not the real reasons a practice stops growing or becomes stressful. Though it is true that these factors do have an impact on a practice, it is equally true that there is little, if anything, that an individual practice owner can do to control these factors. The obvious conclusion is: One should invest one’s time, effort, and resources into those things which one can control or have an impact on.
How good a doctor you are has nothing to do with how successful your career will be. It is common in any area of the U.S. and Canada to find brilliant doctors struggling to make ends meet while less skilled doctors in the same geographical area are making their fortunes. How well you hire and train your staff, do case presentation, handle your finances, do internal and external marketing, monitor and correct your staff, and the accuracy of your decisions as an executive, will be the primary factors in determining your career satisfaction and financial success.
In lieu of executive leadership, accurate job descriptions, office policies, and a strategic program to get them implemented, the staff will invent their own, usually based on whatever is most comfortable or easily done, not necessarily what is best for the practice. Often the command structure in this type of practice is relegated to a “social pecking order,” in which the more predominant staff personalities “rule the roost.”
A practice will either sink to the skill level of your staff, or you will bring the skill level of your staff up to meet the challenge of the practice. In short, your problems won’t just go away by themselves. Philosophically you have two choices. Either you’ll be the effect of your environment, or you’ll be at cause over your environment. It’s that simple.