Thinking About Shutting Down Your Private Practice? Ask Yourself These 3 Questions First!

If your business isn't working the way you expected, it's not because you're bad at business. It's because no one ever taught you how it actually works. We were trained to master algorithms in medicine, but when it comes to revenue teams and growth, we were never taught anything. We weren't even told to figure it out. We just assumed somehow we'd know. Like it would magically make sense. But it doesn't. The era of the seven Figure Physician CEO is here. And it's not about working harder. It's about learning entrepreneurship as a system. The same way you mastered ACLs and pals, you can master the algorithm of building a profitable scalable business. That's why I recorded the seven Figure Physician CEO audiobook. Whether you're building a medical or non medical business, and whether your goal is your first million, first 2 million, first 5 million, first 10 million, this is where the journey starts. There is no Calvary coming to save us.

We are the Calvary.

So. So go get your audiobook now. Www.entremd.com sevenfigurebook and let's rewrite the narrative for physicians.

Starting today, you can get a players, people who are a players somewhere else and they can come into your practice and they can be C and D players. Not because they don't know what to do. It's because we haven't created an enabling environment for them to thrive. Hi docs. Welcome to the onchamd podcast where it's all helping amazing physicians just like you, embrace entrepreneurship so you can have the freedom to live life and practice medicine on your terms. I'm your host, Dr. Una. In 2021, 11,000 private practices either went out of business or sold out their companies to private equity. That is one stat that makes me really rethink what what I do as a private practice owner. The second stat is that out of every 10 businesses that are started, nine of them will go out of business after the first 10 years. Now, if you know me, you know I'm a very positive person. So am I saying this to say doom and gloom woe is everybody? No. But this is just to point out how seriously we have to take our businesses if we're going to thrive. Can we thrive? Absolutely. Are we going to thrive by. By default? Absolutely not. So today we're going to talk about three questions you should ask yourself before you decide to quit on your private practice. Okay, now I start. I want to talk about this because, you know, I've seen in a lot of Facebook groups when I in conversation with physicians, doctors are like, you know, I met somebody, went to one event. I met three doctors who told her, I am shutting down my private practice. I'm like, oh, my goodness. I, you know, give them the podcast, tell them to come to the business school. I say that because there are things that we can do to thrive. Okay? So I'm creating this episode. You. You may be thriving in private practice. This episode is still for you. It's three questions I want you asking regardless, because these are the questions that are going to stop you from getting to a point where you're like, I think I should shut down my private practice. Okay. And if you're not in private practice, I want you to listen as well, because the principles are universal. Now, you guys know that. You know, I've talked about a lot on the podcast that I started, you know, this whole journey of strength training, because I want to be super strong on my 90th birthday. I want to be dancing, picking up grandbabies, doing all of those things. And I am at week 17. You can believe it. And in the beginning, I noticed that I was getting results faster. And as I got closer to week 15, week 16, week 17, it seemed like it kind of stood. And I started investigating, like, what is going on. And I have learned that I will put in the effort even if I don't see the result. Like, it's not a reason to quit. But at the same time, I want to make sure I'm optimizing, you know, the time and, you know, the. The project, if you will. And so I started looking at it. Was I working out? Yes. I was still going to the gym four days a week, working with my trainer, who we call a torturer, by the way, because he does a really good job. However, there were other parts of my fitness journey that I had kind of stalled on. So I was not sleeping as well as I used to sleep. I was not eating as clean as I used to eat because I had quite a bit of travel that I was doing. I was not drinking as much water. So there's all these things, like, strength training is not enough. There are other things I need to do if I want to be successful. And in the same way, Right. There may be things you're doing well in your practice, but. Or your business, but doing one thing does not remove the need for all the other things that you need to do. So in coaching hundreds and hundreds of physicians, these are three of the areas that I find are almost always lacking when there's a private practice that's struggling. Okay? And when people start thriving, these are also the areas that people start slacking on, which inevitably gets them to a place where they start having challenges. Okay? So three questions. First question, the very first question is, am I holding my team accountable for profits? Now, when you hear that, that may go like, well, I'm the business owner. That's my responsibility. They shouldn't need to deal with that. And it may seem almost like, wow, all I care about is the money, right? I'm holding my team accountable for making me profits and all. So I just want you to take a deep breath and go with me, okay? This is the deal. I want you to think about your business as a whole entity. So don't worry about, like, I go in the office, this is. This person does this task, I do this task. Like, forget about all of that. Think about your business. Chances are when you started, you started, you know, like by yourself. Like, this is before you started even hiring people. You had this dream, I'm going to build this practice. These are the kind of people who are going to serve. These are the kinds of, you know, like, outcomes they're going to have. This is the kind of revenue we're going to bring in. This is going to be our position in the community. And all of that, it was you. Everything came out of you, right? The whole business was you. Now after you are done with that, you decided to recruit a team. And sometimes we think of the team as, I recruit these people who can help me do some stuff, or I recruit these people because that's what people do. Like, when you start a private practice, you should recruit a front desk person, you should recruit a medical assistant, you should recruit a referral coordinator, things like that. But the truth of the matter is you had a vision and you brought on the team to help you with your vision. Now, your vision includes profitability, because if there is no profit, you have to shut it down, right? And so one of the best things you can do for your practice is remember why you brought the team on in the first place. It is to help you. And part of what you do is you make sure the practice is profitable so that you can continue to serve. Okay? Now I want us to look at it. I want us to look at it this way. When you bring them on, you can get A players, people who are A players somewhere else, and they can come into your practice and they can be C and D players. Not because they don't know what to do. It's because we haven't created an enabling environment for them to thrive. What is required for that enabling environment? One, you have to be very clear, like this is their role, this is their role because sometimes you have offices where it's everybody's responsibility. But the thing is this, anything that is everybody's responsibility is nobody's responsibility and nothing gets done. Right? So very clear on what the role is. Very clear to the path to profitability. For instance, my medical assistant, right, would come in and work up the patients so that I can see more patients. That's one way to create revenue. I, my medical assistant makes sure that everybody who leaves leaves with a follow up appointment. So that means If I saw 20 patients, let's say, you know, there are a few who didn't want to schedule no matter what she did, but let's say 80% of them schedule, that is 16 appointments she created that day. Right? And I can go on, on and on. So it's very clear. This is my medical assistant. These are the things they do. This is how they contribute to the bottom line. Your front desk person may be the number of calls that they're converting to appointments and all of those things, the percentage of the CO pays that they make sure they collect because we don't get paid because we saw patients, we get paid because we got paid. Right. And so are they collecting the money and all of that? So if you look at every role, the question is how is this role contributing to the bottom line? Okay. Because the number one reason why private practices will go out of business, or any business actually is cash flow problems. That's the, if that's the biggest quote unquote risk, then we want to make sure our team is on board helping us mitigate that risk. That it's not just you, the business owner, that's quite a bit of a weight to carry. Okay? So if you think of it in that way, it's not slimy, sleazy or slimy. You just need to define the role, define how it's profitable. And then when you meet with them, it's not just about the task, but you're reviewing the outcome, right? So 80% of the people who came in yesterday left with appointments. Really good. Only two co pays were collected and there should have been 20 copays collected. Let's work on that. Right? Like don't be afraid to do that. Because listen, your, your private practice shutting down doesn't serve anybody. It doesn't serve, it doesn't serve you, it doesn't serve your team, it doesn't serve your community. It doesn't serve your patients right. So we want to pay attention to this. So that's the first question. The second question you want to ask is, did I abdicate the management of my revenue generation, my revenue cycle? Okay? And I'll tell you what I mean by this. Now there is delegation, which means I have somebody else doing a task for me, but I've defined what the task is, how the task needs to be carried out. I have checks and balances. I have ways of evaluating was it done or was it not done. That's delegation abdication, which I see happen a lot with billers who manage the revenue cycle is, oh, my goodness, I have a biller. May the force be with them. And a lot of times, doctors won't want to meet with the billers. They won't want to dig into the numbers. They don't really want to know what is happening. All they know is there's cash in the bank. But that is not the way a savvy entrepreneur is going to lead. And if we have numbers, like thousands of practices going out of business and nine out of 10 businesses failing the first 10 years, we don't have the luxury of doing that. Your revenue cycle in your business is like your. A order in your body. If you nick it, you bleed out. Like, that's. That's just the way it is. And so we don't want. We want to delegate that, but we don't want to abdicate that. And sometimes you may not intentionally want to do that, but you get so much kickback. You try to meet with the bill and they're like, oh, everything is fine. Okay. Your billing department, your revenue cycle is data driven. It has numbers. So there's nothing. Like, everything is fine. Right? Like, everything is fine. Great. I'm happy you think that. Now let's look at the reports. Don't be afraid to look at the reports. Don't be afraid to question things. Don't be afraid to look into bedpoint, that is your aorta. Chances are, if that department doesn't work, your practice doesn't work, period. Right? And so don't abdicate, and don't be intimidated if someone tells you, oh, it's okay. I don't know why you're asking these questions. Like, I had a client whose biller was like, I don't understand. Nobody's ever asked me all these questions before. I don't understand why you want to know these things. I've told you that these things are okay. I don't know why that's not enough. It's not enough because the buck stops with me. And it is my responsibility to know what my numbers look like, right? Like, hello, you don't want me to say, yeah, we're going to pay you someday. You want to be paid. You want to be paid on a schedule. You want paid some specific dollars in the same way I expect specific results, like reports, right? Okay, so that's the second question. The second question that you want to ask. Did. Did I abdicate? Because this is the deal. If, if we're not holding our team accountable to. To profits and we start. We can start generating profits almost right away. Almost right away, right? You tell them, okay, here's a list of all the people who are overdue for appointments. Go schedule these, right? Like, these are all the people whose co pays. You forgot to collect yesterday. Hit the phone, get them. Like, do you see? Like, you can start generating profits right away if you start looking to your billing department. You can start shifting things right away so you can make a big difference in your private practice right away. The third question you want to ask is this. Am I making sure that new people find my practice every single day? Am I making sure that I. I am doing things to make sure that new people find my private practice every day? Why is this important? And this is especially important if you're busy? Because when we get busy, we're like, oh, we're so busy we can't see any more patients. Oh, we're not talking to referral sources anymore. We're not posting on social media anymore. We're not sending emails anymore. We're not doing that because we're so busy. But guess what usually happens happens that busyness lasts for a season. It only lasts for a season. And after that, it's like, I don't know why our schedule is not full anymore. And at this time, referral sources have forgotten about you. They're patients who have forgotten about you. The momentum you built was gone. So this applies to you even if you're bursting at the seams, okay? Why is it important for new people to find you? Because people are going to leave your practice. It doesn't matter how good you are. People are going to need to move. People are going to age out, People are going to die. There's so many reasons why, right? People are going to leave no matter how good your practice is. So think about a population where they're like, oh, my goodness, you know, there's so many of us. There's 120 million of us. And then they stop having babies. It's only a matter of time, right? It's only a matter of time. And the longer it lasts, the more of a snowball in the wrong direction is being created, right? Where it's going to be even harder to recover. Now, when I say harder, I do not mean you cannot recover, because of course you can recover, okay? Now, so there's the mechanics of it, right? Like, how do I put myself in front of new people? So that's you talking to referral sources. That's you speaking out events. That's you networking out events. That is you. When I say referral sources, it's other doctors who could refer to you as patients, who can refer to you as the whole main yard is all of that. So that's the mechanics, but the other part is the mindset piece, right? Because a lot of times people feel, if I practice good medicine, they'll come. It's not true, right? Like, yeah, if you practice good medicine, they'll stay. But practicing good medicine does not attract them, right? Like, there are other things that attract them. Some people feel like, I shouldn't have to do this. And I think that's the most damaging mindset. I shouldn't have to do this. I shouldn't have to market, right? Because, you know, because what I do is good, because I'm a good doctor. It's not fair. I'm a professional, whatever it is, but I shouldn't have to. There is a doctor in the entrepreneur business school. Her date, her name is Dr. Karen Kaufman. I've interviewed her, I think twice on the podcast. And, you know, she made a statement that I just love. And I filed it somewhere in my brain and I pull it in and pull it out anytime I need it, like now. And she said, this is what she said. She said, marketing. That's part of my job. That's part of my job. Now, she's been in private practice for three years. She just hit three years, and she just hit patient 5,000. She's an allergist, right? But she has this understanding that, yes, it's my responsibility to build my team, is my responsibility to provide great medical care. It is my responsibility to market my practice. If you can have that thought, it is so liberating, it is so empowering. It puts you in control. It makes you the driver in your practice. You know that you can create results. You don't have to just wait at which things will happen, right? That can be your experience. But in order for that to be your experience, you have to come to terms with the Fact that marketing your practice, putting yourself in front of new people is your job. Okay? Now you might say, but, Dr. Una, I have a team who's doing that. If you have an empower, if you have empowered a team and the team is doing a good job, that's great. You know what we say in entre, in the entrepreneur world, we say it needs to be done right. It does not all need to be done by you, but it needs to be done. So as long as they're doing it and they're getting results, we're good. Sometimes on the other end, what I see is people will hire a marketing company and they're like, you fix. You fix all my marketing problems, right? But then they don't give them the information they need. They're not doing any of the supporting activities, like maybe, you know, also going out to events and all of those things, because they all work together. Nobody's going to make this go away. We need to do this. And especially, especially if you're in a place where you're struggling with your private practice, own this. Because this alone can turn your practice around. I have seen it time happen time and time and time again with the clients that I've worked with, okay? And with the doctors in the entremity business school. So maybe your practice is struggling. I want you to hear me. Maybe you're at a point where you're like, forget it. I'm going to shut my doors before you do. I want you to hear me. Maybe you're here, you're thriving. I want you to run an audit to make sure that, yes, I'm thriving, but I am also setting the stage to continue to thrive. Because not just about thriving, it's about continuing to thrive. Ask yourself these questions. If you have an office manager or practice administrator or anything like this, you can make this a team question and you guys can sit and workshop this, but this is a practice. These are three questions that have the potential to save your practice, to get you back to thriving, to bring in millions and millions of dollars into your practice. This is serious. So, number one, am I holding my team accountable for profits? Number two, did I abdicate my revenue generation cycle? Number three, am I making sure new people find my practice every single day? Okay? And as you ask these questions and you answer them truthfully, I want you to pick the 180 for the ones that you're like, yeah, I'm not. This is not the way I should be doing it.

Right.

I want you to pick the 180, and I want you to start right away. I want you to start holding your team accountable. This is not a bad word. They will actually love you for it, right? It would be a much better run practice. I want you to start holding them accountable. I want you to have those difficult conversations with your billers and I want you to do it to go like, you know what? Before every day runs out, new people are going to find out about my practice today, right? And if you make this a habit, everything will change for you. Okay? Everything will change for you. So I want you to imagine this. I know that yes, there's all these things going on, you know, decreasing reimbursements and all of those kind of things, but this is the truth. You can still thrive. You can still thrive in private practice and you can still build a practice where your thriving is sustainable. It's not something that happens for a year or two years or three years, but 10 years later, 20 years later, 30 years later, if you still decide to hang on to the practice, right? Like it's still working. It's still working. So I want to invite you to do that. I want you to create a dream practice. I want you to thrive as a physician entrepreneur because it is within reach for you. The second thing I want you to do is I want you to take this episode, grab the link, and I want you to share it with every doctor you know who's in private practice. Why do I want you to do this? Because the more private practices thrive, the more private practices will thrive. The more private practices thrive, the more examples of what is possible we have. And this is going to be a situation where the some get better, and because of that, all of us get better. So you'll be a part of the calvary bringing change to medicine, changing the narrative for physician communities. And all you have to do is share this episode. So grab the link, share it with the doctors in your world who are in private practice, and I will see you on the next episode of the Ontarian podcast.