Many practitioners go into private practice with the intention of ‘starting their own business’ but soon find that what they have really created is a job for themselves. If you are generating all or most of the revenue and taking everything after expenses and tax as your salary then you really have just created a job for yourself (and often with more headaches than it seems to be worth)

What do you really want?

If your desire is to spend the majority of your time treating patients, that is absolutely okay –  you then need to make the decision whether you want to own your own practice or work as a therapist for someone else.

If you want to build a practice and continue doing clinical work you either need to bring someone on board that will grow and run the business for you or you need to put adequate time aside to focus on working on the business, not just in it.

What do you need / want for your current lifestyle and for your future in terms of time, energy and money and what does your career / practice need to be like to generate that?

Work on your business not just in it

I am yet to find a therapist who loves working into the night when the kids have gone to bed to catch up on paperwork, marketing etc. Trying to squeeze running the business into the gaps between patients and after hours will soon result in you feeling disillusioned and burnt out.

Set aside time during your chosen working hours for working on your business. Make sure you set yourself up for success by being prepared for the tasks you need to do and getting rid of distractions.

We recommend that you set yourself the top three to four goals that you’d like to achieve in the next 12 months that will take you closer to your bigger picture. Make a list of the key results that will be evidence that you have achieved your goals and then set activities you will focus on in the time you’ve set aside to work on your business.

It would be remiss of me not to recommend having a business coach to guide you through this process and keep you accountable.

What time will you put aside to work on your business and not just in it?

Delegate and systematize

Make sure you are not doing tasks that you really should be delegating. When setting up a business it is tempting to ‘save money’ and do everything yourself. Things like bookkeeping, cleaning, answering the phone, dealing with insurance companies, changing light bulbs etc. should be delegated to someone else. You would be better off seeing a few extra patients at a higher rate per hour than you’ll be paying for those services.

If a receptionist is beyond your current budget, sign up for a virtual reception service. They are able to take calls and book appointments into your practice management software. Some of our bigger clients have receptionists and the virtual reception service to pick up calls when the receptionists are busy or when the clinic has no reception cover. The company we hear the most compliments about is Best Reception

Whether you delegate to an external company or you employ someone, make sure the task delegated has a clear process in place (and this is recorded as a video or in written form) In an ideal world I would be able to come into your practice and be able to carry out any task because it’s clearly explained in a practice manual.

What do you need to delegate or outsource?

Consider employed versus self-employed

The private therapy world has historically been dominated by the self-employed model. Whilst I have seen this work well in some practices, if you want more control of your business an employed model might be better for you.

Employed staff are often more engaged as they have a greater sense of belonging. You can also include non-clinical work in their job description for times when they are not seeing clients whereas with self-employed, they might only attend the clinic when they have patients. Self-employed team members can also take as much leave as they like and whilst you don’t pay them while they are not working, you might be left with an empty room not generating income and costing you to run.

In one of my conversations (41.45 minutes in) with Josh Catlett from Verilo, with whom we inter-refer clients where appropriate, another good reason highlighted to employ your therapists is that your business will be viewed more favourably by buyers if you want to sell one day.

How is your current model working for you and what is the first step you’ll take if it is not working?

Know your numbers

Only knowing your turnover is not enough. That is not the most important number. You could have a clinic turnover of £500K and be making less profit that a clinic turning over £250K. A few of the key numbers we recommend you know are the following:

  • Turnover, Expenses and Profit: know this on at least a monthly basis, ideally real-time, definitely not only annually when you submit your accounts!
  • Split between revenue generated by you and the rest of the team: this will highlight how dependent the business is on you and you can then take action to reduce this dependence.
  • Profitability for each revenue stream – this will help you make decisions about what to keep and what to ditch. Some revenue streams might not be profitable on the face of it, but you might still provide the service as it is a source of referral to another revenue stream
  • Booking stats: No. of new patients, follow ups, cancellations, patient visit average, saturation etc. – per practitioner and the clinic as a whole
  • Accounts receivable – make sure you keep on top of this! If you work with third parties, insurance companies, case managers etc. make sure you have a robust system in place to ensure you receive monies owed in a timely fashion.

What numbers do you need more visibility of?

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